Preparing to take Letrozole, from a Nutritionist's Perspective

I'm starting to move toward taking an aromatase inhibitor like Letrozole or Anastrozole. After a year or more of studying this option, I've decided (for now) that it is the best way forward for me and my ongoing cancer risk. Dr. Azra Raza and her brilliant book "The First Cell" were the determining factors for me, being that taking endocrine therapy has been offered as an option and not a mandate due to my tiny cancer size. How am I getting ready for the day when I'm allowed to start taking it--the day I am fully in menopause? That's what I'm talking about here.
Just another breast cancer survivor and advocate, here--don't take my words as medical advice please!
- Supplement Links:
Melatonin: us.fullscript....
Carlson Fish Oil: us.fullscript....
Vitamin D3/K2/Zinc: us.fullscript....
CoQ10: us.fullscript....
Glucosamine: us.fullscript....
Real Mushrooms Turkey Tail must be bought direct, here: shop.realmushr...
Gaba Calm: us.fullscript....
And Dr. Raza's book "The First Cell" is here: www.powells.co...
My favorite menopause/women's health/hormone/detox book is here: affiliates.liv...
- Related Videos:
Foods I eat to reduce my risk of recurrence: • Nutritionist Tips - Br...
Why I don't take Tamoxifen: • Why I don't Take Tamox...
My mastectomy story playlist: • Mastectomy Story
My professional KZbin channel is at / @seekingdeeperhealth
More Notes:
The land where I shot this video was once Kalapooia Tribal land. Join me by contributing to and learning from your own local indigenous farms here: www.soulfirefa...
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#seekingdeeperhealth #nwnutritionist #breastcancer #lobular #letrozole #anastrozole #exemestane #aromataseinhibitors #endocrinetherapy

[@anonnymous595]

One thing I've learned in my research is that while joint pain is indeed an uncomfortable side effect, what is of more concern is that many of these drugs can cause osteoporosis, far more serious than pain issues and other side effects.

[@bchmom03]

That is one of the stumbling blocks for me. I already have osteopenia. I weigh 112, 5’2”. Post menopausal. 4mm ILC, DCIS, both low grade, node neg. I am not quite a yr from dbl mastectomy. I filled the Letrazole, but yet to take it. I also am concerned with pelvic and vagina pain, pain with intercourse, by decreasing what estrogen I do make in my 63yo body. A broken hip his high mortality the older we get as well as cardiovascular incidence. I was told vaginal estrogen is ok. I take the weakest form estriol, compounded. My med onc is fine with that.

[@estrogendiaries]

Absolutely. Do a google search for "Chris Kresser, Osteopenia" for a great podcast from 9/22 on boosting bone health. It's not about the calcium!

[@roselucht4583]

I’m a very young 72 and well past menopause ( from age 50-60) I will be having a double mastectomy in June for my ILC. Last month my Oncologist started me on Letrozole. I’m finding I have so much pain in my hips when I walk more than 1/4 mile with my dog. I just started a water Aerobics class and am loving how I feel afterward. I’ve added Vitamin D3. We just discovered I also have Non Hodgkin’s lymphoma in my retroperitoneal abdomen in multiple areas. It’s slow growing my Oncologist said. We’ll find out after mastectomy more if it’s under my arm. He said I would then need low dose chemo and radiation. Thank you again ! Thank you for sharing this I will be ordering your recommendation.

[@susanseverance9683]

My story is the same, including the newly found second cancer. I nearly laughed out loud and said, Really? Really? Best health to you!

[@lizahennke9296]

I am opting out of 2 weeks of radiation and hormone blocker meds. I value my quality of life. As of 4 months ago, I am not taking hormone therapy. There is still too much not known by the oncology medical field, and a womens quality of life is being dismissed! All my labs are positive. I had a lumptectamy on 5/23/24.

[@estrogendiaries]

True true!

