Select Dietary Supplements and Functional Foods (Appendix C Green Book) Flashcards
Benefits of Aloe?
May be useful for constipation.
May delay radiation dermatitis in HNC patients.
May improve radiation proctitis.
Aloe side effects?
Aloe latex used orally may be unsafe and cause diarrhea.
Benefits of ⍺-lipoic acid?
Improves insulin sensitivity and diabetes management.
Aids with hypertension.
May mitigate radiation damage.
May have potential benefit for mucositis.
May reduce symptoms of neurotoxicity / peripheral neuropathy.
Inhibits tumor cell growth of breast, colon, lung, liver and pancreatic cancer cells.
Can ⍺-lipoic acid prevent neurotoxicity from oxaliplatin or cisplatin?
No
What are dietary sources of ⍺-lipoic acid?
Spinach, broccoli, brewer’s yeast
Interesting fact about ⍺-lipoic acid?
⍺-lipoic acid is both fat- and water-soluble and is able to function throughout the body.
Benefits of Black cohosh?
Suppresses hot flashes associated with menopause and cancer treatment.
What are potential adverse reactions to Black cohosh?
headaches, vomiting and gastrointestinal irritation.
Black cohosh may interfere with which medications?
Tamoxifen
Doxorubicin
Doxetaxel
What is Coenzyme Q10 (CoQ10)?
Endogenous antioxidant involved in cellular energy production and found in every cell in the body.
What are the anticancer benefits of CoQ10?
May reduce renal toxicity and cardio toxicity of Doxorubicin (Adriamycin)
What are potential adverse reactions to CoQ10?
Mild gastrointestinal side effects (nausea, vomiting and diarrhea).
CoQ10 is contraindicated with which medication?
Warfarin (because CoQ10 is structurally similar to Vitamin K)
Which plant does curcumin come from?
Turmeric
What are the reputed anticancer benefits of curcumin?
May inhibit growth of cancer cells.
Anti-inflammatory, antioxidant and anticancer properties.
What are reported anticancer concerns of curcumin?
May prolong activated partial thromboplastin and prothrombin time.
Curcumin enhances the anticancer effects of what medications?
5-fluorouracil (5-FU) and the combination of 5-FU and cisplatin.
How does curcumin effect cancer medications?
It enhances tumoricidal actions of docetaxel.
Reverses resistance to irinotecan in colon cancer cells..
May improve myelosuppression induced by carboplatin.
Improve efficacy of cisplatin.
Is curcumin easy to absorb?
No. Curcumin has poor solubility and bioavailability. Some supplements add piperine to improve absorption.
Is incorporating turmeric within a varied diet reasonable and safe?
Yes.
Food sources of indole-3-carbinol (I3C)
cruciferous vegetables (broccoli, Brussels sprouts, cabbage, kale, kohlrabi, boy chow, mustard greens and turnips)
What is 3,3’-Diindolylmethane (DIM)
a naturally occurring plant alkaloid bioactive metabolite of indole-3-carbinol.
What are reported anticancer benefits of DIM and I3C??
May benefit breast and lung squamous cell carcinoma.
They target molecules controlling cell division, apoptosis or angiogenesis deregulated in cancer cells.
What are reported anticancer concerns with DIM and I3C?
DIM may interfere with hormone therapy d/t potential antiestrogenic effects.
DIM enhances the therapeutic efface of what medication?
Paclitaxel in gastric cancer.
Flaxseed is a good sources of…?
⍺-linolenic acid (an omega-3 fatty acid), lignans, soluble and insoluble fibers and has phytoestrogens and antioxidant properties.
What are the reported anticancer benefits fo flaxseed?
Lignans, fiber and ⍺-linolenic acid are protective of cancer.
May enhance efficacy of tamoxifen.
What are the reported anticancer concerns of flaxseed?
Nausea, gas, diarrhea.
May be contraindicated in those with inflammatory bowel disease
May affect the absorption of some drugs.
Possible allergic reactions.
T/F: Unfiltered flaxseed oil contains both ⍺-linolenic acid and lignins?
True. many flaxseed oils do not contain lignans.
What should you do to flaxseed?
Ground it to exert its biological effects.
Flaxseed and medications?
Medications and flaxseed should be taken 1-2 hours apart to reduce effects on drug absorption.
Dose of flaxseed that is considered acceptable and safe?
1-2 TBSP per day
What can you do with ground flaxseed?
