Author: Mia James
When we hear the words “supplements” or “vitamins,” we tend to think healthy. Supplement use, however, is not that straightforward. This is especially true for cancer patients, who may be at risk of negative interactions between certain treatments and medications and particular supplements. Fortunately, with the help of qualified experts, such as naturopathic doctors (NDs), also known as naturopathic oncology providers and naturopathic clinicians, you can make safe and beneficial supplement choices.
A dietary supplement, as defined by the National Institutes of Health Office of Dietary Supplements (ODS) (ods.od.nih.gov), is “a product that is intended to supplement the diet,” meaning it is used in addition to your primary source of nutrition, which is food. As well, the ODS explains, “A dietary supplement contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids and other substances) or their components.” A supplement is taken by mouth (in pill, capsule, tablet or liquid form) and is labeled a dietary supplement.
A sound supplement program (one that’s safe for you and targeted at your specific concerns) can be used alongside, not in place of, conventional cancer treatment. Shauna Birdsall, ND, FABNO, Director of Naturopathic Medicine at Cancer Treatment Centers of America® (CTCA) in Goodyear, Arizona, says, “We see supplements as an option for some health conditions, but we wouldn’t tell patients to use them as an alternative to conventional treatment.” At CTCA supplements are one piece of an integrated treatment plan, meaning that NDs choose products that are most likely to work safely with patients’ medical treatments and medications.
What supplements can do for you
Supplements, according to Dr. Birdsall, can be used to improve your health and well-being during treatment and can be particularly helpful in side-effect management. For example, Dr. Birdsall explains, “There are a number of different chemotherapy drugs that cause peripheral neuropathy, which is numbness and tingling of the hands and feet.” She says that this side effect can often be managed through supplement use, and a naturopathic doctor might recommend supplements such as vitamin B6, L-glutamine and acetyl-L-carnitine for patients who experience peripheral neuropathy. Other common side effects that may be eased with supplement use include nausea, fatigue, insomnia, hot flashes, anxiety, depression, constipation and diarrhea—in general, some of the more common side effects of cancer treatment.
In addition to potentially helping manage side effects of treatment, supplements may help you manage general health concerns and conditions (such as migraine headaches and chronic conditions), improve overall quality of life during treatment, help you heal faster after surgery and support your immune function.
Supplements and cancer drugs
Though supplements can be highly beneficial, there are some concerns about using them during cancer treatment. “The number one concern that any health-care provider should have— and that patients should question as well,” Dr. Birdsall says, “is Will this interact with any of my medications or treatments?”
Supplements can interact with cancer medications if a supplement and a drug are metabolized in the body in the same way, by either the liver or the kidneys. Katherine Anderson, ND, FABNO, National Director of Naturopathic Medicine at CTCA, says that because some chemotherapy drugs and some supplements are metabolized through the liver, for example, the combination can prove dangerous. “If taken together, the result can be an increase or decrease in chemotherapy drug dosage,” she says. “If metabolism of the chemotherapy drug is increased, it may be cleared by the body too quickly, which decreases the drug’s effectiveness. Decreased metabolism of a drug, on the other hand, means that the dose will remain in the body system for a longer period, thereby increasing the drug toxicity (causing worse side effects).”
Though these potential interactions are serious concerns, with expert guidance they can be avoided. If you are undergoing treatment for cancer, it is especially important to make sure that all members of your treatment team (such as NDs and medical and surgical oncologists) are working together and that you are discussing all supplement use with your providers.
How to take your supplements
Research into supplements can help determine their safety and benefits as well as effective dosages. Providers use these study results to determine the supplement amount that is safe and likely to provide a benefit. “The evidence-based research generally supports the dosage that is well correlated with the symptom management,” Dr. Birdsall says. In other words, an expert will recommend to you the dosage that is most likely to help manage your side effects or other medical concerns. It is important to take this recommended dosage. “To receive the full benefit of the supplement, it is best to take it as recommended.”
It is important to keep in mind, Dr. Birdsall adds, that in some circumstances you may need to alter your supplement use. For example, she says, “If someone becomes nauseated from chemotherapy or isn’t eating enough, supplements may actually make them more nauseated.” In these cases, she recommends holding off on supplements until you are feeling better. And if you think you may be having a bad reaction (a rash, for example) to the supplement, Dr. Birdsall says you should stop using it and contact your health-care provider.
What to take, what to avoid
“Patients really need to be taking supplements that have scientific evidence behind them, in terms of being beneficial,” Dr. Birdsall says. This means separating products supported by researchers from those backed only by marketing claims. A qualified expert, such as an ND, can help you make safe and appropriate choices.
Anderson says that she often uses research from scientific studies to choose safe supplements for patients and to help explain benefits and potential risks. “We always aim to start where there is the strongest body of evidencebased research,” she says, explaining that she aims to choose products with “a lot of value with limited side effects.”
In addition to helping you choose supplements most likely to benefit you, your health-care team can help you avoid potentially harmful products. “Natural” doesn’t always mean safe when it comes to supplements, and there are some known to be especially risky during cancer treatment. For example, Dr. Birdsall explains, “Patients should know that St. John’s wort can be helpful for mild to moderate depression, but it interferes with at least 50 percent of all medications.” By telling your ND about all of the supplements you are thinking about taking, you can avoid potentially harmful choices.
The bottom line
There are some very real risks associated with supplement use during cancer treatment, but there are also some great benefits, especially when it comes to managing side effects. And with qualified experts like NDs who work closely as part of your health-care team, you can avoid the risks and get the most out of your supplement program.