Supplements Flashcards
Ginger
May help N/D, gas, heartburn, anorexia
Antioxidant/anti-inflammatory properties
May interfere with anticoagulants
Up to __ g ginger/day is considered safe per the FDA
4g/day
1000mg fried ginger/day = safe (< 1500 mg for N)
Major bioactive component in fresh ginger
Gingerols
Ginko Biloba
May inhibit proliferation of cancer cells
May increase bleeding risk - interfere with anticoagulants/antiseizure meds
When to discourage use of Ginko Biloba
with alkylating agents, antitumor antibiotics, and platinum analogues due to free radical scavenging effects
Glutamine
May reduce inflammatory side effects from treatment
Plays a role in maintaining intestinal mucosal barrier
May interact with antiseizure meds
Depleted with stress (surgery, cancer, sepsis)
Glutamine is converted to
Ammonia - may decrease the effectiveness of lactulose
Glutamine is contraindicated with
those taking lactulose and antiseizure medications
Green tea
hepatoprotective, cardioprotective, neuroprotective, anticancer, antiobesity, antidiabetic, antibacterial, antiviral, hypoglycemia effects
Green tea is discouraged with
erlotinib + pazopanib due to possible effects on cytochrome P450 1AZ isozome induction
Polyphenols are mainly composed of
Catechins
Major polyphenol = epogallocatechin-3-gallate (EGCG)
Garlic
Known for its allium compounds
May stimulate apoptosis and help regular cell cycles
May interfere with some prescription drugs including saquinavir and antiplatelet medications
N-acetylcysteine
Stimulates glytathione synthesis and scavenges for free radicals
Antioxidant properties
Prevents nuclear KB activation, which increases inflammatory response
N-acetylcysteine dose amount
600-1800 mg doses daily
Most side effects when > 9g/day is used
Melatonin
May increase risk of bleeding
1-5 mg/day for insomnia, up to 20 mg/day for anticancer effects
Omega 3 fatty acids
Cardioprotective, anti-inflammatory, immunomodulatory
EPA and DHA may increase bleeding risk if taken in high doses - up to 3g/day = safe (up to 4 g if monitored by MD)
Quercetin
May be beneficial in patients at risk for hemachromatosis
can bind with iron, which can decrease iron bioavailability
Quercetin found in
Citrus fruits, apples, onions, parsley, tea
Quercetin can cause
Flushing, sweating, N/V, dyspnea
Reishi mushroom used for
Prevent aging, enhance immune system, HTN, HLD, viral infections, cancer, inflammatory disease, cardiovascular disease, DM
Reishi mushroom safety
Possible unsafe when used > 1 mo
May increase bleeding risk when combined in high dose (>/= 3mg) with anticoagulant medications
Resveratrol
Antioxidant, anti-inflammatory,antimutagenic, anticarcinogenic, antiprolferative
Has been reported to cause cell arrest, promote apoptosis, and inhibit cancer cell proliferation
Resveratrol safety
Has antiplatelet effects, so could cause excessive bleeding with blood thinning medications
Resveratrol food sources
The root of the knotweed, grapes (black > red/green, especially the skins)
Selenium serves as a cofactor for
Glutathione peroxidase - an enzyme of the antioxidant defense system
Excessive selenium can cause
Acute toxicity including N/V, abd pain, dermatitis, nail changes, fatigue, irritability, alopecia, impaired endocrine function, neurotoxicity, wt loss
Selenium tolerable upper limit
400 mcg/day
Preferred form of selenium
Selenomethionine
Silymarin
Extract of milk thistle
Antioxidant, anti-inflammatory, liver protective, anticancer
Allergic reactions for silymarin > _____ mg/day
> 1500 mg/day
Caution silymarin with
Tamoxifen
Why are clinical applications limited with silymarin?
It is water soluble - poor absorbance
Combine with Silybin _ phosphatidylochline (PC) for enhanced bioavailability
St. John’s Wart
Used for pain
May interact with many medications, including Warfarin
Increases cytochrome P450 (CYP) 3A4, resulting in lower plasma levels of drugs that are CYP 3A4 substrates
AVOID with all concurrent chemo
Theanine is found in
Tea and mushrooms
Theanine
Antioxidant
May enhance efficacy of Doxorubicin and Idarubicin
May reduce BP
Theanine common dose
200-400 mg/day or BID with a max dose of 1200 mg
Turkey tail mushroom/Yun zhi
Bioactive component from the cultured mycelia including the protein bound polysaccharide-K (PSK) and polysaccharopeptide (PSP)
Antimicrobial, antiviral, immunomodulatory, antitumor
Turkey tail mushroom/Yun zhi common dose
3 mg/day
Vit D
Fat soluble
Anti-inflammatory, immunomodulatory, bone protective, anticancer
Replicates genes that influence cell proliferation and apoptosis
Vit D toxicity can result in
Hypercalcemia
Upper intake level of vit D
4000 IU/day
Vit D maintenance blood level
40-60 ng/mL (up to 100 ng/mL is safe)
Aloe
May be useful for constipation
May delay radiation dermatitis
A-lipoic acid
Cellular antioxidant improved for energy production
Improved insulin sensitivity/DM management
Aids with HTN
May mitigate radiation damage
May reduce symptoms of neurotoxicity
Inhibits growth of breast, colon, lung, liver, and pancreatic cancer cells
Fat and water soluble
A-lipoic acid dietary sources
Spinach, broccoli, brewers yeast
Black cohosh
Suppresses symptoms associated with menopause (hot flashes) and cancer treatment
may interfere with the biological activity of atorvastatin, azathioprine, and cyclosporine
Coenzyme Q10
Fat soluble
Structurally similar to menaquinone (K2)
May have procoagulant effects, influencing the efficacy of Warfarin
Coenzyme Q10 causes
Mild GI side effects (N/V/D)
Coenzyme Q10 levels _____ with aging
Decline
Curcumin
Found naturally in tumeric
May inhibit growth of cancer cells
May prolong activated patyial thromboplastin time and prothrombin time
Curcumin supplements are combined with
Piperine (in black pepper) to improve absorption
3,3 Diindolylmethane (DIM) and indole-3-carbinol (I3C)
Found in cruciferous vegetables
Proposed chemoprevention for breast and lung SCC
Flaxseed
Excellent source of a-linolenic acid
Rich in ligans
Provides soluble and insoluble fibers
May affect absorption of some medications
Flaxseed may cause
N/D, gas
Possible contraindicated in those with IBD
Flaxseed:meds relationship timing
Meds should be taken 1-2 hours before/after consuming flaxseed to reduce effects on drug absorption
Flaxseed dose
1-2 tbsp/day = safe