It can be added to cereals, muffins, yogurt and salad
What is the reported anticancer benefit of garlic?
It may stimulate apoptosis and help regular cell cycles.
What are the reported anticancer concerns of garlic?
It may interfere with the function of some prescription drugs (saquinavir and anticoagulant medications)
What is allium?
A compound found in garlic that may have anti-cancer properties.
What are the reported anticancer benefits of ginger?
May ease nausea, heartburn, anorexia, diarrhea and gas.
May ease nausea associated with chemotherapy.
May inhibit carcinogenesis.
Has antioxidant and anti-inflammatory properties.
Promote apoptosis.
What are the reported anticancer concerns of ginger?
May interfere with the activity of anticoagulant drugs, but evidence is equivocal.
What is the upper limit of daily ginger consumption?
4 g per day
What forms does ginger come in?
Fresh, dried, pickled, preserved, crystallized, candied, powdered or ground.
What is the daily recommended ginger dose?
1000 mg per day (1 tsp fresh ginger or 4 c ginger tea or 2 tsp of ginger syrup or 2 squares of crystallized ginger)
What is the reported anticancer benefit of ginkgo biloba?
May inhibit proliferation of cancer cells.
What are the bioactive ingredients of primary interest in the ginkgo biloba leaf?
triterpene, lactones and flavonoids
What are the reported anticancer concerns of ginkgo biloba?
It may increase bleeding risk, though evidence is inconclusive.
It may interfere with anticoagulant drugs and anti seizure medications.
How is ginkgo biloba typically consumed?
It is dried into a powder and formulated into pills, tablets or capsules.
What is glutamine?
It is the most abundant nonessential amino acid in the human body. It is involved in cell replication for rapid cell turnover, primarily in the gastrointestinal mucosa and immune system. It is essential for gut health.
What are the reported anticancer benefits of glutamine?
May reduce inflammatory side effects of cancer treatments (i.e. may reduce degree of mucositis, stomatitis, esophagitis and diarrhea).
Plays a roll in maintaining the intestinal mucosal barrier: glutamine-enriched nutritional support can reduce intestinal damage from chemotherapy.
What are the reported anticancer concerns with glutamine?
It may reduce the effect of lactulose when glutamine and lactulose are given at the same time (because glutamine is converted to ammonia.
What depletes glutamine?
stress (major surgery, sepsis and cancer)
When is glutamine contraindicated?
In those taking antiseizure medication and lactulose
Green tea provides what beneficial compound?
epigallocatechin-3-gallate (EGCG) a polyphenol
What are the reported anticancer benefits of green tea?
It has hepatoprotective, cardioprotective and neuroprotective, anticancer, antiobesity, antidiabetic, antibacterial and antiviral and hypoglycemic effects.
What are the reported anticancer concerns of green tea?
May cause nervousness, anxiety, heart irregularities, headache, tremors, hypotension, restlessness, insomnia, irritation of the gastrointentinal mucosa, diuresis and daytime irritability.
The use of green tea is discouraged with which medications?
erlotinib and pazopanib
What is melatonin?
It is a natural indolamine produced by the pineal glad that has many functions, including regulation of the circadian rhythm.
What are the reported anticancer benefits of melatonin?
Antiproliferative and proapoptotic effects, evading growth suppressors
What are the reported anticancer concerns of melatonin?
May be unsafe for use during pregnancy.
May increase the effects of herbs with anticoagulant products, so could increase the risk of bleeding.
What is the melatonin dose for managing insomnia?
1-5 mg/day
What is the anticancer dose of melatonin?
Up to 20 mg/day
What is N-acetylcysteine (NAC)?
NAC is an antioxidant that stimulates glutathione synthesis and scavenges free radicals.
What are the reported anticancer benefits of N-acetylcysteine (NAC)?
Has antioxidant properties.
Increases inflammatory response.
Has been used as an antidote for overdosed drugs in the ED.
What is the typical dosage of N-acetylcysteine?
600-1800 mg/day
At what dose do side effects of N-acetylcysteine usually occur?
a single dose of greater than 9 g daily
What are omega-3 fatty acids (EPA and DHA)?
They are long-chain poly unsaturated fatty acids that are found in fatty fish and dietary supplements (fish oil) and they direct eicosanoid metabolism toward anti-inflammatory pathways.
What are the reported anticancer benefits of omega-3 fatty acids?
May offer cardioprotective, anti-inflammatory and immunomodulary effects.
May reduce inflammation.
