Ask The Nurse // 6th October 2020
Many patients we speak to have an increased focus on their health and general fitness after finding out they have cancer. They want to know what they can do to keep themselves as healthy as possible and whether there is anything extra they could be doing to relieve their symptoms or to ‘boost’ their defences. It is for this reason many patients ask us our thoughts on supplements and whether there are any particular options recommended for myeloma patients.
So, in this month’s blog, we answer the questions you ask about vitamins, minerals and supplements.
Can I take vitamins, minerals and supplements?
Anyone, including myeloma patients, who take medication regularly or has a pre-existing health condition should check with their doctor or healthcare team before taking a supplement. Your healthcare team will tell you about any potential interactions between the supplement and your treatment or any complications that could arise.
Some myeloma patients choose to take supplements, like multivitamins, as an additional reassurance that they are getting the right nutrients. Provided your healthcare team have confirmed your myeloma treatment is unlikely to be affected and you have a low risk of experiencing complications, you can take supplements if you want to.
Are any supplements recommended for myeloma patients?
There are no specific recommendations about supplemental vitamins and minerals for myeloma patients. In most cases, a well-balanced diet with plenty of fruit and vegetables should provide an adequate level of vitamins, minerals and nutrients to maintain general health.
However, a vitamin or mineral supplement may be recommended by your healthcare team if there is a risk of deficiency.
Should I be taking vitamin D?
There is no specific recommendation about vitamin D supplements for myeloma patients.
However, it is recommended that all adults in the UK consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter.
Between late March/early April to the end of September, most people can get all the vitamin D they need through sunlight on their skin and from 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.
If you decide to take a vitamin D supplement, it is very important to let your haematologist know in the first instance.
Are there any supplements I can take for my peripheral neuropathy?
Some supplements such as magnesium and vitamin B complex have been considered helpful in the management of peripheral neuropathy. However, there is no firm research to support their use.
If you are struggling with peripheral neuropathy, we would recommend that you talk to your haematologist or clinical nurse specialist. They may prescribe a supportive treatment or refer you to a specialist team to help with your symptoms.
You can find out 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 affect the immune system and how well it responds to infection.
There is no real evidence that supplements can ‘boost’ your immune system or reduce the risk of infections (e.g. cold or flu).
Myeloma patients should avoid supplements aimed at boosting the immune system (e.g. echinacea) since it is unknown how these may affect your myeloma.
The best way to support your immune system is to look after yourself by eating well, staying hydrated, exercising regularly and getting enough sleep.
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 in some cases anaemia.
In myeloma, anaemia is caused by suppression of red blood cell production, not iron deficiency. Therefore, it is unlikely that an iron supplement will help with fatigue caused by myeloma-related anaemia. If you have persistent anaemia your haematologist will prescribe supportive treatments to help.
If your fatigue is related to your diet, it is unlikely that you would be deficient in one nutrient, so an iron supplement would not be recommended. In most cases, keeping hydrated and eating a well-balanced diet with plenty of fruit and vegetables will help reduce your fatigue.
If you are finding your fatigue challenging, speak to your healthcare team as they will be able to suggest potential treatments or methods to reduce your fatigue.
You can find out more about managing fatigue in our Fatigue Infoguide.
Can supplements help treat my myeloma?
There is no real evidence that herbal remedies and supplements are safe and effective for the treatment of myeloma. Green tea and curcumin, the main ingredient in the spice turmeric, are two of the supplements we get asked about the most. This is because they have been the focus of several news reports because of their potential anti-cancer properties.
Whilst high concentrations of these supplements have been shown to kill myeloma cells in the lab, the anti-myeloma effect has not been replicated in myeloma patients.
Curcumin has been tested in a very small number of myeloma patients with inconclusive results.
Additionally, there is no real evidence that it is safe for myeloma patients to take large quantities of herbal supplements like curcumin and green tea.
For more information about living well with myeloma, you can download the “Infopack for living well with myeloma”. You can also learn more about diet and myeloma by reading the “Spotlight on Diet” in the Autumn/Winter 2019 edition of Myeloma Matters.
If at any time you have any questions about supplements, diet or living well with myeloma you can contact us on the Infoline (0800 980 3332 (UK) or 1800 937 773 (Ireland)) or through the Ask The Nurse email service.
The Myeloma Information Specialist Team