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Boron

Nutrient Name: Boron
Synonyms: Boron chelates—boron aspartate, boron citrate, and boron glycinate; sodium borate.
Elemental Symbol: B.
Related Substance: Borax, boric acid.

Summary Table
nutrient description

Chemistry and Form

Boron, the fifth chemical element, is a nonmetallic mineral present in the human body in trace amounts. In nature, boron is most prevalent as borax , which is a mixture of boron, sodium, and oxygen.

Physiology and Function

Boron is involved in the metabolic functions of many key nutrients, including calcium, copper, magnesium, phosphorus, potassium, and vitamin D. Although essential for plants, controversy remains unresolved as to whether boron is an essential nutrient for humans. Knowledge is incomplete as to the mechanism of absorption from the gastrointestinal tract, but it is known that dietary boron is rapidly absorbed. Boron is distributed throughout the body tissues, with the highest concentrations found in bones, dental enamel, spleen, and thyroid gland. Boron is primarily excreted in the urine, with bile, sweat, and breath serving as secondary routes of elimination.

The available streams of research have yet to coalesce into a comprehensive understanding of this nutrient's functions and relationships. Conventional research usually focuses on boron's particularly strong affinity for bone and joint tissue, where it influences composition, structure, and strength. However, a broader interpretation of the body of scientific evidence from animal and human studies indicates that boron acts as an essential ally of other substances in fine-tuning many human physiological interactions. Thus, boron exerts much of its influence by playing an integrative role in the areas of bone metabolism, joint health, mental acuity, wound healing, and proper functioning of the endocrine system. 1 Boron plays a major role in cell membrane functions, where it affects response to hormones (e.g., estrogen, vitamin D) that are involved in bone turnover and through its influence on transmembrane signaling or transmembrane movement of regulatory ions (e.g., calcium, magnesium). Boron participates in many aspects of the regulation of metabolism. For example, it lowers blood glucose levels in vitamin D deficiency states through its interaction with compounds having hydroxyl groups; it exhibits estrogen-mimetic activity; it appears to participate in regulating the respiratory burst of neutrophils; and it affects the activity of certain enzymes. Boron also plays an important but as-yet not fully elucidated role in cognitive and psychomotor functions.

The relationship between boron and calcium appears to be especially important, with increased boron levels associated with increased absorption of calcium, magnesium, and phosphorus and reduced urinary excretion of minerals, notably calcium. Boron facilitates metabolism of magnesium, copper, and potassium. It facilitates hydroxylation reactions to participate in the activation of vitamin D and to affect human steroid hormone levels and synthesis of estrogens and testosterone. Thus, increased boron intake may enhance both calcium absorption and serum levels of endogenous estradiol and testosterone. These multiple actions suggest that boron plays a key role in calcium and magnesium homeostasis, promotes bone mineralization, and mitigates bone loss, thus reducing the risk of osteoporosis. However, as with most nutrients, this effect is most significant in individuals with inadequate dietary intake of relevant minerals, with deficient magnesium intake being critical to variability in the activity of boron.

nutrient in clinical practice

Known or Potential Therapeutic Uses

Consistent but limited evidence suggests that supplemental boron may be beneficial in supporting bone health and treating skeletal degeneration. In particular, preliminary evidence indicates that boron exerts beneficial effects on calcium metabolism and bone demineralization in postmenopausal women by reducing calcium loss (through excretion in the urine). 2,3Findings from a double-blind, placebo-controlled pilot study involving 20 subjects with osteoarthritis demonstrated a significant favorable response to supplementation with 6 mg boron per day; 50% of subjects receiving the nutrient improved, compared with only 10% receiving placebo. 4 However, strong evidence is lacking from clinical trials to confirm boron's efficacy in preventing or treating osteoarthritis. Emerging epidemiological data and experimental research support the use of boron in prevention and treatment of prostate cancer. 1,5,6

Some commentators have voiced the recommendation that food sources may be safer than supplements and therefore preferable. Nevertheless, health care professionals trained and experienced in nutritional therapies generally administer boron within the context of a comprehensive strategy including calcium, vitamin D, magnesium, and trace minerals such as zinc, copper, and manganese. Principles of judicious clinical management suggest that laboratory assessment of boron levels to elicit deficiency status may be valuable.

