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Old 09-08-2007, 10:51 AM   #1
anitab
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Thyroid function in postmenopausal breast cancer patients treated with tamoxifen

Anker GB, Lønning PE, Aakvaag A, Lien EA. Thyroid function in postmenopausal
breast cancer patients treated with tamoxifen. Scand J Clin Lab
Invest 1998; 58: 103–107.


Thyroid function was evaluated in 26 postmenopausal women with breast cancer
before and at various time intervals during treatment with tamoxifen. Tamoxifen
treatment suppressed plasma levels of FT3 and FT4 (p<0.005 for both) and
elevated plasma concentrations of TBG (p<0.005) and TG (p<0.025). In
general, these changes became significant after 6 months of treatment. Plasma
TSH increased significantly after 1 y of treatment (p<0.025). A fall in FT4 and
FT3 combined with increase in TSH suggests a reduced bioavailability of T4
and T3 during tamoxifen treatment. The increase in TG may reflect a reduced
synthesis or liberation of T4 resulting in a reduced plasma level of FT4. Our
findings suggest that tamoxifen influences the thyroid hormone levels, not only
by modulating plasma TBG, but also by interfering with hormone synthesis or
secretion in the thyroid gland.

This is the abstract from a small study. I don't have the link, unfortunately.

Anita
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Old 09-08-2007, 02:48 PM   #2
rentrac
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The thyroid gland is a touchy little thing. It's notorious for getting easily stressed during acute illnesses, and it can take a while to recover. At least somebody looked at the effect of Tamoxifen on the gland, because long term effects of a drug on the thyroid function are not always done or published. Having had my own run-ins with this gland over the years, I'm convinced the very best way to deal with any thyroid condition during cancer treatment is with an endocrinologist, as that's the specialty that truly knows how to manage it.
Here's to normal TSH for all,
Rentrac
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Oct. 2003: Dx age 48, Stage IIIA Ductal Ca. dense dose neoadjuvent AC. BrCa 1&2 -, ER+, PR-, Her2+. 2004: R mastectomy, 3+ nodes, dense doseTaxotere ( allergic), total hysterectomy, radiationx36 . Tamoxifen x6 mo., Arimidex x9 mo. Jan. '06: Multi left metastatic nodes left neck. Stage IV. Taxol, Carboplatin (allergic to both), Herceptin, radiationx27. Herceptin cont'd. 1 mediastinal met in old rad field. April: 2 brain mets - Rcerebellar, Ltemporal lobe. Gammaknife. Stop Herceptin, Start Tykerb. May: CyberKnife-mediastinal node, Zometa restart. July: New RLung mets. Xeloda add. Jan. 2008: CT: Lung mets shrinking. Fatty liver w/increased liver function panel. Feb '08: MRI: brain mets back, 2nd GammaKnife. June: Migraine headaches from cerebellar tumor. Team for WBR - Choose Craniotomy on Cerebellum only. Aug: Crainiotomy successful. Sept: PET -right lung apex clean; left internal mammary artery appears malignant. Herceptin in future. Left mastectomy?
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Old 09-09-2007, 10:18 AM   #3
Hopeful
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I am wondering if this effect is Tamoxifen specific, or would also be the result of "natural" SERMS like flaxseed that some of us use in our diets? I had elevated TSH results prior to dx when I was taking flaxseed tablets, which I stopped prior to dx. I had my thyroid retested following radiation therapy, and all results were normal.

Hopeful
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Old 09-09-2007, 10:31 AM   #4
dhealey
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I had an elevated TSH about 6 months prior to my bc diagnosis and was put on synthroid. I did some research when I was diagnosis about the affects of tamoxifen on the thyroid before I ment my oncologist and I was dead set against taking it because of what I had read in my research. I told the oncologist about this and she kind of brushed it off and wanted to start me on tamoxifen after my chemo treatments, but blood test revealed I had been through menopause so I was started on arimidex instead have now switched to aromesin instead due to severe joint pain. I had allready decided I wasn't going to take the tamoxifen anyway because of it's effects on the thryoid since mine was already out of wack.

