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By admin, June 10, 2010 9:17 am

There are few good things to say about breast cancer-except that, in most cases, there are usually good treatment options. For many men with prostate cancer, however, the decision about how to proceed is often less clear.   Many doctors advocate a “let’s see what happens” approach, which can be less than encouraging.

Prostate cancer now often gets detected early, thanks to the PSA blood test. Most cases are  slow-growing and many men are diagnosed with it later in life, which mitigates most serious risks to life and well-being. Because treating prostate cancer can result in lifelong side effects, including incontinence and impotence, in many cases doctors advise “watchful waiting” for older men with less aggressive tumors. But the idea of “watch and wait” or even agreeing to just have “active surveillance” (periodic checkups to see whether the cancer is progressing instead of treating the cancer aggressively) isn’t always a comfortable one. Unfortunately, no treatment might be better than any for an older man.

What the Data Says

Studies that compare treatment versus waiting to see how the cancer develops were outdated until recently;  the most reliable of which was done all the way back in the days before the PSA blood test was available, when a digital rectal exam was used to diagnose prostate cancer. This meant that cancer wasn’t identified until a tumor had grown to be large enough that doctors could feel it.  Now, in a new study from the Cancer Institute of New Jersey/University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, researchers looked at records of 14,516 prostate cancer patients (average age 78) diagnosed between 1992 and 2002 who had received no curative therapy (surgery or radiation) for at least six months after they were diagnosed. Men with less aggressive prostate cancer (Gleason scores under 7) had less than 10% likelihood of dying from prostate cancer.  For those with the highest initial Gleason scores (8 to 10), the death rate climbed to 25.6%.

What to Make of This

Study author Grace L. Lu-Yao, PhD, MPH, told me that the goal of the research was to obtain balanced data that is both current and correct. She agreed that aggressive treatment may be very appropriate for men who are younger and expected to live longer than 10 years — but it’s a far more nuanced decision for older men, especially those with low or moderate Gleason scores. Older men now have a clearer picture of their survival odds one way and another. It’s still not an easy decision, but at least it can now be a more informed one.

Source(s):

Grace L. Lu-Yao, PhD, MPH, associate professor of medicine, Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, New Brunswick.

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By admin, June 4, 2010 12:42 pm

A pill that can prevent cancer? Not long ago it would have seemed far-fetched, but now we actually do have drugs that hold back cancer risk…. but before we start celebrating, it’s important to know the details. For example, while the drugfinasteride can reduce the risk for prostate cancer, its potential side effects include impotence and loss of libido. Tamoxifen can lower certain breast cancer risks — but it, too, comes with serious potential problems, including an increased likelihood of developing uterine cancer, blood clots, cataracts and stroke. Deciding whether or not to take such drugs is difficult, to say the least, and the issues are not the same for everyone.

Based on your individual and family health history, the risk/benefit equation for anticancer drugs may work out differently — this is something you can discuss with your doctor. But here is the really good news: There are safe, natural substances that help prevent cancer — not 100%, but enough to make a big difference for many people. To explore them, I turned to Mark A. Stengler, ND, a leading authority on the practice of alternative and integrative medicine and author of The Natural Physician’s Healing Therapies. Here is what Dr. Stengler suggests his patients take to prevent — or slow the progression of — cancer…

Anticancer Supplements

Vitamin D. Dr. Stengler told me that if he had to choose just one supplement to fight cancer, it would be vitamin D-3. Not only is it a potent immunity booster and inflammation fighter, it’s also critical for the support of normal cell division. Vitamin D is most notably helpful for breast, colorectal and prostate cancers.

What to do: Get your blood level of vitamin D tested and aim to achieve at least a mid-range level. For many patients, Dr. Stengler prescribes 2,000 IU daily to be taken with a meal.

Fish oil. Dr. Stengler often prescribes fish oil for patients who are fighting cancer. Two omega-3 fatty acids in fish oil — EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) — support the immune system and block the production of cancer-promoting hormones. Studies also demonstrate that fish oil helps fight wasting symptoms, including weight and muscle loss, in cancer patients.