Historical/Ethnomedicine Precedent

Boron has not been used historically as an isolated nutrient.

Possible Uses

Osteoarthritis, osteoporosis, prostate cancer, rheumatoid arthritis.

Deficiency Symptoms

Consensus is lacking on specific signs and symptoms of boron deficiency. However, observed effects of boron depletion include increased urinary loss of calcium and magnesium and increased rate of bone demineralization. Epidemiological evidence from geographic areas with low soil boron reveals an inverse relationship between the dietary intake of boron and the incidence of arthritis. In areas of the world where daily boron intakes usually are 1.0 mg or less, the estimated incidence of arthritis ranges from 20% to 70%, whereas in areas of the world where boron intakes are usually 3 to 10 mg, the estimated incidence of arthritis ranges from 0% to 10%. Therefore, patients living in such areas should be especially informed regarding this factor, and the same approach applies to other elements, significantly influenced by locale, such as selenium and vitamin D.

Dietary Sources

Raisins, prunes, dates, almonds, hazelnuts, and peanuts are the richest sources of boron. Significant amounts are available in most leafy vegetables, noncitrus fruits, and legumes, as well as beer, wine, and cider. However, the actual amounts of boron in plant sources will vary widely, depending on boron levels in the soil in which the food is grown. Meat, fish, and poultry provide minimal amounts of boron.

Dosage Forms Available

Capsule, liquid, tablet.

Source Materials for Nutrient Preparations

Sodium borate is the simple sodium salt of boric acid. Chelates are produced by reacting boron compounds with various organic and amino acids.

Dosage Range

Adult

  • Dietary:   No dietary or nutritional requirement for boron has been established. Average adult boron intake in the United States has been estimated at 1 mg per day. 7 Rainey and Nyquist 8 confirmed this in a six-nation comparison of dietary boron conducted during the 1990s for the World Health Organization. They found that U.S. adults consumed, on average, slightly more than 1 mg daily, approximately 7% to 10% less than average boron intake levels of individuals in Britain and Egypt and 32% to 41% less than Germans, Kenyans, and Mexicans. Individuals who eat healthy amounts of fruits and vegetables, nuts, and legumes will generally have a boron intake in the range of 2 to 6 mg per day. 9
  • Supplemental/Maintenance:   The optimal dose of boron for proper physiological function and prevention of osteoporosis appears to be 3 to 6 mg per day.
  • Pharmacological/Therapeutic:   Pharmacological doses used in clinical studies range from less than 1 mg up to 12 mg per day. Administration of 3 mg three times daily constitutes a typical therapeutic dose in the treatment of arthritis. A trial period of 2 to 4 months is usually indicated. Individuals being treated for rheumatoid arthritis will generally report symptom amelioration within 4 weeks of beginning boron supplementation. 10
  • Toxic:   The potential lethal dose for adults is estimated at 15 to 20 g per day 11 ; 150 mg per liter of water represents a toxic concentration of boron.

Pediatric (<18 Years)

  • Dietary:   No minimal dietary requirement established specifically for infants and children.

  • Supplemental/Maintenance:   Not currently recommended for children.

  • Pharmacological/Therapeutic:   Reports based on clinical observations indicate that children with juvenile arthritis (Still's disease) may improve in 2 to 3 weeks with administration of 6 to 9 mg boron daily. 10

Toxic: No toxic dosage level established specifically for infants and children.

Laboratory Values

Deoxypyridinoline (D-ppd), and to a lesser degree pyridinium (Pyd), can provide a noninvasive evaluation of the biochemical markers of bone loss and assessment of bone resorption, which may be affected by multiple factors, including boron status.

Blood levels and hair analysis may also provide useful data in establishing boron status.

safety profile

Overview

Boron is generally considered relatively nontoxic for most individuals at usual supplemental doses, which are approximately equivalent to typical dietary intake levels. Adverse effects such as nausea and vomiting are only associated with doses 50 times the upper level of the recommended range.

