Metabolic Check In

It’s been an eventful week here. I had my oncology follow-up earlier in the week, which any cancer patient knows can be nerve racking.  Coming into end of week, I had made my first podcast appearance to talk about my journey. More news to come when that hits the air!

As we talked before, cancer is a metabolic game. My blood work came back just as I had hoped to see. Both my kidney and liver results showed optimal function. I attribute a lot of that to dietary changes and the LMNT electrolytes I drink daily.  I was concerned that the electrolytes would impact my blood pressure, but I came in at 104/68 which was a relief. My glucose levels are down to an excellent fasting range which may be a result of the Berberine and apple cider vinegar. Albumin shows good protein status which is surprising given how hard it is to get enough protein in! My calcium levels have increased but are still in normal range, which can just be a sign of too much Vitamin D. I will have to monitor that on the next round of blood work and will try dialing back my supplement dosage. Sometimes that can be indicative of a thyroid issue but is also normally seen in cancer. Again, everything in the body is interconnected so it’s all about finding the balance. My BMI is down to 18% which I haven’t seen since my 20’s although I would like to put on 5-10 lbs over the coming months through muscle gain. I also continue to tolerate Tamoxifen well as far as shorter term side effects. In three months they will test my hormones to see if I am approach menopause. This will also align with my annual gynecologic exam to monitor for uterine thickening as Tamoxifen can increase risk of uterine cancer. Isn’t being a woman fun?

My research this week has taken me back to the MTHFR gene mutation discussion since I do carry a mutation myself. The MTHFR gene (methylenetetrahydrofolate reductase) is often discussed in relation to cancer risk because it plays a key role in folate metabolism, DNA synthesis, and methylation, all processes important for regulating cell growth and repair. Here’s a breakdown of that this gene does:

• MTHFR makes an enzyme involved in converting folate (vitamin B9) into active forms the body uses.
• It helps regulate homocysteine levels and supports methylation, a process that turns genes on/off and repairs DNA.
• Variants (or polymorphisms), most commonly C677T and A1298C, can reduce enzyme activity.

Research is mixed and often depends on cancer type, folate status, and environment, but it really is a nutrition and lifestyle consideration. Below are some nutritional & lifestyle considerations:

• Folate intake matters: People with MTHFR variants may benefit from adequate folate (from leafy greens, beans, fortified foods) or sometimes L-methylfolate supplements if recommended.
• B12, B6, and riboflavin are also important cofactors in the same metabolic pathway.
• Alcohol use can interact with folate metabolism and raise cancer risk in MTHFR carriers.
• Methylation patterns from MTHFR variants may interact with environmental exposures (smoking, diet, toxins).

Why does it matter to you?

• MTHFR helps regulate methylation → turns genes on/off. Abnormal methylation patterns can silence tumor suppressor genes or activate cancer-related genes.
• With lower MTHFR activity, DNA repair and synthesis may be impaired, especially if folate/B vitamin intake is low.
• This could contribute to genetic instability, a hallmark of cancer.

Specifically, the following considerations exist in regards to breast cancer.

• Low folate + MTHFR variant → higher breast cancer risk in some studies.
• Adequate folate may be protective.
• Alcohol depletes folate and increases risk further in women with MTHFR mutations.
• Some research suggests MTHFR variants may influence estrogen metabolism and treatment response, though this is still being studied.

If you have an MTHFR variant and breast cancer (or a family history), some things that may help lower risk or support treatment:

• Prioritize natural folate: dark leafy greens, beans, lentils, avocados, asparagus.
• Consider L-methylfolate (active form) instead of folic acid if supplementation is needed.
• Ensure adequate B12, B6, and riboflavin, which support the same pathway.
• Limit alcohol (especially important with MTHFR).
• Don’t smoke.
• Maintain healthy weight and exercise regularly.
• Some studies suggest MTHFR variants may influence chemotherapy toxicity (like methotrexate or 5-FU), but this is not yet standard testing for breast cancer treatment.

MTHFR variants alone don’t cause breast cancer, but in combination with low folate or certain lifestyle factors, they may modestly increase risk or influence outcomes. Supporting healthy methylation with diet and avoiding folate-depleting behaviors is important!