What Dr. Stengler does: Dr. Stengler typically prescribes one gram per day in total of EPA and DHA… or directs patients to eat two to three weekly servings of cold-water fish such as salmon, herring or sardines.

Glucosinolate. Dr. Stengler pointed to research from Johns Hopkins identifying glucosinolate, an extract from broccoli and broccoli sprouts, as a powerful detoxifier and antioxidant. It works by blocking the action of free radicals, which are activated oxygen molecules that damage cells and precipitate cancer. While eating cruciferous vegetables of all kinds, including broccoli, bok choy, cabbage, kale, cauliflower and Brussels sprouts, is a smart dietary strategy, taking glucosinolate as a supplement adds further protection.

Dr. Stengler’s approach: He often prescribes BroccoMax, made by Jarrow (800-726-0886, www.Jarrow.com). A typical dose is one or two 250-mg capsules per day.

Kitchen Cures: Foods that Fight Cancer

Tomatoes. Research demonstrates that men who follow a diet high in the antioxidant compound lycopene have lower rates of prostate cancer — and it is an important cancer fighter for women, too. Tomatoes are the most concentrated food source of lycopene, and cooked tomato products, such as tomato sauce and paste, are even better ways to get lycopene than raw tomatoes. Other good food sources of lycopene include apricots, guava, watermelon, papaya and pink grapefruit.

Dr. Stengler says: A daily dose of 5 mg to 10 mg of a lycopene supplement can help protect against prostate cancer — and for women, against breast and cervical cancers. If you are eating lycopene-rich vegetables and fruits, you’ll get better nutrient absorption by combining them with a small amount of oil or fat (such as olive oil in pasta sauce or on salad).

Mushrooms. Author of The Health Benefits of Medicinal Mushrooms, Dr. Stengler is a strong believer in mushrooms for cancer prevention. He recommends mushroom extracts such as Grifola frondosa (Maitake), Lentinula edodes (Shiitake) and Coriolus versicolor (Yun zhi, or “Turkey Tail”). Published research says that these mushrooms have the potential to improve the concentration and activity of immune markers that are implicated in cancer, including natural killer cells, tumor necrosis factor (which causes the death of cancer cells), T-helper cells and a variety of interleukins.

What Dr. Stengler does for his patients: For prevention, he suggests taking 25 mg to 50 mg of maitake gold extract (available from various companies) daily… while he often directs patients with cancer to eat one-quarter cup of mushrooms two or three times per week, emphasizing the varieties named above.

Turmeric. Evidence suggests that this bright yellow antioxidant, which can be used on its own as a spice and is also an ingredient of Asian curry powder, helps suppress breast, colon and skin cancer. Curcumin, an active compound of turmeric, is anti-inflammatory and helps prevent new blood vessel growth (angiogenesis) associated with cancer tumors. Up to 3 grams per day of turmeric is considered safe.

How Dr. Stengler uses it: Dr. Stengler typically directs cancer patients to take turmeric in capsule form up to three times daily. He adds that for prevention purposes, it’s great to use turmeric frequently in your cooking.

Green tea. In a meta-analysis of studies examining tea and lung cancer risk, investigators found that increasing green tea consumption by just two cups a day was associated with an 18% decreased risk for lung cancer. Green tea contains powerful antioxidant polyphenols that appear to kill off cancer cells. Other research suggests that green tea may stave off cancers of the skin, esophagus, stomach, colon, pancreas, bladder, prostate and breast.

Dr. Stengler advises: Drink two cups of green tea daily (or more, if you are a smoker).

The list goes on…

Other potentially beneficial supplements include vitamin C, vitamin K, panax ginseng and folate. Dr. Stengler said that all these remedies have a long track record for safety and effectiveness and can improve your resistance to cancer… enhance your natural defense mechanisms if you already have cancer… and help minimize side effects of conventional cancer therapies.