Rentrac what part of North Carolina are you from? I live in Lexington. Good to know a breast cancer sister in my state.
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Diag 10/2006-high grade invasive ductal carcinoma- mastectomy L breast
2.5 cm tumor ER/PR pos-Her2+++
4 rounds A/C, 4 rounds Taxol
Herceptin every 3 weeks until Jan. 2008
6/18/07 prophylatic mastectomy R breast
8/2007 started aromasin/stopped arimidex (side effects)
12/07 stopped aromasin due to side effects (now what?)
Finished herceptin 1/8/08
started tamoxifen for 2 years then will switch to femera
allergic to tamoxifen started femera 4/2008
June 20, 2008 portacath removed
Learnig to live life to the fullest!
Stopped Femera due to side effects
July 28, 2008 start trial for breast cancer vaccine
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Old 09-09-2007, 12:46 PM   #5
rentrac
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Talking

I live in Blounts Creek, but I'm only half flat-lander as my dad's family is from the Brushy Mountains - Lenoir, Wilkesboro, etc. I even used to live in the village of Grover - a spot in the road where I-85 crosses from NC to SC. Amazing how many of us Carolinians there are on this site - I prefer to think of it as our being smart and having good taste rather than too many of us in this kettle of fish!
Rentrac
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Oct. 2003: Dx age 48, Stage IIIA Ductal Ca. dense dose neoadjuvent AC. BrCa 1&2 -, ER+, PR-, Her2+. 2004: R mastectomy, 3+ nodes, dense doseTaxotere ( allergic), total hysterectomy, radiationx36 . Tamoxifen x6 mo., Arimidex x9 mo. Jan. '06: Multi left metastatic nodes left neck. Stage IV. Taxol, Carboplatin (allergic to both), Herceptin, radiationx27. Herceptin cont'd. 1 mediastinal met in old rad field. April: 2 brain mets - Rcerebellar, Ltemporal lobe. Gammaknife. Stop Herceptin, Start Tykerb. May: CyberKnife-mediastinal node, Zometa restart. July: New RLung mets. Xeloda add. Jan. 2008: CT: Lung mets shrinking. Fatty liver w/increased liver function panel. Feb '08: MRI: brain mets back, 2nd GammaKnife. June: Migraine headaches from cerebellar tumor. Team for WBR - Choose Craniotomy on Cerebellum only. Aug: Crainiotomy successful. Sept: PET -right lung apex clean; left internal mammary artery appears malignant. Herceptin in future. Left mastectomy?
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Old 09-09-2007, 01:34 PM   #6
Lani
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I haven't had time to access the article yet but I wonder

how many of those patients had radiation therapy also--which perhaps can affect the thyroid gland and, thus, how much was the effect of the tamoxifen alone and how much might have been due to the radiation therapy or the combination of the two...

Just food for thought
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Old 09-09-2007, 11:09 PM   #7
Joanne S
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The link is