[@Elenitsa21]

Encouraging video! After 2 yrs of tamoxifen, onc is putting me on Letrozole. Took my first pill today. Terrified of side effects. Hopefully collateral damage won’t be too heavy…

[@estrogendiaries]

A good podcast about this: kzbin.info/www/bejne/l3jWoIereLN1pdEsi=iHumSY5obleRPU9K

[@colleendooley3820]

Thank you so much for this video. You articulate everything so wrll & i found your information & resources very helpful! I wlll be deep diving into this wkd. I just finished active cancwr treatment 1 week ago & was supposed to start Anastrozole yesterday. Your video gave me permission to give myself grace to learn about how to set mysrlf up for success. Thank uou! Wishing us both well!

[@estrogendiaries]

May you heal well and learn lots! I just made playlists of my videos by year if you’d like to watch them chronologically.

[@BJocsak-qc2xt]

Thanks for sharing about the multifaceted journey that breast cancer brings. Also, may I add how important it is to realize that bone loss accelerates with cancer treatment. Very important to monitor. Ask your health care team re Dexa Scan so you have a baseline going forward before treatment. Wish I would have known. Sending you good vibes.

[@estrogendiaries]

Yes, I meant to mention that I am scheduling a dexa scan. I'll do another video, I'm sure! Learning a lot about how to "shore up" my bone strength too. I'll share soon!

[@jessicas9136]

Thanks for the recommendation for the brain fog. I'm on my fifteenth month of an AI and it's been a challenge. It's embarrassing when I struggle in front of people I don't know well. I will say that yoga, strength training, and glucosamine have been life savers for the joint and bone pain. There was a period of time I thought my quality of life was over, but it's been night and day.

[@estrogendiaries]

Keep it up! And tell me if the supplements help!

[@jamieg3009]

Great video. I will be rewatching this. Thank you.

[@estrogendiaries]

Glad it was helpful!

[@saramazer9608]

I was also going to mention osteoporosis prevention. Another idea is Prolon fasting to help with autophagy of damaged cells

[@estrogendiaries]

Yes! Do a google search for "Chris Kresser, Osteopenia" for a great podcast from 9/22 on boosting bone health. It's not about the calcium!

[@donnarichardson4388]

I took anastrozole for 3 weeks. I felt so sick couldn't get out of bed, bone pain, brain fog, loss of appetite. My cancer was IDC grade 1, no lymph nodes involved. I'm going to try letrozole at a small dose once or twice a week. If I'm ok I'll add another dose. My PCP said you're 100 percent ER positive, just try.

[@estrogendiaries]

It's worth a try for most of us, it seems.

[@beaglerundog]

You're helping me to make informed decisions Thank you

[@estrogendiaries]

So glad this is helpful!

[@mattiesful]

High cholesterol, headaches, dizziness, extreme hot flashes are some other side effects. I’ve been on AI for 7 yrs. First had anastrozole, second examestane and now Letrozole. I’ve lost 18% of my bone density, fortunately I had very good bone density so I’m still normal on dexascan. But my cholesterol is going up. I’m unable to take statins. I do chair yoga and beginners friendly Pilates. I also take a lot of supplements. I has HER2+ bc so I also had chemo and radiation. Good luck on your journey. Thanks for the info.

[@estrogendiaries]

Look here for a good plan: kzbin.info/www/bejne/l3jWoIereLN1pdEsi=UQgVbSHwE2vsFB74

[@MG-xt3wu]

I respect your decision. I am in the same boat regarding endocrine therapy. My cancer was IDC, only 1.38mm, no nodes, ERPR+, HER2-, 48years old, premenopausal. I had a double mastectomy. I saw two oncologists and both said it is perfectly reasonable not to take Tamoxifen because the chance of reoccurrence is small. My only worry is that during my initial stereotatic biopsy, the nurse didn’t put enough pressure on my breast and I got a 5cm hematoma. I have a constant worry that the cancer was spread because of this. Both oncologist said there is no evidence this can spread the cancer. As I said, I had a double mastectomy so maybe I shouldn’t worry, but the biopsy hematoma gives me second thought about not taking tamoxifen. Did having your BC survivors group help change your mind about taking Letrozole?

[@estrogendiaries]

No, it was seeing my mom die so quickly of her Mets, along with reading Dr Razas book. Something in me felt I should do everything I can, for my daughter’s sake. Intuition is so huge. We just don’t know still, what all the avenues of spread are.