Of course, before deciding on any anticancer strategy — whether screening, prevention or treatment, and including natural ones — carefully discuss the risks and benefits with your physician so that you can make an informed decision about whether or not it is right for you and to be certain that there are no negative interactions with other medications.

Source(s):

Mark A. Stengler, ND, a naturopathic medical doctor and leading authority on the practice of alternative and integrated medicine. Dr. Stengler is editor of the Bottom Line Natural Healingnewsletter, author of The Natural Physician’s Healing Therapies (Bottom Line Books), director of the La Jolla Whole Health Clinic in La Jolla, California, and adjunct associate clinical professor at the National College of Natural Medicine in Portland, Oregon. To learn more about his work, visit www.drstengler.com.

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By admin, March 29, 2010 2:32 pm

As days lengthen through spring my thoughts often turn to… light. Every year I find my spirits lift as the days get longer and I can spend more time outdoors. I see this as yet another example of how much better we feel when we’re living a lifestyle that’s close to “natural.” Curious to see what the latest science shows, I looked for studies on how we can make the most of this seasonal bounty — not only during these bright and sunny days, but at other times as well.

Natural light and your health making changes

Illuminating Information

Recognizing the many health benefits of natural light, the Department of Architecture at the Massachusetts Institute of Technology is studying how to make the most of natural daylight and use less artificial light in buildings. They are developing tools to manipulate illumination to meet human circadian needs so architects can make healthy light-related design decisions.

One recent study, published in the Scandinavian Journal of Work, Environment & Health, found that using white light enriched with blue-light waves helped office workers stay more alert during the day, reduced evening fatigue and improved night sleep. Investigations are also underway to see how other types of light treatment — such as synchronization to individual melatonin rhythms, simulated dawns or adding environmental blue light — might improve individual health and performance.

To learn more about these new findings, I spoke with neuro-endocrinologist, Russel J. Reiter, PhD, at the University of Texas Health Science Center at San Antonio, a long-time researcher on this topic. I asked whether it makes sense to purchase different types of lights for different rooms in our homes, based on these findings. Affirming the connection between blue light and alertness, he told me that white lights (which contain all wavelengths, including blue) are best for rooms where you are reading, working or engaging in other activities that require focus. In rooms where you want to relax, such as the bedroom, it makes sense to use bulbs that have a yellow-to-red cast, which do not have this effect.

The Dark Side

The darker side of this story is that there is evidence that the wrong light can actually damage your health. I spoke with Richard G. Stevens, PhD, a cancer epidemiologist at the University of Connecticut, who has been studying the rise in breast cancer rates that occurred along with industrialization. He told me that increasing use of artificial lighting during the nighttime hours might be disrupting workers’ circadian rhythms, possibly by suppressing melatonin production. Melatonin is produced by the body at night and is known to inhibit tumor formation — however, experts theorize that when the retina encounters light at night, production shuts down and cancer risk increases.

Researchers at the University of Haifa in Israel used satellite images to measure light at night in a variety of communities, finding that those with the highest levels also have the highest breast and prostate cancer rates. To check this theory, a comparison group — blind women unable to see light at night — was measured in four countries and, indeed, found to have 20% to 40% less cancer risk. Dr. Stevens told me that in 2007, after careful study, the International Agency for Research on Cancer identified overnight shift work as a probable carcinogen and he predicts that we will begin seeing more studies focused specifically on the cancer risks of “light at night.”

Let the Sun Shine

Then, of course, is the increasingly well-known link between sunlight, vitamin D production and overall health. For the latest details, I called Michael Holick, MD, PhD, director of the General Clinical Research Center at Boston University School of Medicine.

Vitamin D is unique, he says, “because we make it in skin exposed to sunlight.” It helps absorb calcium for bones, supports immune systems and reduces common cancers, cardiovascular disease, high blood pressure, types 1 and 2 diabetes, rheumatoid arthritis, multiple sclerosis and infections.

