Letrozole and Supplements
Hello and Thank You for the welcome. I had Stage 1A Estrogen Positive BC. Age 68. Lumpectomy 5/7/2024. Now on Letrozole 6 months and doing well so far except I have weight gain. My main question is Supplements. I am confused as to which I could take and/or avoid. Medical oncologist said Calcium/Magnesium 2000MG … but that's so many doses, Fish Oil. Avoid Boron, Turmeric, Iodine.
I managed to find Pure Encapsulations for Calcium/Magnesium, Fish Oil. I have taken a Multi Vitamin all my life and now can't find one that does not have Boron.
I AM SCARED OF RECURRANCE. Surgeon said she's confident I will be fine going forward. I really need support about handling stress.
May I please have advice? Thanks so much, Diane
(Edited by Mods to remove user's last name from the post. We strongly recommend not posting personal information on a public forum, for your own privacy and security.)
Comments
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Hi @drichsa,
Thanks for posting! We're sure you'll get some great advice and experience from others here soon.
We wanted to share with you this research news article that you might find helpful:
Also, here is a podcast episode with tips to help ease stress:
We hope this helps!
—The Mods
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Fear of recurrence comes free with the diagnosis, I'm afraid :(
My cancer center has an integrative medicine unit that they refer people to for more information on supplements. Those doctors keep up with the latest and best research on supplements and theoretically have specific experience and training with interpreting and applying information about non-regulated substances. They may be a good resources for both recommendations and education. If your cancer center has a social worker, they are also amazing and may be able to make a lot more time than a doctor could to sit down with you, look over the doctor's recommendations, and help you find supplements that meet them. They can also be a great resource for helping cope with fear and finding other good resources.
Sloan Kettering has a guide to non-regulated substances ("Herbs app") that might be helpful or informative to browse as well:
If you don't have access to a social worker through your treatment center, I had an awesome experience with Sharsheret. They are a Jewish organization but they provide support for everybody regardless of heritage or religion. Their social worker was a help and comfort to me when I needed one:
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Hello Salamandra,
Thank you for your response and information. Very Helpful and informative. My Oncology Pharmacist at Cleveland Clinic advises the following:
Calcium/Magnesium is OKAY
EPA/DHA (Fish oil) is OKAY
Probiotic OKAY
I am waiting for a response on Vitamin D and Vitamin K as these support Bone Health.
All other supplements or herbs I was advised NOT to take as they have the potential to produce "Estrogenic Effects".
Here was my list:
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Hi again @drichsa! We're just following up to see if you've gotten any insight on the Vitamin D and K? Would love to hear the recommendations!
Hope you're well!
—The Mods
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Hello Mods,
This is what I was advised from my Doctors Office/Oncology at The Cleveland Clinic, Cleveland, Ohio. I travelled there last August for a second opinion on follow up procedure.
This is from recent communication February 2025.
My Diagnosis: April 2024
Stage 1A Breast Cancer, + + -, Lumpectomy, Lymphnodes Negative, Targeted Radiation X5, Onco Score 3, No Chemo Necessary.
Taking Letrozole 2.5MG Daily.
Bold Quotes from Cleveland Clinic Oncology Department
"Eat only Whole Foods. Nothing Processed. Avoid Sugar"
"Avoid the following as they have "potential estrogenic affects":
All Herbs, Boron, Turmeric, High Amounts of B-12, Iodine.
Cleveland Clinic prefers for patients to obtain calcium through dietary/food sources but can supplement if not getting enough.
Calcium 1200-1500 Daily OK
Vitamin D 100-2000 IU Daily OK
"We do not routinely recommend these supplements for our patients however they would be considered safe to take is desired"
Vitamin K: Sources suggest 90mcg - 120mcg. So 100 mcg which is not overly high is reasonable.
Magnesium: 1/2 the amount of calcium. Magnesium helps with the absorption of Calcium. This is my research, Diane.
Fish Oil: 1000 Daily
Probiotic: 20 Billion
"As a caveat, If struggling with hot flashes while on Endocrine Therapy, we would recommend Magnesium 200mg BID and Vitamin E 400IU Daily. If these symptoms are not present we would not recommend."
Okay Friends .. I found the following supplements which are easy to digest, www.vitaminshoppe.com
Solar Liquid Calcium/Magnesium with Vitamin D3
VThrive The Vitamin Shoppe Liquid Liposomal Vitamin D3 & K2
Citrical 1200 Slow Release with Magnesium
Also found a Multi Vitamin that does not have minerals. "Natures Blend Multi without Minerals" but this is not recommended by my Doctor at Cleveland Clinic .. it does however exclude all herbs and the supplements to avoid.
I attached two sheets sent to me from Cleveland Clinic Oncology. Shows sources of foods to get Calcium and D Supplementation in Breast Cancer.
I would be happy to speak with anyone who wants to talk about this information. I hope this all helps.
Diane
(Edited by the Moderation team to remove private information)
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Thank you for sharing this, @drichsa!
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hi everyone. I started Letrozole Feb 21 so far no side effects. Because of food allergies, particularly casein, my calcium food intake isnt great. I take calcium supplement 1500 mg/ day ( divided dosing) and vit D3 4000 iu daily. I take magnesium every other night which helps with leg cramps and sleep. I am starting radiation on Marc 22 for a total of 19.
I am looking forward to spending spring at home! Taking the month off work while I have my treatment and considering it a “ forced vacay”.
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