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For Patients & Caregivers
Flaxseed appears to be effective in reducing menopausal symptoms, but evidence of its ability to reduce cholesterol levels is mixed.
Flaxseed is a very concentrated source of phytoestrogenic compounds called lignans, which have hormone-like effects on the body (soybeans are another source of phytoestrogens). These lignans are likely the reason why flaxseed can affect menstrual cycle length and menopausal symptoms. It contains alpha-linolenic acid (ALA), a building block of omega-3 fatty acids. ALA has been shown to have numerous effects on the body including protecting the kidneys from damage. Results from clinical studies are mixed on flaxseed’s ability to reduce cholesterol. Other studies suggest it may help some aspects of diabetes or related conditions, especially along with other lifestyle modifications.
Flaxseed has also been shown to affect intracellular signals within the body that may play a role in breast and prostate cancer growth. Because flaxseed has phytoestrogenic effects, patients with estrogen receptor positive (ER+) breast cancer should use flaxseed with caution.
- Cancer prevention
Studies of postmenopausal women showed that flaxseed supplementation improved the ratio of hormones that are thought to help prevent breast cancer. Studies in animals have shown promising results, but human data are lacking.
- Diabetes and associated conditions
Some studies suggest supplementation with flaxseed may help some aspects of diabetes or related conditions, especially along with other lifestyle modifications.
- High cholesterol
Study results are mixed.
- Menopausal symptoms
A study showed flaxseed to be as effective as hormone replacement therapy in the management of menopausal symptoms.
One study indicated that flaxseed was not effective for mucositis.
- Periodontal disease
Flaxseed was shown ineffective against periodontal disease in a study.
- Allergic reactions
- Increase of the luteal phase of the menstrual cycle
- Increased bowel movement
- Anaphylaxis has been reported following intake of flaxseeds.
- Dietary flaxseed was shown to worsen dextran sodium sulfate-induced colonic injury and inflammation in mice.
For Healthcare Professionals
Flaxseed has been used in traditional medicine to treat coughs, colds, constipation, urinary tract infections, as a topical demulcent and as an emollient (1). It is rich in omega-3 fatty acids and phytoestrogenic lignans. Flaxseed was shown to have chemoprotective effects in postmenopausal women (2), conferred renoprotection in patients with lupus nephritis (3), and improved mild menopausal symptoms (11). Supplementation with a major lignan derived from flaxseed improved glycemic control in Type-2 diabetic patients (13), and a meta analysis showed significant reductions in blood pressure following supplementation with flaxseed products (34). In prediabetic patients, daily flaxseed powder also lowered blood pressure but did not improve insulin resistance or glycemic indices (35). In other studies, flaxseed supplementation plus lifestyle modification was more effective than lifestyle modification alone to manage metabolic syndrome (36) and non-alcoholic fatty liver disease (37). In hemodialysis patients, daily flaxseed oil consumption significantly reduced inflammatory markers related to cardiovascular disease (38). Although flaxseed-derived lignan reduces blood glucose levels in hypercholesterolemic individuals (14), data on the cholesterol-lowering effects of flaxseed are mixed (11) (15) (26).
Flaxseed supplementation may benefit women with polycystic ovarian syndrome by reducing androgen levels (23); a moderate reduction of estrogens and androgens was also seen in postmenopausal women (24). However, lignan supplementation was ineffective in reducing hot flashes in postmenopausal women with or without breast cancer (28). Flaxseed powder along with Vitex agnus may help to reduce cyclical mastalgia (39).
Flaxseed has been investigated for its anticancer potential. It was shown to inhibit the growth and metastasis of human breast cancer (6) (29), prostate cancer (7) and melanoma (8) in vitro and in mice. It also reduced radiation therapy-induced lung damage and improved survival (27). In other studies, flaxseed was shown to lower tumor biomarkers in men with prostate cancer (9) (25) and in patients with breast cancer (10), but a flaxseed extract was ineffective in preventing oral infection following radiation treatment for head and neck cancer (12).
Flaxseed ingestion can increase urinary lignan excretion (4) and the length of the luteal phase of the menstrual cycle (5).
Flaxseed is the most concentrated food source of the plant lignan, secoisolariciresinol, a precursor for enterolactone. It is thought that phytoestrogenic lignans contribute to the plant’s hormonal effects (4). Flaxseed has been shown to affect the length of the menstrual cycle in premenopausal women (5). It may also alter estrogen metabolism, increasing the ratio of 2-hydroxyestrogen to 16 alpha-hydroxyestrone in a dose dependent fashion (2). Flaxseed’s renoprotective effects are thought to be via high concentration of alpha-linolenic acid, an omega-3 fatty acid precursor (3) or through inhibition of angiogenesis, tyrosine protein kinases and cytokine-induced activation of transcription factors (16). The laxative effects of flaxseed are likely due to its fiber content (22).
In addition, flaxseed’s inhibition of growth of human breast cancer, and metastasis in mice is due in part to the down-regulation of insulin-like growth factor I and expression of epidermal growth factor receptor (6). Flaxseed was also shown to induce apoptosis by significantly upregulating p53 mRNA in breast cancer cell lines (29). In another study, flaxseed oil enhanced the effects of trastuzumab in reducing HER2 signaling via the Akt and mitogen-activated protein kinase (MAPK) pathways, resulting in reduction in cell proliferation and an increase in apoptosis (33).
The antiproliferative activity of flaxseed against prostate cancer in mice is attributed to its inhibition of cellular proliferation (7). The hormonal effects of flaxseed may also play a role in its ability to modulate prostate cancer biology and associated biomarkers (9), and lower serum lipid levels (10).
Common: Increased bowel movements (16), constipation and flatulence (9)
Anaphylaxis has been reported following ingestion of flaxseeds. (17) (30)
A case of false polyposis coli on double contrast barium enema (18), and an increase in the luteal phase of the menstrual cycle (5) were observed after flaxseed supplementation.
Dietary flaxseed was shown to exacerbate dextran sodium sulfate-induced colonic injury and inflammation in mice (31).