You may have noticed from previous posts that I am somewhat conflicted about taking Tamoxifen. As I have made a decision to hold off for now, mum thinks that I should get some input from somebody she trusts. We drive down the Tasman peninsula to see a naturopath, Ree van Galen.
Ree is a very open and welcoming person who speaks in no-nonsense terms. She does not offer advice on whether of not I should take Tamoxifen. That decision is for me alone. She does, however, give me some very useful information to aid me with my decision.
Here is my somewhat simplistic interpretation of what I learned. This post is a touch on the long side but you may find it helpful if you are in a similar quandary. It will certainly help me to refer back to it in the future.
First she builds up a picture of how my body has produced and handled oestrogen in the past. She asks all about my history. Was I ever on the pill? What were my periods like? Did I ever have PMT? Pregnancies? Based on my answers she ascertains that I have not been over-producing oestrogen.
She explains that there are different types of oestrogens, those that we manufacture in our body and those that we ingest from other sources. Tamoxifen blocks the uptake of all oestrogen. Unfortunately it inhibits uptake throughout the body, not just in the breast tumour. I have never been able to quite get past the idea that the rest of my body must need that oestrogen for some important purpose.
If I am not taking Tamoxifen, Ree explains, then I must do two things: reduce any oestrogen from outside sources and also ensure that my liver converts enough ‘good’ oestrogen to occupy the receptor sites, thereby blocking the uptake of the ‘bad’ oestrogen.
So she asks questions about my liver. Have I had hepatitis? Do I drink alcohol? Take drugs? Were my liver function tests at the hospital ok?
Having established that my liver is up to the job Ree tells me the most common sources of ‘bad’ oestrogens: plastics and pesticides. The substances released by plastics and pesticides are not real oestrogen but the human body does not have receptors for plastics and pesticides, yet, so it treats them as strange oestrogen and sends them to the same places.
“Avoid all soft plastic and non-food grade plastic,” says Ree, “especially if the plastic is heated in any way.” What I understand this to mean is: don’t wrap food in cling-film or plastic bags, don’t drink water out of plastic bottles and never eat food that has been microwaved in plastic. “And don’t eat food out of tins that have that white lining. It is plastic and they heat the tins to seal them. That stuff has already been banned in many European countries.” “Not in the UK,” I tell her. She suggests that I contact the manufacturers of my plastic water filter jug to ask them if the plastic that they use is food grade, which means that it does not leach PVC molecules. I have already replaced my plastic water bottle with a glass lemonade bottle that I refill from the tap. “Tupperware is food grade,” says Ree, “but don’t put it in the microwave.” I visualise the shelves of my local Sainsbury’s. Every single edible item is enveloped in a sheath of soft plastic. Avoiding plastic is going to be difficult.
Next, pesticide. That is more straightforward. Eat organic food wherever possible. I have already done so ever since I was diagnosed. The shame of it is that it has precluded shopping for lovely fresh veggies on Portobello market and forced me into the supermarkets where all the produce is sheathed in plastic. If organic is not available, she advises me to reduce my intake of meat, chicken and dairy. “I have already cut out dairy,” I tell her about Jane Plant’s book. “That sounds good,” says Ree, “but you must get your protein. Eat fish and organic meats along with lots of vegetables and whole grains. The most important vegetables for you are brassicas. Make sure that you eat either cabbage, broccoli, pak choy, brussels sprouts or cauliflower every day of your life.” Apparently brassicas contain a substance that is sold as a very expensive supplement called IC3. It helps one’s to liver convert human and animal oestrogen into a quasi-phyto-oestrogen.
Ree tells me to include some soy products in my diet each week, such as tofu. “But don’t go overboard on the tofu and soy milk.” Also to make a mixture called LSA. This involves milling equal amounts of linseed, raw almonds and sunflower seeds in a coffee grinder and adding a teaspoon each morning to my muesli or porridge. “Make it fresh once a week and keep it in the fridge, otherwise it will turn rancid.” I am also advised to add a teaspoon of lecithin granules daily to my cereal. For B vitamins I should eat oats, brown rice, eggs and nuts.
I have lugged my extensive array of supplements along with me. “Which of these can I live without?” I ask with a pleading eye. I find it tedious to force all those pills down my throat each morning. The supplements that she recommends for me are: selenium (200 ug daily) and omega 3 fish oils. I have been taking an expensive high dose co-enzyme Q10 capsule. “That was important to protect your heart whilst you were having chemo,” she says, “but you could reduce it now. Resveratrol is a powerful anti-oxidant. You should definitely continue that as long as you are smoking.” She gives me an oral test to check my levels of zinc. “Medium to low,” she pronounces. “Keep taking the zinc but do one month on and one month off. Have you had your vitamin D levels measured? You will get plenty of sunshine in Australia but you’ll need to top it up if your levels are low.” I recall that Dr Coulter did request a blood test for vitamin D3 before I left but in amongst all the activity I don’t remember if we ever discussed the results.” I promise to call the hospital and check up on that. “Magnesium is important too,” Ree continues, "but there are two good sources for that: Brazil nuts and a twenty-minute soak in a bath with half a cup of Epsom Salts." How hard can that be?
Finally, Ree wants to inspect the fluid build-up in my back. I take my top off. The way that other medical professionals universally celebrate Mr Hadjiminas’ handiwork is a source of continuing delight to me. “Oh my,” gasps Ree, “that is the most beautiful surgery I have ever seen.” She continues, “it takes time for your lymph vessels to re-establish after surgery. The white pith of citrus fruit helps in the strengthening process.” I am pleased to hear this. I regularly chuck half a lemon, with the skin on, into my juice extractor along with the carrots. She suggests lymphatic drainage massage. “They do it in all the breast clinics,” she remarks. “Not in the UK they don’t,” I reply. “Well in any case, apply some calendula cream but don’t rub hard. Too much pressure disrupts the healing lymph vessels. Just lightly stroke it on in a direction away from the scar.”
On the drive home mum and I stop at several roadside stalls. People in Tasmania just grow everything and then sell it from outside their house or the back of their ute. We buy cherries, sylvan berries, pink-eye potatoes, onions, snow peas and carrots. Every single thing is organic and plastic-bagless.