The nutmeg verdict

Sindi-marie de Beer, a dietitian, expands on whether nutmeg interferes with hormone-positive breast cancer treatments. 

---

You can listen to this article below, or by using your favourite podcast player at pod.link/buddiesforlife

Exploring the potential interaction between nutmeg and hormone-positive breast cancer drugs reveals a scarcity of direct research. While numerous studies have investigated nutmeg’s effects on cancer, including breast cancer, limited literature addresses its specific impact on hormone-positive breast cancer treatments. However, before probing into this question, it’s essential to grasp the fundamentals.

All about nutmeg

Nutmeg, scientifically known as myristica fragrans, is an evergreen tree thriving in regions with rich soils and an average rainfall of 2000 – 3000mm/year. It yields two spices: nutmeg (seed of the fruit) and mace (red covering over the seed), with seeds requiring approximately three to six weeks of drying before use.

Rich in both macronutrients and micronutrients, nutmeg provides up to 1591.8 kJ/100g, including carbohydrates, fibre, proteins, fat-soluble vitamins A and E, and vitamin C. Additionally, it boasts essential minerals, such as copper, iron, magnesium, phosphorus, sodium, manganese, calcium, and zinc.¹

While not typically consumed in large quantities, nutmeg’s phytochemicals (plant-based bioactive compounds) offer significant health benefits, exhibiting antimicrobial, antifungal, antioxidant, antidepressant and anticancer properties.

Studies² have suggested nutmeg’s potential in inhibiting or reversing cancer progression in various types, including colon, breast, and skin cancer, by impeding tumour growth or cancer cell proliferation. However, it’s crucial to note that scientific evidence supporting nutmeg as a cancer cure or preventive measure is lacking. 

Concerning excessive consumption, culinary applications typically involve only a few milligrams, but ingesting several grams of nutmeg can result in poisoning, with symptoms like nausea, vomiting, and hallucinations attributed to the myristicin oil content.³ 

Hormone-positive breast cancer

Hormone-positive breast cancer refers to cancers with receptors responsive to female hormones like oestrogen and progesterone, representing approximately two out of three breast cancers. 

Treatment options, influenced by factors such as age, menopausal stage, and cancer stage, commonly include lumpectomy or mastectomy alongside adjuvant therapies like endocrine therapy, chemotherapy, and immunotherapy.⁴ 

Endocrine therapy, exemplified by tamoxifen, is pivotal in hormone-positive breast cancer treatment, blocking oestrogen formation and binding to oestrogen receptors to inhibit cancer growth. However, it’s important to consider drug-nutrient interactions, as certain nutrients may either enhance or diminish tamoxifen’s effectiveness.

While grapefruit, Seville oranges, curcumin (from turmeric), black cohosh, St. John’s Wort, and ginseng are generally advised against during tamoxifen therapy due to their impact on liver enzymes, the effects of nutmeg remain unclear in this context.

Indeed, other nutrients or foods such as chamomile, flaxseed, tangerine, and soya merit consideration regarding their potential interactions with breast cancer medications. However, controversies persist, and clarity is lacking on whether they should be entirely avoided. Studies suggest that these foods can be safely consumed as part of a normal diet if they were previously included. However, if they were not part of your regular diet or if there is personal aversion, there’s no imperative to introduce or increase consumption.

These nutrients and foods have been shown to hinder liver enzymes responsible for converting tamoxifen into its active form. By competing with tamoxifen for these liver enzymes, these foods may potentially reduce the effectiveness of tamoxifen, rendering it less potent in treating hormone-positive breast cancer.

Ask your healthcare team

It’s crucial to consult your healthcare team of professionals, including doctors and dietitians, before incorporating herbal medications or supplements into your regimen. Supplements may pose risks and interact with medications, underscoring the necessity of expert guidance.⁵ 

In conclusion, further research is warranted to elucidate the effects of nutmeg on hormone-positive breast cancer drugs. 

Patients should exercise caution and seek professional advice when considering the use of herbal supplements alongside conventional treatments.

---

References

1. Okiki, P. A. et al., 2023. Assessment of nutritional and medicinal properties of nutmeg. Scientific African, Volume 19. 
2. Muhammad Tauseef Sultan, et al., 2023. Nutritional and therapeutic potential of nutmeg (Myristica fragrans): A concurrent review. Cogent Food & Agriculture, 10 October.Volume 9.
3. Gupta, R., Azhar, M. & Kalam, M. A., 2022. An overiew of Myristica fragrans(Nutmeg)- Its benefits and adverse effects to Humans. Indian Journal Integrated Medicine , 2(2), pp. 35-40.
4. Trayes, K. P. & Cokenakes, S. E., 2021. Breast Cancer Treatment. American Academy of Family Physicians, 104(2), pp. 171-178.
5. Anon., 2021. O Wise. [Online] Tamoxifen: What you should avoid.
   Available at: https://owise.uk/tamoxifen-what-you-should-avoid/
6. Harrigan M, McGowan C, Hood A, Ferrucci LM, Nguyen T, Cartmel B, Li FY, Irwin ML, Sanft T. Dietary Supplement Use and Interactions with Tamoxifen and Aromatase Inhibitors in Breast Cancer Survivors Enrolled in Lifestyle Interventions. Nutrients. 2021 Oct 22;13(11):3730. doi: 10.3390/nu13113730. PMID: 34835986; PMCID: PMC8621720.

Header image by Freepik