Hormone Blockers and Keto/Low Carb Diet

macdebbie

I will talk to my MO of course about this, but wondered if anyone here is on a Keto or low-carb diet while on hormone blockers.

I have been on a low carb diet (@35g/day) and am in nutritional ketosis. I have been eating this way for 7 years now ever since a diagnosis of pre-diabetes because I wanted to halt/reverse the disease and not go on meds, which has worked. I have maintained perfect weight and blood glucose levels during this time.

There is lots of emerging research that Keto helps in the fight against cancer. Whether that is true or not, I want to continue to eat the same way I have been to maintain my health aside from cancer. I have just read, however, that impaired liver function is a contraindication for Keto as the ketones are produced by the liver and the liver produces more bile due to the higher fat macros of a Keto diet.

Since it seems that all the hormone blockers have a side effect of elevated liver enzymes and other liver side effects, I wonder if I will be able to stay on this diet.

Is there such a thing as a nutritional oncologist that I could bring in if my MO doesn't know or want to get into the nutritional aspects of my care? Unfortunately, many of the professionals I have seen think that Keto is some harmful fad, which when used correctly as a lifestyle modification it is not, it is incredibly healthy. I had horrible cholesterol, triglyceride and other levels. Now my bloodwork is perfect.

I don't know who I need to talk to about this (other than my MO).

typhoon

My MO's practice has nutritionists on staff. I was under the impression that it is pretty common for MOs to at least be able to recommend nutritionists, since chemo and other treatments can have side effects which require nutritional management. Why not ask the MO for some referrals/recommendations? If the MO can't help, then your nearest breast health center, or the hospital where you had your surgery, might be good resources.

macdebbie

Thanks for the info. I had been seeing the hospital dietician early on when we moved here. She doesn't believe in Keto at ALL...

I will check around though and ask my MO and maybe my endocrinologist, though when I told him I wanted to lower my carbs he said "Why?", lol so not too hopeful.

Low carb isn't very popular in the south, unfortunately....

Salamandra

I had gained a lot of weight before and after my cancer diagnosis and I went on keto to lose it (and did) while taking fareston. My docs were happy with my weight loss and didn't get into the details of it with me. I want to go back on strictly because I've been taking more and more 'breaks' and am not feeling good about it, plus am starting to regain. Sigh.

I think doctors want you to be a 'healthy weight' and are supportive of various efforts to *get* there, but don't seem to understand that you might have to *stay* on a diet to maintain that weight - which is very frustrating.

There's a couple of keto threads on these boards. I need to get back to it!

macdebbie

Hi Salamandra. Yes, low carb and Keto is not a diet (though some people use it that way) it is a lifestyle, especially for people like me that are pre-diabetic and don't want to be go on meds for the rest of their life.

I was told I it "wasn't sustainable" but I did it anyway, and here I am 7 years later. My cardiologist, endocrinologist and GI doc are all pretty amazed, especially when I told my GI doc my 40+ year struggle with IBS was over.

SpecialK

I think it is important to understand side effects labeling for all drugs tested/approved by the FDA, in that if even one person in the trial experiences a side effect it has to be included in the list. This obviously does not mean that everyone, or even most, have that side effect. There are some that are more common than others like insomnia or joint pain for anti-hormonals, but in my time here I have not seen many complain about an increase in liver function values. Not to say it doesn't or can't happen, but I don't think it is a given, or is common. I spent 7.5 years on either generic Arimidex (anastrazole) or Femara (letrozole), following six infusions of Taxotere/Carboplatin/Herceptin, and 11 more Herceptin while on anti-hormonals, and my liver function values were perfect despite those being liver filtered drugs. I would hazard a guess that your MO will tell you that you should keep doing what you are doing - because it is working for you - and that he/she will certainly monitor your liver function as you go along.

macdebbie

Thx SpecialK. I am looking at the Professional section of drugs.com for the side effects that list specific percentages.

Some of the hormone therapy drugs are better than others with regard to liver issues - Aromasin is the worse at over 10% occurrence. Anastazole and Tamoxifen are 1-10% and Letrozole is 0.1 - 1%.

Hopefully it won't be an issue.