Home > Total Nutrition > Supplements for Health and Healing

Are You Supplement Savvy about Cancer?

By Jill Place, MA, RD

If you've just been diagnosed with cancer, you may be considering nutritional supplements as part of your treatment plan. Here's some general information to get you started. The important thing to remember is that choosing supplements can be complicated, especially if you have cancer. Please leave selection to a professional like a Registered Dietitian or Supplement Savvy Specialist. Using them may also be complicated. So some tips about taking supplements are also included here.

What is a Dietary Supplement?

A dietary supplement is, quite simply, something that "supplements" your diet. Supplements are made up of fragments of nutrients such as vitamins, minerals, herbs, proteins, carbohydrates, and fats or a combination of these fragments. Supplements aren't normal foods because the nutrients are fragmented and come in pills, capsules, tablets, liquids, powders, or other concentrated non-food forms.

There's been a lot of confusion about what's actually considered a food, a supplement, or a drug. It can be generally agreed that vitamins, minerals, and other food fragments are appropriate materials for dietary supplements. But other products, such as herbals Gingko Biloba and St. John's Wort, are not a part of our normal diet. And how can thyroxine, which comes from the thyroid glands of cows, be a drug when melatonin, which similarly comes from the pineal glands of cows, is a "dietary" supplement? Also, there are product lines of soups, drinks, and teas that claim to be dietary supplements because of added herbals, vitamins, and minerals. With all this confusion, how can dietary supplements be defined and regulated?

Regulation of Supplements

Congress passed The Dietary Supplement Health and Education Act (DSHEA) in 1994 to define, label and set down rules for the safety of supplements. But strong public sentiment against strict regulation of supplements has limited the Food and Drug Administration's (FDA) ability to regulate them. The DSHEA doesn't require that dietary supplements be shown to be safe or effective or the FDA to examine them before they're sold to you.

Because of this lack of regulation, there's no guarantee that supplements are what they say they are. As a matter of fact, recent tests have shown that some supplements, especially difficult-to-standardize herbals, don't always have the amount of active ingredient listed on the label. Also, there's no way to find out how safe or pure they are. Imported herbal supplements may be contaminated with drugs or heavy metals. On top of that, supplement manufacturers can make non-FDA approved health claims as long as a disclaimer accompanies them. In other words, they can claim that a supplement cures every ailment known to man as long as they have a disclaimer on the label that says that says the FDA hasn't approved the claim. So use your own good judgment when deciding whether claims ring true or not. If they sound too good to be true, they probably are. And if supplements aren't regulated, how do you choose a safe supplement that works?

Recognizing Quality

Quality is the most important thing to consider when choosing a supplement. And there's no way that an ordinary person, a healthcare professional, or even sometimes a vitamin manufacturer can recognize quality ingredients. PC-SPES, a popular herbal blend for Prostate Cancer, is not manufactured anymore because its raw ingredients were found to be contaminated with dangerous drugs. The manufacturer has closed down production until they can better regulate their raw materials. Suppliers may also offer manufacturers substandard or even mislabeled ingredients or manufacturers may cut corners and use cheaper ingredients for many reasons. Also, supplements must be formulated safely and scientifically to be effective. In other words, it's impossible to know what's in there. So here's some do's and don'ts that will help you choose quality supplements that are what they say they are:

DON'T buy from a vitamin store unless you specifically know what to buy. Most clerks are not Supplement Savvy Specialists and will often encourage you to buy supplements that are about to expire or that are overstocked.

DO get specific recommendations from a dietitian, health care practitioner, or other Supplement Savvy Specialist who knows a lot about nutritional supplements. She or he can help you choose appropriate quality supplements for your wellness goals that may only be available to professionals.

DON'T buy the cheapest thing from vitamins.com. Quality doesn't come cheap.

DO buy a brand that has a proven track record for excellence and a lot of manufacturing integrity.

DON'T use supplements from multi-level marketing programs that focus more on making money than on quality. There are some high-quality supplements made by these companies, but you will most likely pay more for them.

DO look for meaningful label statements about product quality, such as ones that carry logos from U.S. Pharmacopeia (USP), National Nutritional Foods Association (NNFA), or Consumer Lab.com (CL).

REMEMBER the most expensive supplement is the one that doesn't work!

Taking Supplements

You've chosen your supplements or, better yet had them chosen for you by a dietitian or Supplement Savvy Specialist, and have lugged all those bottles home. Getting them home and taking them are two entirely different things. Perhaps you've decided to take supplements before and have had all those bottles gather dust on your counter until you've had to throw them away. Here are some tips on how to take supplements successfully:

First make sure that you're committed to taking supplements. You may be resistant to changing your lifestyle. Talk over your doubts about starting a supplement regime if you have any with your dietitian or Supplement Savvy Specialist. Take the list of supplements she or he has recommended home and think it over. When you're ready, and only then, buy the supplements and start. If you have to, work up to your whole regime in baby steps, adding one supplement at a time every few days. Remember that this is a change for life and that you're the only one who can make it work for you.

Ensure each supplement's potency by storing it away from heat, light, or moisture and keeping it tightly closed between uses. Quality supplements are often appropriately packaged in tinted bottles or opaque containers. Some, like live friendly bacteria and oils, will have to be refrigerated.

Figure out a schedule of what to take when. Your dietitian or Supplement Savvy Specialist can help you with this. Some supplements need to be taken with food and others between meals. Problem-solve a routine for your supplements that is doable and fits your lifestyle and don't leave your supplement consultation without it, especially if you're taking large amounts. Nothing can grind a supplement regime to a screeching halt like opening all those bottles several times a day. Why don't you portion out several day's worth of tablets and capsules on your kitchen counter and store them in snack-size zip lock baggies so that you can easily carry them in your pocket or purse. Pillboxes are just too small for the larger pill sizes and larger pill amounts of most supplement regimes. If you take, for example, several types of digestive enzymes at meals you might want to get a small tin from mints or bottle from over-the-counter medications in which to carry these supplements.

For the first few weeks, make an extra effort to establish a routine for taking your supplements. If you have an alarm on your clock or watch or in your organizer, set it to remind you to take your supplements. Schedule times in your organizer or put up "sticky note" reminders in strategic places in your home or office. It takes about three weeks to form a habit. After that time, you should have no problem remembering to take your supplements.

If you have difficulty swallowing pills, try different forms of supplements. For example, some multivitamins come in tablet, capsule, chewable, and powder form. You might also want to try taking your supplements with moist food such as applesauce so that they slide down easier.

Tell your dietitian or Supplement Savvy Expert IMMEDIATELY if you have any type of reaction to your supplements, such as nausea, irritability, headache…anything unusual. You may have intolerance to an ingredient or combination of ingredients, need to take the supplements with food, or need to break up the dosage. Your dietitian or Supplement Savvy Specialist can best advise you about what to do to make your supplement regime work for you

© Copyright 2002 Jill Place, MA, RD