Nutrient Adverse Effects

General Adverse Effects

Accidental acute exposure to high levels of boron (e.g., oral doses >100 mg/day) can cause disturbances in appetite and digestion, nausea, vomiting, abdominal pain, diarrhea, dermatitis, convulsions, fatigue, and other symptoms; fatality is rare but has been reported. 12 The most frequently cited case involved a reported suicide where boric acid was ingested. 13

Chronic exposures may be responsible for some toxic symptomatology. However, the daily dosage levels of 1 to 3 mg provided by most supplements containing boron have not been linked with toxicity in most reports. Areas with dietary boron intake of up to 41 mg/day have not produced associated patterns of adverse medical or health outcomes.

Adverse Effects Among Specific Populations

In one clinical trial, some menopausal women reported aggravations of hot flashes and night sweats with supplemental boron intake; others experienced amelioration of such symptoms. 14

Pregnancy and Nursing

Qualified reports of adverse effects during pregnancy or nursing are lacking. However, the lack of clinical data from human trials or reports does not provide adequate evidence to confirm safety of boron during pregnancy and breastfeeding.

Infants and Children

Children exposed to boron-containing dusting powders and lotions, particularly containing borax or boric acid, constitute a high proportion of reports of toxicity. Irritation is common when such substances are applied to broken skin and mucous membranes. External boron-related preparations are generally best avoided.

Contraindications

Prudence suggests that supplemental boron be avoided during pregnancy because of potential effects on estrogen metabolism.

Precautions and Warnings

Newnham 10 has cautioned that individuals being treated for rheumatoid arthritis may experience an aggravation of symptoms (Herxheimer response) during the initial 1 to 3 weeks.

The increase in estrogen associated with elevated boron intake indicated by some preliminary research could theoretically increase the risk of several cancers. Nevertheless, no epidemiological evidence has confirmed an increased risk of cancer in areas of the world where dietary boron intake is high. Out of caution, some physicians have recommended that supplemental boron intake be limited to a maximum of 1 mg/day. Boron intake through regular consumption of fruits, vegetables, nuts, and legumes will generally exceed 1 mg/day and can provide a risk-free method for enhancing boron levels. Menopausal women experiencing increased hot flashes or night sweats might consider discontinuation of supplemental boron to determine whether the severity of their symptoms is reduced.

interactions review

Strategic Considerations

The effects of boron on calcium metabolism and steroid hormone activity form the basis for the known and other potential therapeutic activity and related interactions. In particular, the probable interaction between boron and estrogen (as well as testosterone) may exemplify a bimodal interaction pattern. Boron's direct role in bone health and various effects on calcium, other minerals, and vitamin D provide its primary value (and common use) in preventing and treating osteoporosis and osteoarthritis.

Boron's potential ability to enhance estrogen (and possibly testosterone) could be therapeutically efficacious in supporting bone and joint health and preventing bone loss. However, concern has been raised as to potential risk of excessive estrogen response, especially in the context of hormone replacement therapy (HRT), which has already been associated with increased risk of breast and uterine cancer, as well as increased risk of dementia and thrombosis. Although long-term use of estrogen and progestin in combination does appear to lower a woman's overall risk for colon tumors, researchers say HRT users who do develop colon cancer are less likely to have it detected at an early stage, when it is most treatable. The coadministration of boron and estrogen support therapies could provide a valuable strategic synergy in the preventing bone loss and treating osteoporosis. Clinicians working to enhance the effects of estrogen are advised to monitor any changes in hormone status related to coadministration of boron. Conversely, restriction of boron intake could conceivably play a supportive role in therapeutic strategies aimed at limiting or reducing estrogen levels, such as in the prevention or treatment of estrogen-sensitive breast cancer. Boron supplementation might also prove useful in situations of hormone blockade and chemotherapy-induced osteoporosis, common in treatment of breast and prostate cancer, although careful clinical trials would be necessary to ensure that any increase in hormone levels induced by boron would be adequately offset by boron's apparent chemoprevention properties.