The sun has been the natural source for vitamin D for hundreds of thousands of years, Dr. Holick noted. Vitamin D-deficiency rickets became a health problem when industrialization began to keep people working indoors all day. He believes more than half of Americans are vitamin D-deficient today because they avoid sun altogether, overuse sunscreen and spend too much time indoors, in front of computer screens and in artificial light. Dr. Holick offered some general recommendations for the spring and summer months: Get 15 minutes of arm and leg exposure two or three times a week, between 10 am and 3 pm. (Note: This is the guideline for those whose skin turns pinkish in a half hour of sun.) Sun exposure requirements vary by latitude, time of day and skin pigmentation, so adjust accordingly. Use sunscreen with at least an SPF 15 on your face, since it is more prone to skin cancer, but on your body only after your initial exposure, because it significantly reduces your vitamin D-making ability. This should generate about 1,000 IU of vitamin D per day, which Dr. Holick says is enough.

At the End of the Day

And, of course, light — or rather the lack thereof — has an effect on how well we sleep at night. Here are some tips from our experts…

Darken your room as much as possible. Turn off your computer monitor. Don’t sleep with the television on. Don’t use a nightlight in your bedroom.

If you need light for safety — for instance, in the hallway or bathroom — use low-wattage and preferably red light bulbs in a nightlight. (These are available in hardware stores — Dr. Stevens suggests using Christmas bulbs if you can’t find other red bulbs.)

Use light-blocking shades to keep outdoor lights from brightening your room. If “trespass light” leaks in anyway, wear eyeshades while sleeping — it’s not dangerous but you can minimize its effect on your circadian rhythm by blocking it out.

If you wake up and want to go back to sleep, do not get up and go into a lighted room. Instead, lie quietly in the dark — counting sheep, your blessings or whatever works for you — while you wait for sleep to return.

Source(s):

Michael F. Holick, MD, PhD, professor of medicine, physiology and biophysics, director of the General Clinical Research Center, director of the Vitamin D, Skin and Bone Research Laboratory, director, Biologic Effects of Light Research Center, Boston University School of Medicine, Boston.

Richard G. Stevens, PhD, professor and Cancer Epidemiologist, division of epidemiology & biostatistics, department of community medicine and health care, University of Connecticut Health Center, Farmington, Connecticut.

Russel J. Reiter, PhD, professor, department of cellular & structural biology, University of Texas Health Science Center, San Antonio, Texas, and editor-in-chief, Journal of Pineal Research.

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By admin, March 23, 2010 10:25 am

Cost-consciousness and excellent medical care can go hand in hand — for instance, a recent discovery in genetic medicine lets doctors customize chemotherapy not only to increase the likelihood it will work, but also to dramatically cut overall costs. Specifically, scientists have found that people with a certain gene mutation do not respond to cetuximab (Erbitux), a powerful chemotherapy drug for treatment of advanced colorectal cancer.

Make colon cancer less scary

Testing for this mutation before initiating treatment spares patients from ineffective and potentially toxic therapy, so they can try other therapies more likely to work, explains study author Veena Shankaran, MD, of the Northwestern University Feinberg School of Medicine in Chicago.

Sparing Patients and Saving Health Dollars

Cetuximab and similar drugs such as panitumumab (Vectibix) work by blocking epidermal growth factor receptor (EGFR), a substance that makes tumors grow. But when there is a mutation in a specific gene called the Kras gene, this therapy doesn’t work. Dr. Shankaran said that testing for it can therefore help patients have faster access to chemotherapy that may work better.

The cost savings are quite significant, too. In her study, Dr. Shankaran made calculations based on a theoretical population of patients to forecast how much would be saved by testing all advanced colorectal cancer patients for Kras mutations before administering cetuximab chemotherapy, as follows:

• Estimated number of patients annually with metastatic colorectal cancer: 28,274 (American Cancer Society statistics).
• Approximate percentage of patients with Kras mutations: 35.6% (based on estimates from a recent study by Van Cutsem et al).
• Average cost of a Kras test: $452.
• Average cost of cetuximab treatment: starting dose, $3,986… weekly dose, $2,491 (or assuming $61,279 per patient).

