Supplements during chemotherapy

Has anyone used berberine during Chemotherapy? It may lower blood sugar levels, thin blood, kill some gut bacteria (some good and some bad bacteria are affected). Berberine exhibits multiple anticancer mechanisms, including reducing cancer cell growth, preventing metastasis, and inducing apoptosis. It may also enhance the effects of other cancer treatments, by sensitizing cells to chemotherapeutic drugs via interactions with DNA repair proteins.
It can strengthen contractions in people with congestive heart failure, increase bilirubin levels causing yellowing of the skin, and lower blood pressure.
The cancer killing aspects sound great, some of the side effects, not so much.

Hi @beebe, I know the temptation is always there when we have cancer or on chemotherapy to try and mitigate the damages. I think we feel helpless and want to do ‘something’ to be proactive! We see ads for supplements, herbs and quick fixes but unfortunately there can be potential dangers lurking with even the most innocent looking ‘natural’ supplements. Most are not regulated by the FDA and the labeling can be misleading.

During chemo, I was instructed to not take any supplements including vitamins, curcumin/turmeric, iron, B12 or B6 vitamins, pomegranate juice, etc.,the list was lengthy…unless prescribed by my doctor at the time.
Some of the compounds can/may interfere with the meds we’re on, either by causing too much retention or non-absorption or unknown drug interactions. There may also be liver and kidney damage, blood thinning/clotting,
I found a couple of articles for you. This from Mayo Clinic:

Cancer and nutritional supplements.
https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/cancer-and-nutritional-supplemnts/
And this article from MDAnderson a top cancer clinic. https://www.mdanderson.org/cancerwise/should-you-use-dietary-supplements-during-cancer-treatment.h00-159303834.html

From what I was instructed by both my local hemo/oncol and my team at Mayo for my BMT, no supplements can replace a healthy diet. Which isn’t always that easy when you don’t feel like eating. So please do a little more research and run this past your doctor before trying berberine. Another thought…have you talked to a pharmacist about this supplement?

Hi @beebe I know when we have cancer or on chemotherapy that we feel helpless as to what we can do to mitigate the damage and to keep us as healthy as possible. It’s easy to get lured into ads for supplements which may potentially be a wonder drug.

The problem is most supplements aren’t regulated by the FDA and can actually make our conditions worse or create new issues. Anything can be written on the labels but it doesn’t make it true and often facts are misrepresented.
You mentioned berberine and its side effects. While the ads say it may have cancer killing aspects, it also has some serious side effects. If you’re on chemo, you’re already on a medication that’s killing cancer cells. The other frightening statement is that it may also enhance the effects of other cancer treatments, by sensitizing cells to chemotherapeutic drugs via interactions with DNA repair proteins.
That makes berberine an unknown quantity as far as how it will interact with your cancer treatments. It could create some very serious side effects, potentially lethal, from an already powerful chemotherapy drug.

When I had my chemo, both my local oncologists and Mayo transplant team had me avoiding all supplements except for anything recommended or prescribed by them. I wasn’t able to take turmeric, ginger, pomegranate juice, etc…there’s a long list of herbs, natural products and minerals that were off the table for a while. Because the products aren’t regulated our doctors and pharmacists have no way of knowing how the product may interact with the meds we’re currently taking. Supplements can cause issues like excess bleeding, interference with medications such as blocking absorption or causing too much retention. Often they’re associated with liver and kidney damage and can lead to failure of those organs. Even something as simple as a multivitamin. I had liver damage from an OCT daily multivitamin I took well after my chemo. So these things really need to be run past your doctor.

A healthy, balanced diet rich in antioxidant foods is our best defense. Though I know if you’re on chemo, you may not feel like eating much. Talk to your doctor or better yet, a dietician associated with your oncology team. They will help you come up with a plan for getting the nutrition you need without taking Berberine.
Have you talked to a dietician about healthy alternatives to supplements?

MSKCC has a great phone app called "About Herbs". You can also view and search the database online via web browser. They have a patient-centric and doctor-centric explanation for each herb.

Here is their link for berberine:
https://www.mskcc.org/cancer-care/integrative-medicine/herbs/berberine

Hi @markymarkfl, I agree, MSKCC has a good site for information regarding herbs. However, there is also an important disclaimer that this site is informational only and not to be used instead of medical advice from a physician.

Here’s the disclaimer from MSKCC:
“ This Web site — Information About Herbs, Botanicals and Other Products — is for general health information only. This Web site is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. Users of this Web site should not rely on information provided on this Web site for their own health problems. Any questions regarding your own health should be addressed to your own physician or other healthcare provider.
Memorial Sloan Kettering Cancer Center makes no warranties nor express or implied representations whatsoever regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced on this Web site. Memorial Sloan Kettering does not assume any risk whatsoever for your use of this website or the information contained herein. Health-related information changes frequently and therefore information contained on this Web site may be outdated, incomplete or incorrect. Statements made about products have not been evaluated by the Food and Drug Administration. Use of this Web site does not create an expressed or implied physician-patient relationship.
Memorial Sloan Kettering does not record specific website user information and does not contact users of this website. You are hereby advised to consult with a physician or other professional health-care provider prior to making any decisions, or undertaking any actions or not undertaking any actions related to any health care problem or issue you might have at any time, now or in the future. In using this website you agree that neither Memorial Sloan Kettering nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to your use of any information presented at this website.”

It’s always important, especially for someone on chemo, as was the basis for this discussion, to check with their doctors before taking supplements which could be contraindicated.

With respect to any supplements or other medicaion before I take any of these, my immediate practice is to check/confirm whether to take these or not with my cancer pharmacist. My pharmacist is able to tell me whether there is any contradictions or issues of which I should be aware, including whether to take the supplement or additional medication in question. This practice has served me well!

Great link! Thanks for the help:)

I have not met my cancer pharmacist, your suggestion is a great one. Hopefully I will be able to talk with him/her at my infusion appointment.

What a zoo it was at the oncologist office yesterday for my first infusion. The oncologist office has joined a local hospital and were training new staff, it was so noisy at times, like sitting in an airport!
Unfortunately the pharmacist who was on-site is now somewhere in the hospital which is miles away from the infusion center, so I won't be able to ask him supplement questions.

@beebe , Please push for these questions to be answered at a follow-up or by telephone sooner if necessary. One of the infusion nurses should be able to relay a question or two to the pharmacist or to your oncologist. Once you've gotten stuff established, you might also check to see if you have or can get a "portal" connection to them on the computer.

When I first started chemo, the oncology pharmacist set up an "orientation" phone call with me to provide info and Q&A time about my drugs. I got her phone number and email address for follow-ups, which was very helpful. She identified that a couple "basically friendly" supplements I had been taking could affect my CA19-9 test results or interfere with my chemo drugs. Definitely worthwhile!

I agree, the About Herbs site/app are basically just there for general education / familiarization, but might help you formulate the best questions for your specialists. Their time is so limited it can be hard for them to cover a bunch of random questions.

Good luck with your next infusion(s) and your recovery from the first! Noise-cancelling headphones and some good music (or at least a set of earplugs) are lifesavers, to distract from the beeping pumps if nothing else.