Chemotherapy can be an effective treatment for cancer, but it often comes with difficult side effects like nausea, fatigue, appetite changes, nerve damage, and increased risk of infection. Many people undergoing chemotherapy look to nutritional supplements to help manage side effects and support their body through this challenging treatment. Choosing the right supplements during chemotherapy is important, as some supplements may interact with your cancer treatment. Work closely with your oncology team to determine which supplements are safe and beneficial for you.
Why take supplements during chemotherapy?
There are several reasons supplement use is common among chemotherapy patients:
– Help manage side effects – Certain supplements may help control symptoms like nausea, neuropathy, or fatigue. Always talk to your oncologist before taking anything new.
– Support immune function – Chemotherapy can damage healthy cells like white blood cells that fight infection. Some supplements may help boost immunity.
– Enhance nutrition – Poor appetite and nausea can make it hard to maintain good nutrition during chemo. Supplements can help fill nutrient gaps.
– Provide antioxidants – Chemotherapy increases oxidative stress. Antioxidant supplements may help neutralize free radicals.
– Improve energy – Fatigue is one of the most common chemo side effects. Some supplements aim to increase energy levels.
– Control inflammation – Chemo can promote inflammation. Anti-inflammatory supplements may help reduce this.
– Protect organs – Certain supplements may help protect the kidneys, liver, heart and other organs from chemo toxicity.
Always discuss supplements with your oncologist first, as some may interact with your chemo drugs. Your oncology team can help determine if supplements are right for you.
What to look for in supplements during chemotherapy
If your oncologist approves supplement use during your chemotherapy treatment, keep these tips in mind when choosing products:
– High quality – Look for reputable brands that contain the ingredients listed on the label in the stated amounts. Third party testing provides assurance of quality and purity.
– Absorbable forms – Supplements should contain bioavailable forms your body can easily absorb and utilize. For example, magnesium citrate is better absorbed than magnesium oxide.
– Minimal additives – Avoid supplements with artificial colors, flavors, preservatives, or other unnecessary additives. Look for all-natural products when possible.
– Non-GMO – Choose non-GMO supplements whenever available to avoid genetically modified ingredients.
– Right dosage – Be sure to follow dosage recommendations on the label or provided by your doctor. More is not always better when it comes to supplements.
Consult with a nutritionist or integrative oncologist to help determine which supplements and doses may be most beneficial during your treatment. Work closely with your healthcare team to continually monitor your supplement regimen.
Top supplements to consider during chemotherapy
While everyone’s nutritional needs vary, the following are some of the most common and potentially beneficial supplements taken during chemotherapy cycles:
1. Probiotics
– What they are: Live microorganisms that support gut and immune health.
– Key benefits: Help maintain healthy gut flora, improve diarrhea, support immunity and reduce infection risk.
– What to look for: Multi-strain formulas with lactobacillus and bifidobacterium species. At least 10 billion CFUs. Enteric coated capsules can help deliver probiotics through the stomach.
– Dosage considerations: 1-2 capsules daily, separate from antibiotics. May increase to 2-4 capsules during diarrhea.
2. Omega-3 fatty acids
– What they are: Essential fats EPA and DHA found primarily in fish oil supplements.
– Key benefits: Reduce inflammation, enhance immunity, improve nerve and brain health, increase fatigue-fighting proteins.
– What to look for: High-quality fish, krill, algae or calamari oil. Minimum 500-1000 mg combined EPA/DHA per dose. Third party tested.
– Dosage considerations: 1000-2000 mg EPA/DHA daily with food, unless advised otherwise by your oncologist.
3. Vitamin D
– What it is: The “sunshine vitamin”, vital for immunity, bone health, mood and energy levels.
– Key benefits: Supports natural immunity, inflammation control, fatigue reduction, mood support, bone protection.
– What to look for: Vitamin D3 (cholecalciferol), not D2. Look for good absorption forms like nanoemulsified, liposomal or liquid vitamin D.
– Dosage considerations: 1000-5000 IU daily, ideal to maintain blood levels of 40-60 ng/mL. Have levels monitored. Upper limit is 10,000 IU per day.
4. Vitamin C
– What it is: An essential antioxidant water-soluble vitamin and immune booster.
– Key benefits: Stimulates immunity, acts as antioxidant to reduce oxidative damage of chemo, supports tissue healing, aids iron absorption.
– What to look for: Vitamin C products with bioflavonoids for better absorption. Liposomal vitamin C is also highly absorbable.
– Dosage considerations: At least 500 mg daily up to bowel tolerance levels, in divided doses. IV vitamin C requires medical supervision.
5. Glutamine
– What it is: An amino acid important for immune health, gut integrity and energy production.
– Key benefits: Helps maintain muscle mass, supports immune cells, protects the gut lining, increases glutathione for detoxification.
– What to look for: L-Glutamine powder from a reputable brand.
– Dosage considerations: 5-10 grams of L-glutamine powder twice daily. Space doses apart.
6. Ginger
– What it is: A root spice used to help reduce nausea and vomiting.