Using these figures, the annual cost of testing patients for Kras mutations is $13 million, compared with the cost of treating the 10,066 patients with Kras mutations (in whom treatment is ineffective), which is $617 million. Thus testing patients for Kras mutations before treating them would save $604 million. Dr. Shankaran presented these results at the January 2009 Gastrointestinal Cancers Symposium.

Dr. Shankaran recommends that all patients with advanced (or metastasized) colorectal cancer be tested for Kras mutations beforecetuximab chemotherapy. In the future, identifying more Kras-like markers is likely to result in more targeted therapies — treatments that are both more beneficial for patients and more cost-effective for our health care system as a whole.

Source(s):

Veena Shankaran, MD, Northwestern University Feinberg School of Medicine, Chicago.

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By admin, March 22, 2010 9:15 am

In light of the fact that there are no clear answers, how should a man diagnosed with prostate cancer determine his course of action?

Discover your options

The most important thing to do, suggested Dr. Jones, is have a heart-to-heart discussion with your doctor, discussing the factors that must be considered, including your age, your general health, your expected life span, the stage and grade of your cancer, and your feelings about how aggressively you want to treat the disease.

The first question a man needs to ask himself, says Dr. Jones, is, “am I going to treat this cancer or am I comfortable with expectant management?” If you decide to treat, the second decision is, “am I going to have surgery to remove the prostate or am I going to try another treatment?” If you decide to try another treatment, the third question is, “which one should I choose, based on the pros and cons of each treatment option and my own feelings on the matter?”

Finally, seek a variety of medical opinions. “As the saying goes, if your only tool is a hammer, every problem will look like a nail,” said Dr. Jones. In other words, if you seek a surgeons opinion, he will likely be thinking surgically. If you see a radiation therapist, his recommendation will probably be radiation. Ultimately, you want to find a doctor you trust, who takes the time to explain all of your options to you, and helps you to think them through.

Source(s):

Stephen Jones, MD, is chairman of the department of regional urology at the Cleveland Clinic Glickman Urological and Kidney Institute, and is associate professor of surgery (Urology) at Cleveland Clinic. He is author of two books, The Complete Prostate Book(Prometheus) and Overcoming Impotence (Prometheus).

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By admin, February 25, 2010 12:05 pm

Ginger has long been recognized as a natural antidote to nausea, and now a new study affirms its value in soothing nausea for those undergoing chemotherapy for cancer.

Have ginger help you with your chemo

The Study

The study, from the University of Rochester Medical Center, involved 644 patients nationwide in various cancer centers who had undergone chemotherapy that had made them nauseous and who were scheduled to have at least three additional chemo treatments. Patients were separated into four groups — three took varying dosages of ginger (0.5 gram, 1 gram or 1.5 grams per day) while the fourth took placebo capsules, all in addition to standard antinausea medication (e.g., Zofran, Kyrtil). Unlike in other trials, these patients started taking the ginger (or placebo) three days before chemo began, as well as on the day of chemo, and for two days after chemo, for a total of six days.

Results: All those taking ginger reported improvement in nausea on their first day of chemotherapy (as much as 40% less than in their previous treatments). Those taking the lowest (0.5 gram daily) and middle-range (1 gram daily) doses had a greater reduction in nausea than those in the high-dose (1.5 grams daily) group. Patients in the placebo group did not experience any reduction of symptoms.

I spoke with Julie Ryan, PhD, MPH, assistant professor in dermatology and radiation oncology, who was the study leader. She attributed the effectiveness of the smaller dosage to the fact that one gram of ginger is the maximum the stomach can absorb, adding that it probably works because ginger has an antispasmodic effect on the stomach lining. (Note:Excessive amounts can be irritating to some individuals.)

