Ask the Nurse: Vitamins, minerals and supplements

Updated: 15/01/2024

Following a myeloma diagnosis, many people focus more on their health and general fitness. They may be particularly interested in whether there is anything extra they could be doing to relieve their symptoms or to ‘boost’ their immune system to keep themselves as healthy as possible.

Many myeloma patients ask us if supplements could be helpful in supporting their health. In this month’s blog, we answer the questions we are asked about vitamins, minerals, and supplements when living with myeloma. 

Can I take vitamins, minerals, and supplements?

You should always check with your healthcare team before taking any kind of supplement or alternative treatment they have not prescribed. This is because they have potential to interact with your myeloma treatment and can, in some instances, cause serious problems and complications.

Make sure you speak to your healthcare team before taking anything, so they can ensure it is safe to do so and the risk of harmful effects is minimised. This includes herbal, traditional and natural medicines and remedies, and vitamins and wellbeing supplements taken in any format, such as teas, soups, powders, tinctures or tablets.

Provided your healthcare team have confirmed your myeloma treatment is unlikely to be affected and you have a low risk of experiencing complications from a specific supplement, you can take that supplement if you want to. For example, although most people are able to get enough nutrition by ensuring they maintain a well-balanced diet, some myeloma patients find reassurance in taking additional supplements, like multivitamins.

Are any supplements recommended for myeloma patients? 

There are no specific recommendations about supplemental vitamins and minerals for myeloma patients. Usually, a well-balanced diet that follows the same basic principles of healthy eating that apply to everyone should provide adequate levels of vitamins, minerals, and nutrients to maintain general health. Read more about maintaining a healthy diet in our Infopack for living well with myeloma.

However, if you are struggling with low appetite or nausea that affects your eating, speak to your healthcare team for support. You can get tips about managing nausea and other gastrointestinal symptoms and complications in our Gastrointestinal disturbances Infosheet.

Your healthcare team may recommend specific supplements if you are at risk of a deficiency or found to have a deficiency. Some people may benefit from a referral to a dietician who can recommend specific changes to their diet or appropriate supplements to support them.

Should I be taking vitamin D? 

There is no recommendation about vitamin D supplements specifically for myeloma patients.

Throughout the spring and summer, most people can get all the vitamin D they need through sunlight on their skin and a balanced diet.

However, in autumn and winter, the sun is not strong enough for the body to make vitamin D and you need to get it from your diet, which can be difficult. The NHS recommends that all adults in the UK consider taking a daily supplement containing 10 micrograms of vitamin D during this period.

As with any supplement or alternative treatment, it is important to let your haematologist know before taking a vitamin D supplement.

Are there any supplements I can take for my peripheral neuropathy? 

Peripheral neuropathy can be uncomfortable and painful. Talk to your haematologist or clinical nurse specialist for support if you are struggling. They may be able to prescribe a supportive treatment or refer you to a specialist team to help with your symptoms.

Some people consider supplements such as magnesium and vitamin B to help manage peripheral neuropathy. However, no firm evidence supports their use and you should always seek advice from your healthcare team.

You can learn more about potential treatments and methods of managing peripheral neuropathy in our Peripheral neuropathy Infosheet.

Are there any supplements I can take to support my immune system? 

Many myeloma patients have regular or recurrent infections. This is because myeloma and its treatments can affect the immune system and how well it responds to infection.

There is not enough evidence to know if supplements can ‘boost’ your immune system or reduce the risk of infections such as colds or flu. However, myeloma patients should avoid supplements aimed at boosting the immune system (for example, echinacea) as it is unknown how these may affect your myeloma or interact with your treatment.

The best way to support your immune system is to look after yourself by eating well, staying hydrated, exercising regularly, and getting enough sleep.

If you experience any unexpected changes to your health, such as prolonged or an increased number of infections, let your healthcare team know. Our Patient Diary can help you keep track of changes in symptoms or side effects.

Will an iron supplement help with my fatigue? 

Myeloma patients experience fatigue for various reasons. It can be due to treatment side effects, difficulty sleeping, poor nutrition or anaemia.

In myeloma, anaemia is most often caused by suppression of red blood cell production, not iron deficiency. Therefore, an iron supplement is unlikely to help with fatigue caused by myeloma-related anaemia. If you have persistent anaemia, your haematologist will prescribe supportive treatments to help.

If diet is the cause of anaemia, it typically causes deficiencies in more than one nutrient, so an iron supplement may not be the best solution. In these cases, keeping hydrated and eating a well-balanced diet with plenty of fruit and vegetables can help reduce your fatigue.

If you are finding fatigue challenging, speak to your healthcare team, as they can suggest potential treatments or methods to reduce your fatigue.

You can find out more about managing fatigue in our Fatigue Infoguide.

Can supplements like curcumin help treat my myeloma? 

There is no clear evidence that dietary supplements are helpful for treating myeloma.

Some supplements such as green tea and curcumin, the main ingredient in the spice turmeric, have been studied in relation to treating myeloma. However, these have mainly been laboratory or small clinical studies with very few patients, which have not provided any conclusive evidence of patient benefit.

Importantly, some supplements are also known to interfere with prescribed treatments. For example, green tea and vitamin C supplements can affect the way bortezomib (Velcade^®), a drug commonly used in myeloma treatments, works.

This is why it is important to check with your healthcare team before starting any supplements or alternative treatments and to remind them of any you are taking if your prescribed treatments change.

You can read more about making healthy lifestyle choices whilst living with myeloma on our website, or discover more information about living well with myeloma in our Infopack for living well with myeloma.

Get in touch with us through the Myeloma Infoline on 0800 980 3332 (UK) or 1800 937 773 (Ireland) or by using the Ask the Nurse email service.