Nutritional Supplements and CA Treatment Flashcards
t/f natural is safe / better
false, most toxic substances occur naturally
t/f long term use is not proof that it works or that it’s safe
true, traditional medical systems did not have scientific methods
t/f megadosing antioxidants like vitamin c, beta carotene, and vitamin e are ok
false!! large doses of vitamins/ minerals are toxic
vit c can interfere with body’s ability to absorb copper
phosphorus can inhibit ca absorption
expected to satisfy needs of 50% of people in that age group based on rrl
estimated average requirements
the daily dietary intake levels of a nutrient considered sufficient by f&n board to met reqs of most people
recommended dietary allowance (computed from ear)
where no rda has been established, but amount established is somewhat less firmly believed to be adequate
adequate intake
to caution against excessive intake of nutrients that can be harmful in large amounts
tolerable upper intake levels
highest level of daily consumption with no side effects
vitamin c toxicity
- > 2000 mg/day
- well tolerated unless not absorbed or degraded into oxalate
- oxalate nephrolithiasis
- higher risk if iv form
vitamin a toxicity
- does not lower cancer risk
- long term use causes inc risk for lung ca in high risk individuals
- hepatotoxicity
(>600kU) - toxicity is associated with idiopathic intracranial hpn
- skin manifestations: xerosis, pruritus, erythema, skin hyperfragility, desquamation
vitamin e toxicity
- antioxidant but at megadoses
- no prooxidant effects on ldl
- production of a-tocopheroxyl radicals
- antagonizes effects of vit k (>1000 IU/d) = bleeding
vitamin d and k toxicity
d: hypercalcemia
k: interfere with coumarin based anticoagulation (warfarin)
toxicity of vit b6, b3, b1
b6: neurotoxicity
(b1, b6, b12 protect nerves)
b3: hepatotoxicity
b1: lethargy and ataxia
zinc toxicity
- gastric erosions
- low hdl levels
- impaired cellular immunity (but helps when normal levels)
iodine toxicity
- hypothyroidism (wolff-chaikoff effect)
t/f it can’t hurt to take supplements with regular medicines
false, it can block or speed up absorption of drugs
t/f the fda wouldn’t let them make it if it wasn’t true
false, safety is up to the manufacturer
fda regulations
- all prescription and non prescription drugs are regulated
- dietary supplements are like special foods (no strict safety)
- drugs are unsafe until proven safe
- dietary supplements are considered safe until proven unsafe
problems with supplements
- tainted with germs, pesticides, or toxic heavy chemicals
- do not contain what is listed
- contain different amount than listed
- have ingredients that are not listed
t/f people in chemo may be at higher risk for drug interactions if they take dieteary supplements
true
grapefruit juice and st john’s wort
grapefruit juice: enzyme inhibitor = accumulates drugs
st john’s wort: enzyme inducer = faster clearance of chemo drugs
t/f patients using antioxidants (vit a c e, carotenoids, coq10) were 41% more likely to have recurrence if they use before and during chemo
true
herbs that can increase risk of bleeding
dang gui and botanicals
- should not use these herbs at least 2 weeks prior
herbs that interfere with hormone therapy
red clover and soy = mildly estrogenic and can stimulate hormone sensitive cancers (tamoxifen)
immunosupp and immunostim herbs
immunosupp: st john’s wort
immunostim: astragalus
what is turmeric
- to improve circulation and digestion
- marketed for arthritis and cancer prevention
- active constituent: curcumin
- helps relieve adverse effects due to ca treatments
consensus on turmeric
- safe but antioxidant = can decrease side effects of chemo
- interfere with cyp450
- antiplatelet activity = bleeding, thrombocytopenia
what is green tea
- prevent hyperlipiedmia, hypertensioin, atherosclerosis, and cancer
- active constituent: epigallocatechin 3 gallate: chemopreventive and can reduce myelodysplastic syndromes
negative effects of green tea
- can negate the therapeutic effect of bortezomib
- increases risk of toxicity when used with tamoxifen and irinotecan
- elevated risk of hepatotoxicity
- interfere with cyp450
what is ginger
- for common cold, headache, fever, gi and inflammatory disorders
- reduce nausea and vomiting
side effects of ginger
- for patients on warfarin, elevates risk of bleeding
- discontinue before op due to bleeding
what is ashwagandha
- relieve stress, anxiety, and fatigue
- treat osteoarthritis and skin diseases
- rejuvenate and improve endurance
- active constituent: withanolides
drug interactions of ashwagandha
- potentiates sedative effects of triazolam
- has antioxidant and antiplatelet properties
- can alter cyp450 hepatic enzymes
what is reishi mushroom
- strengthen body, increase vitality, treat insomnia
- enhance immune response in late ca
- remission of hepatocellular ca
drug interactions of reishi mushroom
- antiplatelet effects = bleeding
- antioxidant property
- alter immune response
- inhibit cyp450 = increase toxicity
what is boston c
bullshit
what is deer placenta
- boost immune system
- regenerate and repair damaged tissues
- wakes dormant cells
UNAPPROVED AND MISLEADING!!
what is moringa oleifera
- promotes natural serum cholesterol
- anti-inflammatory
- fights many types of cancers
NO PROOF THAT MORINGA CAN FIGHT MANY TYPES OF CANCERS, GENOTOXIC
what is laetrile (amygdalin or vitamin b17)
- contains cyanide
- promoted to be alternative to cancer treatment
what is noni juice
- hepatotoxic, hyperkalemia
- should be avoided with chemo and radio
what is active hexose correlated compound
- shiitake mushrooms
- improves immune function
- can reduce the side effects of chemo (induces cyp450 2d6 = decrease activity of drugs)
what is spirulina
- modulate immune functiong and exhibit anti-inflammatory properties
what are transfer factors
- proteins with many molecules
- antigen specific activity
- can have immunomodulating capabilities
- not enough evidence
what are probiotics
- daily use can protect from severe radio/chemo effects
- lower chance of responding to checkpoint inhibitor immunotherapy
what is medical cannabis
- thc = mental state
- cbd = no high but sleepy, diarrhea, liver function
- epidiolex for seizures for two rare and severe forms of epilepsy (lennox gestaut syndrome or dravet syndrome)
