CAM
& Life Style or Resources
for Physicians > Supplement
Safety and Biological Activity
Also Alerts and Resources to Check for Interactions and Product
Quality
Last Update: 07/18/2008 |
 TOPIC
SEARCH: ASCO
| FDA
Medwatch | Medscape
| Web
125 Fake Cancer 'Cures' Consumers
Should Avoid fda.gov/
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ConsumerLab
Independent testing of
health and nutrition products
consumerlab.com
"Consumer Reports, the
bible of independent consumer ratings, has introduced a new
database of information on thousands of herbs, dietary supplements
and other natural medicines, a response to the enormous growth in
the use of these products." Source |
"First, the internet is largely a
horrible place for information on natural medicine choices.
Misinformation outweighs objective truth 99 times out of 100
(no exaggeration). Most internet sites are written to sell you
a product and make you think you are getting “scientific”
information." Terra Sigillata
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Factors that Influence Supplement Safety
and Potential Biological Activity |
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Safety |
Biological Activity |
 | Was independent testing done on the product
to determine quality, purity, strength, composition?
Supplements may have
 | wrong ingredients |
| too much or too little of a dietary
ingredient |
| improper packaging |
| improper labeling |
| contamination problems due to natural
toxins, bacteria, pesticides, glass
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| Interactions with drugs
| Reduce or exaggerate drug effects? |
| toxic interactions?
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| Dose and frequency of administration
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News
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New:
Dietary flavonoids inhibit the anti-cancer effects of the proteasome
inhibitor Bortezomib (Velcade)
Dietary flavonoids, quercetin and myricetin, which are abundant in plasma,
inhibited Bortezomib-induced apoptosis of primary CLL and malignant B-cell
lines in a dose-dependent manner.
Blood First Edition Paper, prepublished online
July 16, 2008; DOI 10.1182/blood-2008-04-150227.
Sources of flavonoids: http://lpi.oregonstate.edu/infocenter/phytochemicals/flavonoids/
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Purity? Unfortunately, the risk
of ingesting inferior or contaminated
herbal products is significant and well documented.
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NEWS:
Final Rule Promotes Safe Use of Dietary Supplements fda.gov
Under the final rule, manufacturers are required to evaluate the
identity, purity, quality, strength, and composition of dietary
supplements.
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| Quackery: Life
Rife Frequency Generator healthwatcher.net
Although unanimously condemned as worthless by mainstream
scientists and banned in at least two American States, the highly
profitable Rife industry is flourishing in Australia because of a lack
of effective regulation, says John Dwyer, the head of medicine at
Prince Henry and Prince of Wales teaching hospitals in Sydney. He
blames this on "buck-passing" among no fewer than five
government agencies supposedly responsible for protecting health
consumers (see "Nothing to do with us, say agencies") which
have failed to act against promoters of Rife machines and other
"cures" he regards as quackery
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| Clinical Relevance
of Drug–Drug and Herb–Drug Interactions Mediated by the ABC
Transporter ABCB1 (MDR1, P-glycoprotein) theoncologist.alphamedpress.org
The importance of ABC transporters in drug–drug interactions
is increasingly being identified. ... Also, genetic variability
in the MDR1 gene affects absorption and tissue distribution
of P-gp substrate drugs.
Furthermore, CAM use, like herbs, food, and vitamins, by patients
has increased significantly in recent years. Surveys have shown
that the prevalence of CAM use among cancer patients receiving
conventional therapy is 54%–77%, and that about 72% of patients
do not inform their treating physician. CAM use significantly increases
the risk for interactions with anticancer drugs, especially because
of the small therapeutic range and steep dose–toxicity curve
of these drugs. ....
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| High Doses Of Phytochemicals In Teas And Supplements Could Be
Unhealthy Science
Daily
"The report cites specific examples of toxic effects,
including reports of liver, kidney, and intestinal toxicity related to
consumption of high doses of green tea-based dietary supplements. The
risk of such toxicity may be greater in individuals taking certain
medications, or with genetic traits, that increase the bioavailability
of phytochemicals, the researchers said."
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Resources
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Consumer Report on
Herbs and Supplements consumerreports.org
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| FDA Food and Drug
Recalls, Market Withdrawals and Alerts (includes supplements) www.fda.gov
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| Food Additives PAL
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Safety Issues in Using Complementary and Alternative Medicine jco.org
2006 full text
"While many forms of CAM are associated with no or minimal
risk to a patient, this is not true for all such therapies.
