Supplements to Consider
Vitamin D, Fish Oil, and Magnesium are all supplements to consider taking that are generally safe during cancer treatment. Supplements should be taken alongside, not substitute for, standard cancer treatment. Remember, it is always safer to communicate with your doctor about supplements that are being taken. You are able to build more trust when you communicate about dietary supplements with an open, informed, and patient-centered approach.
Vitamin D
Humans typically get the majority of our vitamin D from sunlight. It is present in liver, cod liver oil supplements, egg yolks, and other sources, but we efficiently convert sunlight into vitamin D our body can use. Vitamin D is fat-soluble, meaning we store it if we have extra. So while we need to be careful to not get too much, getting vitamin D from foods, sunlight, and reasonable supplementation pose little to no risk.
Uses:
Vitamin D’s controls how our body using calcium, and helps to store extra calcium in our bones. Vitamin D deficiency has also been linked to fatigue, mild depression, digestive issues, and others.
Precautions:
If you have known parathyroid issues, please check with your physician before supplementing with vitamin D.
Testing:
Vitamin D levels can easily be checked via a blood test, abbreviated “25(OH)D”. While the range for ‘normal’ vitamin D is typically 32-100, many studies now suggest that ideal levels target the range of 45-60.
Dose:
Although the ‘recommended daily allowance’ (RDA) is 600IU for people ages 1-year-old to 70 years-old, the RDA is only enough to prevent frank deficiency. In the case of vitamin D, it’s enough to prevent rickets. The body uses about 2,000IU vitamin D daily. Therefore, 2,000IU daily can be safely taken by most everyone to maintain vitamin D levels. For pregnant women, this use is doubled to 4,000IU daily. Most health food stores carry vitamin D in doses of 5,000IU daily. Clinical experience shows that taking 5,000IU daily typically increases vitamin D levels by 10-15 points per month. If you are taking more than 2,000IU daily, it is recommended that you get your vitamin D levels checked every three (3) months to avoid getting too much vitamin D.
Fish Oil
Fish oil contains omega-3 fatty acids that help to reduce inflammation in the body. Studies have shown it is beneficial in a variety of heart conditions, including congestive heart failure, high blood pressure, high cholesterol, and others. It is also helpful in decreasing symptoms of arthritis and may be helpful to reduce symptoms of irritable bowel syndrome (IBS). For patients with cancer, studies have shown that fish oil helps patients to maintain their muscle mass (and therefore, healthy weight), reduce pain, and support happy mood.
Dose:
For kids under 10 years of age, usually no more than 2,000mg daily is recommended as it could cause some stomach upset. For adults, many studies have been done using 3,000-4,000IU daily.
Precautions:
If patients are taking anti-coagulants such as coumadin, lovenox, and other medications that may make it more difficult to form clots, OR if their platelets are less than 100, they may not want to take fish oil. Supplements such as fish oil, vitamin E, ginger, ginkgo biloba, and others may make it more challenging to clot or may lead to increased bruising if your child is taking an anti-coagulant or has a low platelet count.
Tips for Taking Fish Oil:
If you get ‘fish burps’ about 30 minutes after taking your fish oil capsules, refrigerate or freeze them. This will reduce the burps and make it more palatable.
Some children still will not take fish oil capsules, especially if they are experiencing taste changes related to treatment. In this case, flax oil is easily hidden in oatmeal, pudding, yogurt, or other foods (even macaroni and cheese).
Flax oil dose: 1 tablespoon daily. This can be taken all at once or in divided doses.
Magnesium
This mineral is found naturally in green leafy vegetables. However, even if one eats nothing but kale, the amount of magnesium found in our food is directly linked to the magnesium content, and overall health, of the soil. Therefore, supplementation can be helpful.
Uses:
Magnesium needs to be present for our body to produce many of the hormones and other substances that keep us going. It is required to make serotonin, one chemical (called a ‘neurotransmitter’) that helps us to feel happy. It is also used in large amounts by the adrenal glands to help us handle stressful situations better. It also is needed to help our muscles relax, and therefore can be helpful in cases of recurrent headaches (including migraine prevention) menstrual cramps, muscle cramps–including those experienced during pregnancy, and helping our body to relax so we are able to fall asleep more easily.
Dose:
For children under 10 years of age, start with 100mg and increase, if you wish, to no more than 200mg. If your child has trouble sleeping, have them take it about 30 minutes before bed (maybe with the bedtime snack). If they are anxious in the morning, or hyperactive, magnesium can help to ease this and may be taken after breakfast. NEVER take magnesium on an empty stomach–most minerals, including 10mg zinc lozenges (which may help with taste changes), WILL cause nausea and sometimes vomiting if taken on an empty stomach. For adults, doses start at 200-300mg at night before bed.
Forms:
There are big differences between the different forms of magnesium, and they relate to bowel function. Some encourage more frequent bowel movements or can cause diarrhea, while others have minimal effect. Remember, the higher the dose of magnesium, the more likely it will cause soft stool.
Types that cause more frequent bowel movements, and therefore may be helpful in preventing constipation:
- Magnesium oxide: cheaper and poorly absorbed. Most likely to cause soft stool.
- Magnesium citrate: a little more expensive and better absorbed. Still a little irritating to the digestive tract, and can cause a minor digestive upset.
Most other forms of magnesium typically do not have any effect on bowel function. These include magnesium glycinate, amino acid chelate, and aspartate.