Folic Acid
Folic acid or
folate is a key nutrient involved
in the production of cellular DNA.
A deficiency in folic acid causes
abnormalities in the structure of
new DNA. These
abnormalities in the DNA can
increase the cells susceptibility
to viruses and carcinogens (cancer
causing agents). Folic acid
deficiency also causes specific
cervical cell changes, termed megaloblastic changes, that make
the cells larger and ‘puffier'
than they should be. This
growth causes
a fragile cell membrane and
increased susceptibility to
viruses and carcinogens. [11] Folic acid deficiency is
more significant in women who
smoke, who are pregnant, and who
take oral contraceptives (birth
control pills). [12]
Although cervical cell changes may
still occur when the blood levels
of folic acid or folate are
measured to be in the normal
range, there is a far greater risk
for change when a deficiency is
present.
One study found
that supplementation with folic
acid for 3 months caused
the regression of cervical dysplasia
in women who were taking oral
contraceptives. [13]
Another study found that folic
acid supplementation was
correlated with a decreased risk
of developing cervical cancer from
low grade SIL (LSIL). [14]
Other studies have found that low folate in
blood serum and red blood
cell to be associated with an
increase risk for developing
cervical cancer. [15]
The overall treatment with
supplementary folic acid
causes a regression rate between
20-100%, depending on the grade of dysplasia.
This statistic is compared with a
regression rate of 1.3% with no
treatment for mild dysplasia only.[16]
Beta-carotene and
Vitamin A
Beta-carotene is a
well-known anti-oxidant, which
harnesses certain immune
stimulating properties. It
is equally vital for the integrity
of certain cellular structures,
most notably, epithelial
cells. Vitamin A also
exhibits certain anti-viral
properties. Interestingly, women with
cervical dysplasia were found to
have a 4.5 times lower serum
concentration of retinoids
(Vitamin A), than women not
suffering from this condition. Studies have also
found that there is an increased
risk for developing cervical dysplasia when plasma carotenoids
are low. [17]
Topical application
of all-trans-retinoic acid
(Vitamin A) was shown to induce
regression of CIN II. [18]
Though most studies using
beta-carotene as a treatment have
not had significant results,
supplementation is recommended, because low serum beta carotene
has been linked to a 3-fold
increase of risk for developing
severe dysplasia. 38% of
cervical dysplasia patients have low serum
beta-carotene, which directly correlates with
the severity of disease. [19]
Indole-3-carbinol
Indole-3-carbinol
is a nutrient found in foods,
specifically vegetables such as
cabbage, kale, broccoli, and
brussel sprouts. It has the
potential to prevent and treat
cancer, especially those that may
be related to estrogen. Its
primary mechanism is to improve
estrogen metabolism via the liver.
Women with moderate and severe dysplasia have been found to have
an abnormality in the metabolic
pathway for estrogen. [20]
In a particular double-blind
study, supplementation with
indole-3-carbinol for 12 weeks induced
a complete regression in
nearly 50% of cervical dysplasia cases,
as compared to 0%
in the placebo group. [21]
Anti-oxidants
Low anti-oxidant
status has been linked to the
development of precancerous and
cancerous cells. It has not always
been fully understood which came first; the deficiency of anti-oxidants
causing susceptibility, or the
abnormality that uses up the
available anti-oxidants in an
attempt to decrease severity of
disease. Anti-oxidants are key in
the fight against reactive oxygen
species (ROS) and free radical
damage. If anti-oxidants are low,
then the DNA is at risk for damage
by free radicals as is the outer
membrane of the cell.
In one study, patients with confirmed dysplasia
were found to have lower levels of
serum CoQ10 and Vitamin E. [22]
Another study found an increased
risk of cervical dysplasia to be
associated with low levels of
Vitamin C, Vitamin E, and
beta-carotenes. [23]