This brief report provides a broad overview into the
potential toxicities associated with CAM, including the
risk to the patient who uses CAM to avoid or delay
established, effective treatment in the management of
malignant disease."
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Supplements
| Consumerlab news on supplements- independent review
consumerlab.com
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| Generally Recognized as Safe (GRAS) - FDA
Summary of GRAS Notices FDA.org
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| Longwood Herbal Task Force www.longwoodherbal.org
Massachusetts College of Pharmacy and Health Sciences in Boston.
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Natural Medicine comprehensive databases www.naturaldatabase.com
(requires subscription)
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A vitamin a day may do more harm than good msnbc.msn
Of 21 brands of multivitamins on the market in the United States
and Canada selected by ConsumerLab.
com and tested by independent laboratories, just 10 met the stated
claims on their labels or satisfied other quality standards. ...
"I was definitely shocked by the amount of lead in [this] woman's
product," he said. "We've never seen that much lead in a
multivitamin before."
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| Use of Complementary/Integrative Nutritional Therapies During Cancer Treatment: Implications in Clinical Practice,
Nagi B. Kumar, PhD et. al. Cancer Control 9(3):236-243, 2002. © 2002 H. Lee Moffitt Cancer Center and Research Institute, Inc.
Medscape
(free login req.)
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Known Interactions
and Cautions
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Amino
Acids | Curcumin | Fish oil
| Immune stimulants | Licorice
| Iron | NAC | St. John's Wort
Vitamin A |
Vitamin C | Vitamin D
Here we list
known interactions and cautions about supplements and treatments for NHL.
We strongly recommend that you consult with your doctor about the use of
any supplements, especially when receiving treatment.
Amino Acids: Arginine, Glutamine and Whey Protein
Despite the potential of amino acids to protect the patient from
side effects and wasting while receiving chemotherapy treatment, there
is a general concern that some amino acids might stimulate
the growth of malignant cells. More
research is needed.
Curcumin (Turmeric) and Chemotherapy Alert
The following study indicates that curcumin can inhibit some
chemotherapy agents. While the study is for breast cancer, the JNK
pathway for chemo-induced cell death described in this abstract might
also apply to lymphoma according to our research.
| Dietary curcumin inhibits chemotherapy-induced apoptosis in
models of human
breast cancer. Cancer Res. 2002 Jul
1;62(13):3868-75. PMID: 12097302 PubMed
| More
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| "Exhibits
antiplatelet activity. May enhance effects of anticoagulant
medications such as warfarin and
potentiate bleeding." - Nagi
B. Kumar, PhD, et. al. Medscape
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Fish oil
High doses of fish oil might interfere with
the maturation of key immune cells.
| Fish oil consumption may increase the risk of bleeding in
susceptible individuals.
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Immune stimulants: Mushrooms, Echinacea
There is a theoretical concern that immune stimulants might increase
the growth of lymphoma cells, which are immune cells.
| Polysaccharide isolated from the radix of Platycodon
grandiflorum selectively
activates B cells and macrophages but not T
cells. Int Immunopharmacol. 2001 Oct;1(11):1969-78. abstract
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Licorice (Glycyrrhiza glabra)
"May impair action of drugs that cause potassium loss. May enhance action of
corticosteroids. May counteract effectiveness of drugs used to treat hypertension. Contains glycyrrhizic acid, which can affect the hormone aldosterone that helps regulate blood pressure. For patients with high blood pressure, edema, or electrolyte imbalance, use of licorice root or its products can lead to sodium retention, excessive potassium excretion, and water retention. Some licorice products have the glycyrrhizic acid removed and are sometimes sold as deglycyrrhizic licorice. Nagi B.
Kumar, PhD, et. al. Medscape
Iron
... is essential. Excessive iron,
however, may promote tumor growth.
NAC (N-acetyl-L-cysteine)
... is an important natural supplement. However,
for individuals with NHL, it may prudent to avoid this supplement
for the following technical reasons.
St. John's Wort
... Study shows St John's Wort Interferes with
Chemotherapy www.bmj.com
Vitamin A
Excessive vitamin A increases the risk of broken bones
www.sciencenews.org
Vitamin C
... in high doses can act as an oxidant instead of an
antioxidant. Vitamin C also increases the absorption of copper.
Vitamin D-3
... while beneficial in many respects, Vitamin D-3 might interfere
with the maturation of key immune cells and therefore should be avoided
when you are receiving immune-based therapies, such as vaccines.
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