You will 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 us 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 Placzek presents a breakdown of her self-reported symptoms before going into the details of her test results and a thorough explanation of the biochemical factors at play. Finally, she summarises the whole picture and presents a suggested approach to address the problems and help Loretta get back into balance.
Symptoms and Risk Factors
Loretta's Reported Symptoms
Self-reported symptoms that Loretta rated as severe included breast cancer, rapid ageing, bone loss, allergies, sensitivity to chemicals, and obsessive-compulsive disorder (OCD). Moderately severe symptoms included anxiety, depression, stress, nervousness, addictive behaviours, dry/brittle hair, breaking nails, increased urinary urge, and morning fatigue. In addition, she had multiple symptoms rated as mild in severity.
Taking a closer look at breast cancer, Dr. Kate discusses factors that influence breast cancer risk. Some are not modifiable — such as family history, age at first pregnancy, and age at menopause. But other risk factors are lifestyle-related and could be modified to reduce risk, including 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 risk.
Test Results: What the Science Revealed
Heavy Metals & Elements Test Results
Loretta's test results included Heavy Metals and Nutrients Testing in dried urine and dried blood spot. This showed high levels of bromine and arsenic in urine, and high levels of mercury in both urine and blood spot — urinary mercury indicates 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 concerning for anyone but especially for someone with breast cancer.
Dr. Kate explains how these results relate to increased oxidative stress, which results in mitochondrial injury and DNA damage that can initiate breast cancer. Oxidative stress also accelerates ageing. The body produces a natural antioxidant, glutathione, which helps counteract oxidative stress and detoxify the body — but toxic heavy metals like arsenic and mercury interfere with glutathione production, and inadequate selenium further compromises glutathione synthesis. Loretta is clearly suffering from a compounded impact on glutathione availability.
If you are concerned about your own exposure to heavy metals, our Toxic Heavy Metals & Elements testing page explains how a simple at-home dried blood spot or urine test can reveal your current levels of lead, mercury, arsenic and more.
Neurotransmitter Test Results
Dr. Kate then examines Loretta's neurotransmitter results in relation to the Neurotransmitter Pathways, showing 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. Dr. Kate points out that it is important to remember we are looking at urinary levels of neurotransmitters — for glutamate to appear in the urine it needs to be taken up by the kidneys. In Loretta's case, her high levels of oxidative stress interfere with glutamate transport in the kidneys, so less glutamate appears in the urine than would be expected.
In postmenopause, when estradiol levels are low, serotonin degradation increases, 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 further enhances serotonin degradation and likely contributes to her feelings of depression.
Loretta's histamine levels are high — commonly 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). This pattern is typical in breast cancer patients, where high cortisol production is frequently observed.
Chronic stress and elevated cortisol are closely linked to hormonal disruption. If you recognise these patterns, our Stress & Adrenal Imbalance testing page explains how a cortisol diurnal profile can help identify adrenal dysfunction and guide a path back to balance.
Solutions for Loretta
Dr. Kate summarises Loretta's symptom picture and how it is reflected in her test results. What can Loretta's doctor do to address this? Dr. Kate suggests tackling each aspect of Loretta's health systematically:
- Overall wellness: stress reduction, sleep support, relaxation techniques such as yoga and meditation, and an anti-inflammatory diet.
- Nutritional support: reducing oxidative stress and increasing glutathione production by increasing selenium and zinc intake and supplementing with N-acetyl cysteine (NAC).
- Adrenal/HPA axis support: targeted herbal support, followed by follow-up neurotransmitter testing to monitor progress.
For postmenopausal women concerned about the interplay between estrogen, stress hormones and breast health, our Menopause hormone testing page outlines which tests are most relevant and how to interpret your results in context.
Related Tests
HEAVY METALS & NUTRIENTS — COMPREHENSIVE ELEMENTS PROFILE (DRIED BLOOD & URINE SPOT)
Originally by Kate Placzek, PhD, ZRT Laboratory. Reproduced with permission. Last reviewed: May 2026.