Evidence from in vitro, animal, and human studies indicates that boron can inhibit enzymes such as serine proteases, notably prostate-specific antigen (PSA). In a prostate cancer mouse model employing the LNCaP human prostate cancer cell line, boric acid has been found to decrease PSA by 87%, reduce tumor size, and lower tumor expression of insulin-like growth factor-1 (IGF-1), a tumor trophic factor. 15-18As previously noted, dietary boron intake is strongly associated with reduced risk of prostate cancer. 6,8,19Strum 1 has cited boron's known ability to inhibit cyclooxygenase (COX) and lipoxygenase (LOX), key enzymes mediating the inflammatory cascade, and noted: “Such anti-inflammatory capabilities of boron are clearly pertinent to its anti-cancer effect, because the reduction of COX II and LOX enzymes leads to a decrease in prostaglandin E2(PGE2) and other unfavorable eicosanoids such as leukotrienes.”

No reports or studies documenting drug-induced depletion of boron were accessible for review.

nutrient-drug interactions
Hormone Replacement Therapy (HRT): Estrogen-Containing and Synthetic Estrogen and Progesterone Analog Medications
HRT, estrogens:Chlorotrianisene (Tace); conjugated equine estrogens (Premarin); conjugated synthetic estrogens (Cenestin); dienestrol (Ortho Dienestrol); esterified estrogens (Estratab, Menest, Neo-Estrone); estradiol, topical/transdermal/ring (Alora Transdermal, Climara Transdermal, Estrace, Estradot, Estring FemPatch, Vivelle-Dot, Vivelle Transdermal); estradiol cypionate (Dep-Gynogen, Depo-Estradiol, Depogen, Dura-Estrin, Estra-D, Estro-Cyp, Estroject-LA, Estronol-LA); estradiol hemihydrate (Estreva, Vagifem); estradiol valerate (Delestrogen, Estra-L 40, Gynogen L.A. 20, Progynova, Valergen 20); estrone (Aquest, Estragyn 5, Estro-A, Estrone ‘5’, Kestrone-5); estropipate (Ogen, Ortho-Est); ethinyl estradiol (Estinyl, Gynodiol, Lynoral). HRT, estrogen/progestin combinations:Conjugated equine estrogens and medroxyprogesterone (Premelle cycle 5, Prempro); conjugated equine estrogens and norgestrel (Prempak-C); estradiol and dydrogesterone (Femoston); estradiol and norethindrone, patch (CombiPatch); estradiol and norethindrone/norethisterone, oral (Activella, Climagest, Climesse, FemHRT, Trisequens); estradiol valerate and cyproterone acetate (Climens); estradiol valerate and norgestrel (Progyluton); estradiol and norgestimate (Ortho-Prefest). HRT, estrogen/testosterone combinations:Esterified estrogens and methyltestosterone (Estratest, Estratest HS).
Potential or Theoretical Adverse Interaction of Uncertain Severity
Bimodal or Variable Interaction, with Professional Management
Beneficial or Supportive Interaction, with Professional Management

Probability: 2. Probable
Evidence Base: Preliminary or Emerging

Effect and Mechanism of Action

Boron may elevate estradiol and testosterone levels, especially in those with low dietary intake of boron and magnesium. The probable beneficial influence of boron in limiting calcium loss and supporting bone mineralization may be amplified by enhancement of steroid hormone status.

Research

Several small studies have shown an association between boron and increased estrogen levels, both in menopausal women not on estrogen replacement therapy (ERT) and healthy men and, more markedly, in women on ERT.

For many years a research team led by Nielsen, Hunt, and Penland in North Dakota has conducted numerous studies investigating boron, its activities, and therapeutic implications. In a 1987 clinical trial, 3 they observed marked changes in several indices of mineral metabolism in seven women consuming a low-magnesium diet and five women consuming a diet adequate in magnesium after administering a nutritional dose of boron (3 mg/day) for 48 days to these 12 women, age 48 to 82, not on ERT. Before the study, all subjects had consumed a conventional diet supplying about 0.25 mg boron daily for 119 days, that is, a diet essentially devoid of fruits and vegetables. Women receiving the boron demonstrated marked reductions in urinary excretion of calcium and magnesium and increased levels of plasma ionized calcium, especially in subjects receiving low dietary magnesium intake. Boron supplementation depressed the urinary excretion of phosphorus by the low-magnesium, but not by the adequate-magnesium, women. These researchers also reported marked elevations in serum concentrations of 17β-estradiol (the most potent of the naturally produced estrogens) and testosterone in response to the boron supplementation; again, the elevation was more pronounced in subjects on a low-magnesium diet. These findings “suggest that supplementation of a low-boron diet with an amount of boron commonly found in diets high in fruits and vegetables induces changes in postmenopausal women consistent with the prevention of calcium loss and bone demineralization.” 3 Subsequently, Nielsen and Penland 14 reported elevated estrogen in several perimenopausal women administered 2.5 mg boron per day as well as other changes in boron metabolism and indices associated with macromineral metabolism, hormonal status, and immune function.

