You’ll find case presentations focused on various conditions from anxiety and depression, ADHD, PTSD, insomnia and many others, highlighting real patients and their results, ranging in age from children to postmenopause, as well as a veteran with PTSD.
For Breast Cancer Awareness Month let’s take a closer look at a recent case study of a postmenopausal woman with breast cancer.
Loretta's Case Study
Loretta is a 62-year-old postmenopausal woman suffering from breast cancer as well as depression, anxiety, and stress. Dr. Kate presents a breakdown of her self-reported symptoms before going into the details of her test results and a thorough explanation of biochemical factors at play that explain both her symptoms and her observed results. Finally, she summarizes the whole picture and presents a suggested way to address the problems and help Loretta get back into balance.
Self-reported symptoms that Loretta rated as severe included breast cancer, rapid aging, bone loss, allergies, sensitivity to chemicals, and obsessive-compulsive disorder (OCD). Moderately severe symptoms included anxiety, depression, stress, nervousness, addictive behaviors, dry/brittle hair, breaking nails, increased urinary urge, and morning fatigue. In addition, she had multiple symptoms that she rated as mild in severity.
Taking a closer look at breast cancer, Dr. Kate talks about factors that influence breast cancer risk; some are not modifiable, such as a family history of breast cancer, age at first pregnancy, age at menopause, etc. But other risk factors are lifestyle-related and could be modified to reduce risk, e.g., alcohol use, smoking, exposure to heavy metals, and stress. She also presents Dr. Zava’s “Estrogen Matrix” from his book 'What Your Doctor May Not Tell You About Breast Cancer' showing how hormonal pathways, in particular estrogen metabolism and the factors that influence it, contribute to breast cancer.
Elements Test Results
Loretta’s test results included Heavy Metals and Nutrients Testing in dried urine and dried blood spot and this showed high levels of bromine and arsenic in urine and high levels of mercury in both urine and blood spot (urinary mercury is an indicator of cumulative exposure to this toxic element, while blood spot indicates recent exposure). The blood spot elements test also showed that her levels of zinc and selenium were low, which is not healthy for anyone but especially for someone with breast cancer.
Dr. Kate explains how her elements test results relate to increased oxidative stress, which results in mitochondrial injury and DNA damage that can initiate breast cancer. Oxidative stress also speeds up aging. The body produces a natural antioxidant, glutathione, which helps counteract oxidative stress and detoxifies the body – but toxic heavy metals like arsenic and mercury interfere with glutathione production, and inadequate selenium also compromises glutathione synthesis, so Loretta is clearly suffering from a double whammy impact on glutathione availability.
Neurotransmitter Test Results
Dr. Kate then looks at her neurotransmitter results in relation to the Neurotransmitter Pathways, and shows that Loretta has a “brain on fire” pattern where everything is running either higher than normal or at the high end of the normal range. Paradoxically, her GABA and glycine are high, but her glutamate is normal – why is this? Dr. Kate points out that it is important to remember we are looking at urinary levels of neurotransmitters, and for glutamate to arrive in the urine it needs to be taken up by the kidneys. In Loretta’s case, her high levels of oxidative stress interfere with the glutamate transport in the kidneys, so less glutamate appears in the urine than would be expected.
In postmenopause when estradiol levels are low, this increases serotonin degradation, so levels are often lower than normal and levels of the serotonin metabolite 5-HIAA are high. In Loretta’s case, she also has a low zinc/copper ratio which also has the effect of enhancing serotonin degradation and likely contributes to her feelings of depression.
Loretta’s histamine levels are high, which can be seen in patients with sensitivity to chemicals, and her high PEA is indicative of severe anxiety, a racing mind and sleep problems.
Dr. Kate discusses Loretta’s epinephrine, norepinephrine, and cortisol/cortisone results and how they relate to stress and her adrenal glands. A sustained high cortisol level, in particular high cortisol production during the night as in Loretta’s case, increases the conversion of norepinephrine (NE) to epinephrine (EPI), increasing her levels of both EPI and normetanephrine (NMN) which is the adrenal product of NE metabolism, and this is typical in breast cancer patients where we often see high cortisol production.
Solutions for Loretta
Finally, Dr. Kate summarizes Loretta’s symptom picture and how it is reflected in her test results. What can Loretta’s doctor do to address this picture? Dr. Kate suggests how each aspect of Loretta’s health can be tackled, starting with supporting her overall wellness with stress reduction, sleep support, relaxation techniques such as yoga and meditation, and an anti-inflammatory diet. She covers nutritional support to help reduce her oxidative stress and increase glutathione production, including increasing her selenium and zinc and supplementing with N-acetyl cysteine (NAC). Finally, she suggests herbs for adrenal/HPA axis support, and follow-up neurotransmitter testing to check how Loretta is doing.
Case Study by Kate Placzek, PhD
Published by Margaret Groves