[@jackiemacphee9888]

I found it interesting that you mentioned that having chemo seemed to be related to having more joint pain with the AIs. Can you tell me more about studies on that? I took Letrozole last year for 4 months prior to my surgery and afterward. I experienced hot flashes but no pain. When my Onco score came back high, I began chemo, and Letrozole was suspended until a month after chemo ended. I began Letrozole again in January, and within a few weeks, I began having terrible joint pain. I’ve tried different AIs, acupuncture, tart cherry, Tylenol, ibuprofen-everything. I’m on a month break from Anastrozole and switching to Tamoxifen.

[@estrogendiaries]

I’ll try to find the study for you. I just learned of it myself in a presentation for practitioners who work with breast cancer patients. This is interesting that your own experience confirms it. Letrozole takes about six weeks to start showing symptoms, so you were on it long enough to, the first time. I know that chemo is especially harsh on epithelial cells but it clearly affects soft tissue made of collagen as well: hair and nails. I wonder if it degrades cartilage and ligament in a more lasting way also? That wd be my guess as to the mechanism/effect on joints.

[@jackiemacphee9888]

Thank you. I’m really struggling with not wanting to start Tamoxifen either. However, I can’t deal with the 24/7 pain I was experiencing either. I’ve seen women comment that Letrozole put them in a wheelchair. I thought that was being overdramatic, but I’ve been humbled and “schooled” by my own experience. At 2 weeks into my “break,” I have some relief but not back to normal by any means. And I don’t really understand the mechanism behind what causes the pain.

[@estrogendiaries]

I'm secretly hoping they will start a trial looking at a "half-strength" dose that I can sign up for. I'm not sure I'll be willing to take it daily if they don't start trying a lower dose!

[@Freckles1212]

My Onco RN recently told me some oncologists are now dosing Tam at 1/2 of dosage with success. Has anyone tried?

[@estrogendiaries]

My oncologist says that since AIs are no longer highly priced drugs, the manufacturers are no longer incentivized to trial them at lower doses. The Tamoxifen trial was done in Italy--not here. Maybe the Italians will help us all out with the AIs too?

[@shalandadefin8849]

Can you take vitamin d3 with Letrozole/femara?

[@estrogendiaries]

As your nutritionist I would say yes, but you really need to ask your own doctor--I can't advise over the internet.

[@sarai9911]

This was so helpful! Thank you!

[@estrogendiaries]

Wish it were easier, but you are welcome! A week from tomorrow I’ll have an episode that touches on this coming out on my podcast, which is called @abreastcancerdiary here on KZbin as well as all the podcast players.

[@carolborden2008]

I’m wondering about your thoughts about a whole food plant based diet. I have done alot of research on this and am eating this way since February. I have dcis, had lumpectomy, radiation & now supposed to take aromotase inhibitors. I appreciated this video so much on this subject 💕

[@estrogendiaries]

Whole food and plant based are great values, yes, but as we get older it’s also important to choose organic and grass fed. Oats and wheat are Whole Foods, but they are incredibly toxic if not organic because they are sprayed with desiccants like glyphosate. And animal protein is absolutely essential as we age-but I never touch cheap meats. Only wild fish and wild cuts meet my standard. See my channel @seekingdeeperhealth for my nutrition videos!

[@annettedemant5502]

Thanks for your video. I am 68 year and have metastased lobular cancer and I am on Tamoxifen. In Denmark .You mentioned that Tamoxifen do not have best effects on lobular cancer. Do you have science documentation to scare with me ? ❤

[@estrogendiaries]

I'm afraid that trying to remember to look up the study will cause me to take too much time and forget so I'm going to tell you to look for the youtube channel called "ILC Symposium" instead. The data is in the videos from 2023, I believe it's in the first day's session. AND we are bringing the symposium to Belgium this September, so be sure to come if you can. I'll see you there!!!

[@user-qw9rh6ks3r]

I have a question for you …. I thought if a woman had a double mastectomy she would not need an aromatase inhibitor or tamoxifen. I have been thinking about getting a double mastectomy so that I would not have to take any drugs at all or get radiation. What are your thoughts on this? I only have DCS, but it is a grade 3 and aggressive. I am way past menopause and I’m a newbie to the space. Your videos are so helpful.