In a single-blind, placebo-controlled, crossover trial involving 18 healthy men, Naghii and Samman 20 reported that administration of boron at 10 mg/day for 4 weeks was associated with significantly increased plasma estradiol levels and a trend toward increased testosterone levels. These authors commented that the nutrient-induced elevation of endogenous estrogen suggests a protective role for boron in atherosclerosis.

Nutritional Therapeutics, Clinical Concerns, and Adaptations

The limited body of available evidence reveals a clear and emergent pattern indicating that health care professionals should encourage increased boron intake in individuals for whom elevated estrogen (and testosterone) levels will be beneficial, especially for preventing demineralization, limiting bone loss, and treating osteoporosis. Boron supplementation is especially important in postmenopausal women consuming a low-boron diet to prevent bone demineralization and osteoporosis; the importance of encouraging a varied diet rich in vegetables, fruits, and nuts cannot be overemphasized for general wellness and bone health in particular. A synergistic combination of oral calcium, vitamin D, boron, and magnesium, within the context of an active lifestyle, could reasonably be considered as a core proactive intervention within integrative therapeutics for all individuals at high risk for osteoporosis, or a foundational treatment for diagnosed bone loss. Additionally, hormone supplementation or replacement regimens (conventional HRT, bio-identical estrogens/progesterone, isoflavones, herbal hormone precursors/modulators) may achieve similar effects, but conclusive evidence is lacking; further research through clinical trials is warranted. Well-designed studies, published in peer-reviewed journals, have confirmed the benefits of ipriflavone and its amelioration of bone loss.

Dietary sources may be preferable, but evidence is lacking for claims of a significant adverse effects or increased risks attributable to boron supplementation at usual dosage levels of 1 to 3 mg/day. The consensus for increased dietary intake of foods rich in boron, especially nuts and fruits, receives at least nominal attention in conventional care and is strongly emphasized in health care providers trained and experienced in nutritional, preventive, and integrative approaches to healthy aging and bone-protective strategies. Some authors in secondary and derivative literature have voiced questionable, but often strong, cautions against use of supplemental boron as potentially risky because of possible elevated hormone levels. Such a concern for nutrient-induced adverse effects is curious, if not overstated, given the rising tide of research on adverse effects and limited efficacy of conventional estrogen-based HRT and momentous shift in health policy away from indiscriminate long-term HRT prescribing. Increased risks of breast and uterine cancer, as well as thromboembolism and dementia, may be related to artificial estrogen administration (and poor liver conjugation), but it is unreasonable to attribute such risks to boron. In fact, epidemiological evidence indicates that high boron intake from dietary sources does not affect breast cancer rates. Furthermore, the strong and growing trend of evidence supporting boron's role in reducing risk of prostate cancer (and potentially reversing pathological changes) dissuades against unfounded cautions regarding potential elevations in testosterone levels. Emerging evidence that boron functions as both a COX and LOX inhibitor may be related to its apparent activity as a candidate chemoprevention agent for both breast and prostate cancer. Clearly, the body of specific and general evidence from both the scientific literature and clinical experience supports increased boron intake as part of a comprehensive strategy for bone health.

theoretical, speculative, and preliminary interactions research, including overstated interactions claims
Benign Prostatic Hypertrophy and Prostate Cancer Treatments
nutrient-nutrient interactions
Calcium
Copper
Magnesium
Methionine and Arginine
Phosphorus
S -Adenosyl- SMALLCAPS L END_SMALLCAPS -Methionine (SAMe)
Vitamin B 2 (Riboflavin)
Vitamin D (Calciferol)
Citations and Reference Literature
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