Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients.

Andrea Sechi, Stephano Cedirian, Tullio Brunetti, Federico Quadrelli, Fernanda Torres et al.

Review Nutrients 2025 2 citations

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Study Design

Type d'étude: Review

Intervention: Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients. None
Comparateur: Placebo
Direction de l'effet: Mixed
Risque de biais: Unclear

Abstract

Among the distressing side effects of cancer treatments, hair loss is one of the most disturbing for the quality of life and adherence to therapy in breast cancer patients. Many patients take nutritional supplements to prevent hair loss or enhance regrowth. Based on their mechanism and timing of use, nutritional supplements could be divided into safe, cautious, debated, and contraindicated categories. Non-contraindicated supplements generally include safe supplements like vitamin D, which is not known to interfere with cancer treatments. Those that are contraindicated include phytoestrogens and compounds affecting estrogen pathways because of the risk of stimulating tumor growth in cancers sensitive to estrogen. Antioxidants like tocotrienols and resveratrol are given judiciously because of potential interference with cancer therapies dependent on reactive oxygen species. Supplements debated, including nicotinamide, folate, and iron, pose a risk by promoting cellular proliferation or altering the tumor microenvironment. Biotin is nontoxic but interferes with blood test results and is thus difficult in cancer monitoring. Evidence regarding nutritional supplements' safety and efficacy in this context is conflicting. Management by an oncologist is required along with more studies to clearly establish the safety parameters and efficacy guidelines.

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Tables

Table 2

Supplement	First Author/Year	Study Type	Outcome of the Study
Vitamin D	Ooi et al. (2010) [23]	Original article	An association between vitamin D deficiency and both an increased risk of developing breast cancer and a tendency toward more aggressive disease phenotypes.
Tocotrienols	Nesaretnam et al. (2010) [18]	Original article: double-blind, placebo-controlled pilot trial	Combining tocotrienols with tamoxifen may improve breast-cancer-specific survival due to their growth-inhibitory effects.
Nicotinamide (Vitamin B3)	Ying et al. (2022) [24]	Original article: retrospective cohort study	The study found a significant link between higher niacin intake and reduced mortality among cancer patients, particularly in terms of cancer-specific survival.
Folate (Vitamin B9)	Kim et al. (2016) [25]	Original article: prospective study	High plasma folate concentrations (>24.4 ng/mL) might be associated with an increased risk of breast cancer.
Vitamin B12	Ambrosone et al. (2020) [26]	Original article: observational study	The use of vitamin B12 both before and during chemotherapy is significantly correlated with worse disease-free survival and overall survival.
Iron	Ambrosone et al. (2020) [26]	Original article: observational study	Supplementation with iron during and before various treatment schedules highly associates, in fact, with an increased risk of recurrence of breast cancer.
Zinc	Sullivan et al. (2021) [27]	Original article	Alterations in zinc homeostasis can contribute to onset and development of breast cancer.
Creatine	Zhang et al. (2021) [28]	Original research article	Creatine may promote the metastasis of breast and colorectal cancer through enhancing GATM activity and upregulating Snail and Slug that foster cell migration in orthotopic mouse models.
Omega-3 and Omega-6 Fatty Acids	Park et al. (2012) [29]	Original research article	The study provided evidence supporting the potential of omega-3 fatty acids to reduce the risk of breast cancer in Asian populations.
Omega-3 and Omega-6 Fatty Acids	Engeset et al. (2006) [30]	Original article	The study found no association between fish consumption or marine omega-3 fatty acid intake and the risk of breast cancer.
Pumpkin Seed Oil	Vundru et al. (2013) [31]	Original article; In vitro study	This study has shown its anticancer properties, including inducing apoptosis, inhibiting the proliferation of cancer cells, and modulating immune responses in breast cancer.
Whey Protein	Fraser et al. (2020) [32]	Original article: cohort studies	The study suggests the incidence of human breast cancer, which is more likely due to natural steroid hormones promoting mammary cell growth.
Curcumin	Wang et al. (2018) [33]	Original article; in vitro study	Curcumin-loaded solid lipid nanoparticles arrest the cell cycle at G1/S and reduce the expression of cyclin D1 and CDK4, leading to the strong induction of apoptosis and ROS production in vitro; specifically, they induce apoptosis by activating P53 and P21 proteins, which regulate the PI3K-AKT and NF-kB signaling pathways.
Probiotics	Linn et al. (2019) [34]	Randomized controlled trial	Supplementation of probiotics is an easy and effective way to reduce the incidence and severity of radiation-induced diarrhea.
Biotin (Vitamin B7)	Kabiri et al. (2021) [35]	Original article	Biotin interferences have been observed in immunoassays used to measure cancer markers, which could pose a significant obstacle for monitoring and follow-up in these patients.
Saw Palmetto	Hostanska et al. (2007) [36]	Original article; in vitro study	Saw palmetto demonstrates a dose-dependent inhibition of proliferation ER-positive breast cancer cell lines because it induces apoptosis.
Saw Palmetto	Baron et al. (2009) [37]	Original article: in vitro study	This study has shown that such effects of saw palmetto are more specific to prostate-lines cells, making the safety debated and to be explored in breast cancer patients.
Phytoestrogens	Alnefaie et al. (2024) [38]	Case–control study	In ER-positive breast cancers, phytoestrogens may exert a promoting action on the proliferation of cancer cells through either ERα or GPER signaling pathways.
Resveratrol	Huang et al. (2023) [39]	Review	Resveratrol interacts effectively with GPER, thereby providing possible therapeutic effects in the case of breast cancer.