– Key benefits: Settles the stomach, reduces nausea and vomiting related to chemotherapy. May also have anti-inflammatory effects.
– What to look for: Ginger root capsules, ginger tea, ginger ale, ginger candies. Choose reliable brands.
– Dosage considerations: 250-500 mg ginger capsules as needed for nausea. Can take up to four times daily.
7. Melatonin
– What it is: The “sleep hormone” involved in regulating circadian rhythms.
– Key benefits: Improves sleep quality and duration. Also has antioxidant effects and may support immune health.
– What to look for: Immediate or fast-release melatonin in tablet, liquid, capsule or lozenge form. Sublingual forms improve absorption.
– Dosage considerations: 2-10 mg before bedtime, adjust as needed. Lower doses usually sufficient for chemotherapy patients.
8. Curcumin
– What it is: The active compound in turmeric spice, known for anti-inflammatory effects.
– Key benefits: Reduces inflammation, enhances detoxification, acts as an antioxidant, may improve fatigue, digestion and cognition.
– What to look for: High absorption curcumin supplements with black pepper or phospholipids to increase bioavailability. Reduce risk of potential chemo interactions.
– Dosage considerations: 500-1000 mg daily in divided doses, unless instructed otherwise by your oncologist.
9. Protein powder
– What it is: Supplemental protein from whey, casein, egg, soy or plant sources like pea and rice.
– Key benefits: Provides amino acids to maintain muscle mass and strength. Also helps meet increased protein needs during chemotherapy.
– What to look for: High quality powder from reputable brands. Whey or whey/casein blends may be best absorbed.
– Dosage considerations: 20-30 grams of protein powder once or twice daily in shakes or smoothies. Adjust based on individual needs.
10. Electrolyte supplements
– What they are: Supplements that provide hydrating electrolytes like sodium, potassium and magnesium.
– Key benefits: Replace electrolytes lost through vomiting, diarrhea or poor intake. Prevent dehydration and support energy.
– What to look for: Powdered electrolyte mixes, mineral drops or capsules. Look for all key electrolytes like sodium, potassium, chloride, magnesium and calcium.
– Dosage considerations: Varies by product. Follow label instructions. May dose more with increased vomiting or diarrhea episodes.
Are there any supplements to avoid during chemotherapy?
Some supplements may be unsafe, ineffective or interact with chemotherapy drugs. Supplements to use cautiously or avoid entirely include:
– **Antioxidants (high dose):** High dose antioxidant supplements like vitamin C, vitamin E, selenium, beta-carotene, lutein and others may reduce chemo efficacy. However, moderate doses as an adjunct appear safe for most cancers.
– **Coenzyme Q10:** May protect cancer cells from chemo drugs. Avoid or reduce dose.
– **Garlic, ginseng, turmeric:** These herbs may increase risk of bleeding or interact with some chemo drugs. Discuss with your oncologist.
– **Grapefruit:** Can affect metabolism of many medications. Avoid grapefruit and grapefruit juice.
– **Green tea (EGCG):** May protect cancer cells in certain cancers. Limit to 1 cup per day or avoid entirely. Discuss with your oncologist.
– **Multivitamins:** Choose products without iron, vitamin E, selenium and other antioxidants. These can be added separately in low doses if permitted.
– **Milk thistle and St. John’s wort:** Interact with various chemo agents. Avoid unless approved by your oncologist.
– **Probiotics:** Generally safe but avoid within two hours of immunosuppressants. May temporarily discontinue during neutropenia.
Always verify supplement safety and potential interactions before use. When in doubt, check with your medical team.
Tips for taking supplements during chemotherapy
If you do take supplements alongside chemotherapy, keep these guidelines in mind:
– Take supplements under supervision of your oncology team. Have them review all products for safety and potential interactions.
– Time supplements properly to avoid interactions. For example, take curcumin or probiotics several hours away from your chemo dose.
– Increase fluids when taking additional supplements to support detoxification pathways.
– Split doses throughout the day rather than taking all supplements together for better absorption.
– Take supplements with food when possible to minimize any stomach upset.
– Monitor for side effects like digestive issues, drowsiness, headaches or changes in blood work. Report any concerns.
– Keep a log of supplement doses to share with your oncology team at each visit. Record any positive or negative effects.
– Realize supplements are adjuncts to, not replacements for, conventional cancer care. Follow your oncologist’s recommendations first and foremost.
– Not all supplements are right for every person or every cancer. Follow the approach that your oncologist feels is safest for you.
The takeaway
Dealing with the challenging side effects of chemotherapy can leave you grasping for anything that might help you feel better. While nutritional supplements can provide support through this difficult treatment, work closely with your healthcare team to determine what is appropriate and safe for you. There is no one size fits all approach to supplement use during chemotherapy – the best regimen depends on the type of cancer, chemo drugs used, your own unique needs, and other factors. With the guidance of your oncology team, supplements may act as useful adjuncts to get you through your chemotherapy treatment as comfortably as possible.