[@estrogendiaries]

I have to point you to your doctor/s on this. It is a little different for every oncologist, but it sounds like your situation is even less risky than mine. If you only had DCIS and not IDC, then in my experience most docs probably won't ask you to take any Endocrine Therapy/Aromatase Inhibitors. That's true of me too--mostly high grade DCIS and then a TINY bit of "real" active cancer the size of a grain of rice. Most docs would not press someone like you or me to take these drugs, but my reading of Dr. Raza's book has convinced me to at least give them a try, as an early precaution. I don't think that any oncology doc would refuse to offer you or me these drugs if we asked for them--they are just not as urgent for us because our risk of recurrence is already low.

[@estrogendiaries]

Another note from my studies: I've learned that with Endocrine therapy, studies show that no matter how long a woman stays on them, even being on a few months to a year does a lot of good for cutting down recurrence, so that was another reason I didn't mention, for giving them a try. In the most progressive studies, even women who have never had cancer but have a higher risk as a non-cancer patient are being trialed with some good outcomes. All good topics to bring to your own doc!

[@user-qw9rh6ks3r]

@@estrogendiaries Thank you for responding. It was very helpful. All the best to you!

[@anonnymous595]

As several oncologist explained to me, "recurrence" can occur anywhere in the body, not just the breast, so a double mastectomy doesn't prevent this, especially if you have high estrogen levels. Your oncologist may or may not recommend aromatase inhibitors.

[@AD-xp7ef]

I had a double mastectomy and 18 months later the cancer came back on my chest wall and lymph node. So no mastectomy is not the end necessarily.

[@rebeccakarlsson1395]

So letrozole will be the first endocrine therapy you try after dx? How long ago was your diagnosis? I was started a few weeks after finishing my last radiation session so about 3 1/2 months after my dx. I haven’t had a break from day one and still have another year and 1/2 to go. The problem now is that my MO is telling me that new research is recommending 10 years on anti estrogen treatment. Yikes!

[@estrogendiaries]

Yes. My first drug, in fact. My diagnosis was 18 months ago.

[@DMichaelsen]

Have you done any research on taking DIM in a premenopausal women?

[@estrogendiaries]

Yes, as a Nutritionist who specializes in hormones and detox of estrogen I have a lot to say about DIM. See my professional channel, @seekingdeeperhealth and especially the “foods I eat every day as a cancer patient”. I now take Sulfurophane rather than DIM, and my fave brand is called “Brocelite” from Mara Labs.

[@DMichaelsen]

Thank you for this information! It’s super helpful.

[@katebruno9255]

@@estrogendiariesI’m also a dietitian and just started Anastozole. If side effects are too intense I considered DIM or brocelite like you mentioned. Thanks for sharing so openly

[@danieledidier7631]

je prend du letrozole et pratiquement aucun effet secondaire . (juste les articulations des chevilles et plante des pieds le matin )

[@estrogendiaries]

So glad! I know it’s possible, but so rare to hear.

[@MINDRESET4SURVIVORS]

I wouldn't do it; fracture in the spine is scary.

[@estrogendiaries]

Yes, I’m fortunate to have had over a year already to get ready by strengthening my bones, as well. There’s a lot we can do, and none of it has to do with calcium. Chris Kresser had a great podcast on osteopenia in Sept of 2022 that helped me a lot. He’s one of my nutrition mentors. At my age we need to worry about our bones regardless!

[@bchmom03]

@@estrogendiaries did you start Letrozole? I cld not tol it. I had 4mm low grade stage 1, ILC and DCIS low grade. Dbl Mastectomy. I am doing a lot of the nutritional approach you mentioned. Thanks so much. I am 64, very active and petite. My hormone levels are very low. I hope you are doing well. Also, how do I access your podcast? Is it a video podcast? I am not a techie, lol.

[@estrogendiaries]

@@bchmom03 Yes yes--you can look for my youtube channel called "A Breast Cancer Diary" to access the video version of the podcast here on youtube. See you there!

[@estrogendiaries]

@@bchmom03 No, I'm still transitioning to menopause, so no Letrozole yet for me!

[@bchmom03]

@@estrogendiaries I understand. I have been in menopause since I was 47. It still is a trip.