What are the reported anticancer concerns with omega-3 fatty acids?
EPA and DHA may increase bleeding risk if taken in high doses (>4 g EPA and DHA daily).
What is the safe dose of omega-3 fatty acids?
Up to 3 g daily is considered safe (up to 4 g/day if carefully monitored for bleeding risk).
What is quercetin?
It is a flavonoid found in citrus fruits, apples, onions, parsley and tea. It is also sold as a supplement.
What are the reported anticancer benefits of quercetin?
Provides anti-inflammatory effects
Induces apoptosis in breast cancer cells.
What is the reported anticancer concerns of quercetin?
Side effects such as flushing , sweating, nausea, vomiting and dyspnea have been reported.
How is Reishi mushroom usually taken?
It is usually dried and taken as an extract in the form of a liquid, capsule or powder.
Reported anticancer benefits of Reishi mushroom?
Used to prevent aging, enhance the immune system and for treatment of various diseases (HTN, hyperlipidemia, cardiovascular disease, etc.)
Reported anticancer concerns of Reishi mushrooms?
Possibly unsafe when used in powder form for more than 1 month.
May increase risk of bleeding when combined in high doses >3 g/day with anticoagulant medications.
What are the reported anticancer benefits of resveratrol?
Has anticancer properties arising from anti oxidative, anti-inflammatory, antimutagenic, anti carcinogenic and antiproliferative characteristics.
Cause cell cycle arrest, promote apoptosis and inhibit cancer cell proliferation.
What are the reported anticancer concerns of resveratrol?
Has anti platelet effects so could cause excessive bleeding in a person taking blood thinning medication.
What are good sources of resveratrol?
The root of the knotweed, black grapes (more than red and green). Grape skins are particularly rich in resveratrol.
What is the reported anticancer benefit of selenium?
It serves as a cofactor in glutathione peroxidase, an enzyme of the antioxidant defense system.
What is the reported anticancer concerns with selenium?
When consumed jin excessive amounts, can cause acute toxicity (nausea, vomiting, abdominal pain, dermatitis, nail changes, fatigue, irritability, alopecia, impaired endocrine function, neurotoxicity, and weight loss)
What is the Upper Tolerable Intake Level of selenium?
400 mcg/day
What is Silymarin?
It is an extract of the milk thistle plant.
What is the reported anticancer benefits of Silymarin?
It acts as an antioxidant, has immunomodulary effects, anti-inflammatory effects and liver-protective and anticancer effects.
What is the reported anticancer concern with Silymarin?
Allergic reactions at intakes >1500 mg/d4
Does Silymarin have good bioavailability?
No, due to it’s low water solubility and has limited clinical application and therapeutic efficiency.
What is St. John’s Wort?
It is a bush that usually blooms around June 24th. Yellow flowers from the bush are used as herbal remedies.
What are the reported anticancer benefits of St. John’s wort?
may help with pain
may help make cancer cells more sensitive to photodynamic therapies
What are the reported anticancer concerns of St. John’s wort?
May interact with medications, including warfarin.
Is it safe to take St. John’s wort during chemotherapy?
No d/t possible side effects on enzyme induction for multiple enzymes (cytochrome P-450, 2B6, 2C9, etc)
What is Theanine?
It is an amino acid found in tea and mushrooms.
What are the reported anticancer benefits fo Theanine?
May enhance efficacy of doxorubicin and idarubicin and reduce their adverse side effects.
What are the reported anticancer concerns of Theanine?
May reduce blood pressure and therefore interact with antihypertensive medications.
What is the common Theanine dosage?
200-400 mg daily or twice daily with a maximum daily dose of 1200 mg
What is the reported anticancer benefit of Turkey tail mushroom (Yun Zhi)?
Antimicrobial, antiviral, Immunomodulatory and anti tumor properties.
What is the reported anticancer concerns of Turkey tail mushroom (Yun Zhi)?
Generally low incidents of milk and tolerable side effects.
What are the reported anticancer benefits of Vitamin D?
Regulates genes that influence cell proliferation and apoptosis.
What are the reported anticancer concerns of Vitamin D?
Toxicity, which can result in hypercalcemia.
Which is more bioavailable, D2 or D3?
D3 (cholecalciferol)
What is the Tolerable Upper Intake Level of Vitamin D?
4000 IU/day
What level of 25-hydroxyvitamin D in the blood is considered ideal?
40-60 ng/dL (up to 100 ng/dL is ok)
