Arimidex is a medication commonly prescribed for post-menopausal women with hormone receptor positive breast cancer.
This medication works by decreasing the amount of estrogen the body makes to slow or stop the growth of estrogen sensitive breast cancer cells.
One of the side effects of Arimidex is that it may cause or worsen osteoporosis. Believe it or not, estrogen plays a role in bone repair and formation. Decreased estrogen can lead to bone thinning and weakening.
It is natural for women to experience bone loss starting at menopause due to a drop in estrogen. Adding Arimidex to the picture only heightens this effect.
So if you are a woman taking Arimidex, lets be proactive about your health and explore the things you can do to help strengthen your bones.
Calcium is the poster child of bone health. Ninety-nine percent of calcium in the body is stored in our bones and teeth. The remaining 1% is floating around the body performing other important functions. If we don’t get enough calcium in our diet, our body will actually take it from our bones.
The RDA (recommended dietary allowance) for calcium is 1,200 mg per day for females 51 and up.
You may be wondering if it is possible to meet the recommended calcium requirements if you don’t consume a lot of animal products. Dairy products are definitely a good source of calcium but it is not necessary you consume them to meet your calcium needs.
Calcium is found in a lot of plant foods too. See the list below: (for comparison, and 8 oz glass of cow’s milk=300 mg calcium)
- Collard Greens, 1 cup cooked = 400 mg
- Calcium Fortified Plant Milks, 1 cup= 200-300 mg
- Turnip Greens, 1 cup cooked= 249 mg
- Kale, 1 cup cooked= 179 mg
- Okra, 1 cup cooked= 172 mg
- Bok Choy, 1 cup cooked= 158 mg
- Tahini, 2 Tbs= 128 mg
- Broccoli, 1 cup cooked= 94 mg
- Almonds, 1/4 cup= 89 mg
- Almond butter, 2 Tbs= 86 mg
- Cooked Beans (black, great northern), 1/2 cup= 50 mg
The body is able absorb calcium from green leafy vegetables very well, if not better than dairy products. However, some green leafy vegetables are high in compounds called oxalates which bind calcium and decreases its absorption. These vegetables include swiss chard, spinach, and beet greens. Therefore, they are not considered good sources of calcium, but don’t write them off! They are still very healthy foods to consume!
We also need to be cautious of things that can speed up calcium loss. High intakes of sodium and animal protein can both lead to increased calcium loss (this is usually by way of urine).
Excessive dietary fiber may also interfere with calcium absorption but this interference is thought to be very small. Vegans who consume >50 grams of fiber per day are those most likely at risk.
If you are concerned you may not be meeting their calcium needs, calcium supplements are available. Calcium citrate supplements are thought to be better absorbed than calcium carbonate. Absorption of calcium is most efficient in doses less than or equal to 500 mg. So if you are taking 1000 mg per day, you would get the most benefit by taking 500mg at two different times during the day.
If you are considering taking a supplement, it is best to talk to your health care provider. For tips on selecting a good supplement read a recent post of mine here.
Although adequate calcium intake is very important, it is not enough to slow post-menopausal bone loss alone. There are many other diet and lifestyle factors that play a role.
Other Dietary Factors
A high alcohol intake increases risk of osteoporosis. The reason is not well known but it is thought that alcohol may interfere with calcium absorption. Alcohol intake is also correlated with breast cancer, so it is a good idea to avoid it all together.
Excessive caffeine also leads to decreased bone mineral density. One cup of coffee per day is considered an acceptable amount.
Adequate vitamin D is essential for bone health because it helps the body absorb calcium. Vitamin D can be made in the body when the sun contacts the skin. It is also found in some foods. For more information on vitamin D, read here.
Regular exercise helps strengthen bones and slow bone loss. Weight bearing exercise and resistance training are most helpful for bone health. Examples of weight bearing exercise include running, jogging, jumping, dancing, and stairs. Resistance training would be a weight lifting program.
Smoking tobacco increases bone loss.
What To Do Now
We know that Arimidex promotes thinning and weakening of bones. In the article above, I talked about several things you can do to promote bone health. Lets breakdown the information into actionable steps to get you on the right track:
- Stop smoking if you are smoking
- Avoid alcohol
- Avoid highly salted processed foods
- Cut down on animal products
- Eat high calcium vegetables from the list above regularly
- Consult with your health care provider if you think you may need a calcium supplement
- Get out in the sun
- Get consistent amounts of weight bearing exercise
- Don’t over do it on the caffeine
PubMed Health: Anastrozole
Mayo Clinic: Osteoporosis
Vegetarian Resource Group: Calcium in the Vegan Diet
Vegetarian Nutrition Practice Group: Meeting Calcium Recommendations On A Vegan Diet
National Institutes of Health Dietary Fact Sheet on Calcium
Institute of Medicine DRIs for Calcium and Vitamin D
“Food, Nutrition, and Diet Therapy”; Sylvia Escott-Stump and Kathleen Mahan; 2004.
photo by: katerha