http://www.ingentaconnect.com/conten...00002/art00002
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Aug06...Dx Age 50, IDC Left Breast, 6+/16 lymph nodes, Stg 3, ER+/PR+/HER2+
Sep06-Jan07...Mediport. Chemo: AC x 4, T x 4
Dec06-Nov07...Herceptin
Feb12,2007...Surg MRM Left & SM Right, reconstruct w/expanders
Mar07-Jun07...Saline Exp
Jun07...Start Tamoxifen
Jun07-Aug07...Rad x 25
Jun07-Oct07...Persistent fevers-unknown origin
Jun07-Nov07...PT for Severe PMPS & Capsular Contracture
Nov07...Surg Capsulectomy, Gel Implants, PMPS pain gone instantly.
Feb08...NED 1st CANCERVERSARY!!!!!
Feb08...2 months post surgery Caps Cont again :(
Mar08...Stop Tamoxifen. Start Arimidex.
Apr08...Sudden high fever, Hosp ICU 10 days, staph infect, emerg surg, implants removed. Outpt IVantibiotics Daily x 6 weeks
Feb11...NED 5th CANCERVERSARY!!!!!
Feb12...NED 6th CANCERVERSARY!!!!!
Aug12...Spotting. Surg=D&C
Sep12...STAGE IV = RARE BC METS TO UTERUS ILC ER+/PR+/HER2-Negative) (Different BC than originally diagnosed = IDC ER+/PR+/HER2+).
Sep12...Stop Arimidex. Start Afinitor & Aromasin.
Jan13...MRI = no progression no reduction
Apr13...Progression. Stop Afinitor & Aromasin.
Apr13...Start Chemo: Taxol & Carboplatin.
Nov13...Scans & Pelvic 95+% Reduction. Nueropathy>Stop chemo start Fareston.
Jan14...PET scan = no progression stable.
May14...Pelvic > Bleeding & cramps. TMs up.
May14...PET scan = uterine progression :(
May14...Stop Fareston. Start Chemo: Xeloda.



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Old 09-09-2007, 11:21 PM   #8
Joanne S
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Location: Detroit Metropolitan Area, Michigan
Posts: 592
Topic: Breast Cancer, Tamoxifen, Thyroid & Weight Loss
I found another link on this subject:

http://thyroid.about.com/library/derry/bl1a.htm
__________________
Aug06...Dx Age 50, IDC Left Breast, 6+/16 lymph nodes, Stg 3, ER+/PR+/HER2+
Sep06-Jan07...Mediport. Chemo: AC x 4, T x 4
Dec06-Nov07...Herceptin
Feb12,2007...Surg MRM Left & SM Right, reconstruct w/expanders
Mar07-Jun07...Saline Exp
Jun07...Start Tamoxifen
Jun07-Aug07...Rad x 25
Jun07-Oct07...Persistent fevers-unknown origin
Jun07-Nov07...PT for Severe PMPS & Capsular Contracture
Nov07...Surg Capsulectomy, Gel Implants, PMPS pain gone instantly.
Feb08...NED 1st CANCERVERSARY!!!!!
Feb08...2 months post surgery Caps Cont again :(
Mar08...Stop Tamoxifen. Start Arimidex.
Apr08...Sudden high fever, Hosp ICU 10 days, staph infect, emerg surg, implants removed. Outpt IVantibiotics Daily x 6 weeks
Feb11...NED 5th CANCERVERSARY!!!!!
Feb12...NED 6th CANCERVERSARY!!!!!
Aug12...Spotting. Surg=D&C
Sep12...STAGE IV = RARE BC METS TO UTERUS ILC ER+/PR+/HER2-Negative) (Different BC than originally diagnosed = IDC ER+/PR+/HER2+).
Sep12...Stop Arimidex. Start Afinitor & Aromasin.
Jan13...MRI = no progression no reduction
Apr13...Progression. Stop Afinitor & Aromasin.
Apr13...Start Chemo: Taxol & Carboplatin.
Nov13...Scans & Pelvic 95+% Reduction. Nueropathy>Stop chemo start Fareston.
Jan14...PET scan = no progression stable.
May14...Pelvic > Bleeding & cramps. TMs up.
May14...PET scan = uterine progression :(
May14...Stop Fareston. Start Chemo: Xeloda.



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Old 09-10-2007, 07:12 PM   #9
mom22girlz
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questions

Thank you for this thread. I am struggling with this issue and my doctors. My onc says NO WAY does tamoxifen cause weight gain in any way. I have gained 17 lbs since I started tamoxifen. (about 18 mo.) I have been taking thyroid meds for about 2 mo now with no effect on my weight. I don't really know what to do. When does the extra weight start to affect the chance of reoccurance if you are estrogen positive? Thanks for any input. susan
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