What to Do

Dr. Ryan suggests that chemo patients can ease their nausea by taking between 0.5 gram and 1.0 gram (500 mg to 1,000 mg) daily of purified gingerroot, starting at least two days before the first day of chemo and continuing for at least a day afterward. Ginger-flavored sodas, cookies and other foods aren’t potent enough to be of use.

The capsules used in the study contained a purified gingerroot liquid extract which is equivalent to 250 mg of fresh or dried gingerroot. Ginger tea made with this amount of gingerroot may be helpful as well. Note: Ginger has not been shown to inhibit the effectiveness of chemotherapy drugs, but in extremely large doses it does have blood-thinning properties. It is generally regarded as safe, and there is no evidence of danger with long-term use, but check with your oncologist whether it might be appropriate for you.

Source(s):

Julie Ryan, PhD, MPH, assistant professor in dermatology and radiation oncology, University of Rochester Medical Center.

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By admin, February 24, 2010 6:56 pm

People will do everything they can to avoid cancer so why not find all the preventions possible. Can garlic actually help you prevent cancer? Find out now…

Preventing cancer with garlic... does it work?

Traditional healers and modern scientists often see things differently, but when it comes to garlic, there has seemed to be consensus about its health-promoting properties. So what are we to make of a new meta-analysis of 19 published studies that found no credible evidence of a link between garlic intake and reduced risk for a wide number of cancers? While it did acknowledge “very limited” evidence linking garlic intake to reduced risk for colon, prostate and ovarian cancer, that’s faint praise indeed.

When I spoke with Daily Health News contributing editor Andrew Rubman, ND, about this surprising finding, he pointed out that an issue with meta-analyses — studies that evaluate data from numerous others to reach a conclusion — is that researchers are able to pick and choose among previous studies to skew their findings in a particular direction. This is a particular issue with single-factor studies, when researchers look at a variable in isolation. Dr. Rubman is not saying this is necessarily the case here, but to evaluate how worthy its findings are would require careful investigation of the studies used. It is possible, he says, that the studies showing no discernable effects of garlic used products that were relatively weak or garlic processed at high temperatures, which would diminish its healthful properties.

Dr. Rubman continues to support garlic as one among many cancer-prevention tools when it is part of a healthy diet. He told me that preliminary human studies, evaluated by Natural Standard (http://www.naturalstandard.com/), a clinical database that evaluates evidence-based natural therapies, suggest that regular consumption of garlic, particularly unprocessed, may reduce the risk of developing several types of cancer, including gastric and colorectal. “More studies are necessary to better evaluate preventative or curative capacity,” he said.

Dr. Rubman noted that it is best to crush raw garlic to release its health-benefitting enzymes and then let it rest for 10 or so minutes to “bloom.” Most people start a dish by heating garlic in oil, which is fine, but Dr. Rubman advises adding some at the end of the cooking process as well to ensure that you’ll get the full health value, since some of its healthful properties are reduced — even destroyed — by heat. Another possible solution is to take capsules of cold-pressed extraction of garlic (he recommends those made by a Japanese company called Kyolic,http://www.kyolic.com/). However, with such excellent garlic in markets today, Dr. Rubman says he sees no reason not to consume it fresh in your favorite dishes.

Source(s):

Andrew Rubman, ND, medical director, Southbury Clinic for Traditional Medicines, Southbury, CT. www.naturopath.org.

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By admin, February 8, 2010 1:08 am

Folic acid is not something everyone is going to enjoy and now many less. Most people were not aware that excess folic acid may raise cancer risk and it is time that everyone is.

Understand why too much folic acid can be bad for you.

Where a little may be good, a lot may be hazardous… such may be the case with folate, and its synthetic form folic acid, the B vitamin that helps protect the nervous system and prevent anemia. For years now, the US government (along with Canada and Chile) has required that most breads, flours, cornmeal, rice and some other grains be fortified with folic acid as a way to reduce birth defects known to be caused by folate deficiency.

It’s working — incidence of neural tube birth defects has been reduced by as much as 50% in these countries, but at the same time, there has been another, totally unexpected development. All three countries have also seen rates of colorectal cancer rise, an abrupt reversal after years of decline — with the increase estimated at an additional four to six cases of colorectal cancer per 100,000 people. Adding to that concern were the results of a large clinical trial published in the Journal of the American Medical Association in 2007 concerning folic acid supplementation and colon cancer. The participants, all of whom had previously had colon polyps, were divided into two groups — one group took 1,000 mcg daily (this is considered the uppermost safe limit and exceeds the daily recommended intake, which is 400 mcg) of folic acid and the other a placebo. After seven years, the study found that those taking supplemental folic acid were more likely to have multiple polyps, and at higher risk, than those who didn’t take it. Even more troubling: A follow-up study of this same group found that after 10 or 11 years, those supplementing with folic acid had a three-fold increase in prostate cancer compared with the group on placebo.

TRADING ONE PROBLEM FOR ANOTHER?

Joel Mason, MD, director of the Vitamins and Carcinogenesis Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, is author of a recent report on this topic in Nutrition Reviews. He told me the report generated controversy because folate fortification has so effectively reduced birth defects — but his intent, however, was not to be “anti-fortification,” but rather to generate dialogue about a potential risk for one group of people in spite of the clear benefits for another at a time when many countries are considering fortification.

Paradoxically, there is sound evidence that folate, which has a pivotal role in DNA synthesis, protects against colorectal cancer. Dr. Mason speculated that perhaps its very function of helping create DNA for new cells means that when ingested in large quantities, folate stimulates the growth of existing cancerous or precancerous cells that would otherwise remain stable. Another possibility relates to the fact that folic acid, rather than folate itself, is used to fortify foods because it is cheaper and also more stable. The body must convert folic acid into folate, he says, and ingesting an excessive amount of folic acid may overwhelm the conversion system, leaving a reservoir of synthetic folate that could have detrimental effects. Current research is exploring whether folic acid itself is cancer-promoting, but there’s little evidence of this Dr. Mason said, so he believes it’s more likely related to excessive intake of the vitamin, regardless of its form.

A FOLIC ACID MEASURE

In no way does this diminish the importance of an abundance of folate, says Dr. Mason, describing it as “healthful and in no way harmful.” Dietary folate is available in a variety of foods, including dark green leafy vegetables, legumes, citrus fruits and berries.

And folic acid, for the most part, also is healthful and relatively few people are at risk for getting too much. Dr. Mason says supplementation adds a “fairly modest amount” to typical intake, about 100 mcg to 200 mcg per day. He noted that the situation only gets worrisome for those who routinely exceed 1 mg a day (1,000 mcg) of folic acid through supplementation in a variety of forms. This would describe a person who takes a multivitamin (400 mcg of folic acid), a B complex (another 400 mcg), and then eats fortified breakfast cereal (typically containing 100 to 400 mcg). It’s still morning and we already are at the ceiling of 1,000 mcg folic acid — but then for lunch there is a sandwich with fortified bread (50 to 120 mcg for two slices), maybe a pasta dinner (another 100 to 200 mcg) and the total is nearly 1,400 mcg, clearly topping the upper limit of safety. For those who snack on vitamin-packed energy bars and sip vitamin-infused water all day, the folic acid intake goes even higher.

There isn’t enough data yet to make an absolute statement about folic acid intake, but the current recommendation regarding the uppermost safe intake level (1,000 mcg/day) continues to be an excellent guideline, Dr. Mason said. Vitamin labels clearly identify how much folic acid they contain, but it’s harder to figure out how much is in fortified foods. The law says that all wheat flour, rice and several other uncooked cereal grains labeled as “fortified” must have added folic acid… but there are a few nonfortified examples of these foods on the market. You can look for these, but it might be easier to just be aware of how much folic acid you are ingesting in vitamin supplements, because these appear to be the major source of excessive intake.

Source(s):

Joel Mason, MD, director of the Vitamins and Carcinogenesis Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston.

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