Vitamins

For most patients, it will be safe to take a multivitamin during chemotherapy and radiation that does not contain more than 100% of the US RDA. This is certainly reasonable since it is often difficult to “eat well” during treatment. An exception might be patients who are receiving 5-FU based chemotherapy. There is an interaction between 5-FU and folic acid that can make dosing and managing side effects problematic. Check with your oncologist on that one. For most patients, it will be safe to take a multivitamin during chemotherapy and radiation that does not contain more than 100% of the US RDA. This is certainly reasonable since it is often difficult to “eat well” during treatment. An exception might be patients who are receiving 5-FU based chemotherapy. There is an interaction between 5-FU and folic acid that can make dosing and managing side effects problematic. Check with your oncologist on that one.

As I discuss in detail in my evidence-based book, A Cancer Prevention Guide for the Human Race (http://www.amazon.com/Cancer-Prevention-Guide-Human-Race/dp/1608446913), the overwhelming majority of disease prevention research, including cancer prevention research, is based upon low-level types of research, including survey-based public health studies and retrospective clinical studies. While these methods of research are rather quick and inexpensive to perform, the data that they produce is highly prone to various forms of bias. That is to say, their conclusions are often not highly accurate. On the other hand, prospective, randomized, placebo-controlled clinical research trials, when performed properly, provide the highest level of research evidence available. However, because this type of research is so demanding, and so expensive to perform, very few cancer prevention studies are performed using this high-level approach. With this in mind, it’s important to acknowledge that the vast majority of research on Vitamin D (http://www.cancercenter.com/cancer-center-news/news/vitamin-D-deficiency.cfm) as a cancer prevention agent is based upon methods that produce rather weak (and often contradictory) data. However, among all of the known vitamins, it is fair to say that only Vitamin D is still a reasonable contender as a potential cancer prevention agent, and particularly for people with low levels of this vitamin in their blood. Specifically, based upon available research data, Vitamin D appears to be potentially most effective as a prevention agent for colorectal cancer, with most studies suggesting a 25 to 30 percent reduction in the risk (http://www.doctorwascher.com/vitamin-d/vitamin-d-significantly-reduces-colorectal-cancer-risk.html) of colorectal cancer in patients who take Vitamin D supplements. In terms of recommending a daily dose for Vitamin D supplementation, there is no consensus as to how much Vitamin D should be taken as a supplement, although healthy patients can usually tolerate 1,000 to 3,000 IU per day without serious side effects. However, unfortunately, I cannot make specific recommendations regarding the optimal amount of daily Vitamin D intake at this time. Moreover, Vitamin D can be toxic when taken in high doses, and can lead to kidney stones, kidney failure, calcifications in the soft tissues of the body, GI tract ulcers, and other serious health problems. Therefore, if you are considering the addition of daily Vitamin D supplements as part of a cancer prevention lifestyle (as I discuss in my book), I recommend that you first discuss this with your personal physician. I would also recommend routine testing of your Vitamin D levels, to reduce the risk of Vitamin D toxicity. As I discuss in detail in my evidence-based book, A Cancer Prevention Guide for the Human Race (http://www.amazon.com/Cancer-Prevention-Guide-Human-Race/dp/1608446913), the overwhelming majority of disease prevention research, including cancer prevention research, is based upon low-level types of research, including survey-based public health studies and retrospective clinical studies. While these methods of research are rather quick and inexpensive to perform, the data that they produce is highly prone to various forms of bias. That is to say, their conclusions are often not highly accurate. On the other hand, prospective, randomized, placebo-controlled clinical research trials, when performed properly, provide the highest level of research evidence available. However, because this type of research is so demanding, and so expensive to perform, very few cancer prevention studies are performed using this high-level approach. With this in mind, it’s important to acknowledge that the vast majority of research on Vitamin D (http://www.cancercenter.com/cancer-center-news/news/vitamin-D-deficiency.cfm) as a cancer prevention agent is based upon methods that produce rather weak (and often contradictory) data. However, among all of the known vitamins, it is fair to say that only Vitamin D is still a reasonable contender as a potential cancer prevention agent, and particularly for people with low levels of this vitamin in their blood. Specifically, based upon available research data, Vitamin D appears to be potentially most effective as a prevention agent for colorectal cancer, with most studies suggesting a 25 to 30 percent reduction in the risk (http://www.doctorwascher.com/vitamin-d/vitamin-d-significantly-reduces-colorectal-cancer-risk.html) of colorectal cancer in patients who take Vitamin D supplements. In terms of recommending a daily dose for Vitamin D supplementation, there is no consensus as to how much Vitamin D should be taken as a supplement, although healthy patients can usually tolerate 1,000 to 3,000 IU per day without serious side effects. However, unfortunately, I cannot make specific recommendations regarding the optimal amount of daily Vitamin D intake at this time. Moreover, Vitamin D can be toxic when taken in high doses, and can lead to kidney stones, kidney failure, calcifications in the soft tissues of the body, GI tract ulcers, and other serious health problems. Therefore, if you are considering the addition of daily Vitamin D supplements as part of a cancer prevention lifestyle (as I discuss in my book), I recommend that you first discuss this with your personal physician. I would also recommend routine testing of your Vitamin D levels, to reduce the risk of Vitamin D toxicity.

Yes, FDA regulations for vitamins and supplements are similar to FDA regulations for food products. Note that health supplements do not have to meet FDA standards for drugs, which are more rigorous and require extensive testing for safety.

For more about vitamins and supplements, see our feature article: http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue4.cfm
Yes, FDA regulations for vitamins and supplements are similar to FDA regulations for food products. Note that health supplements do not have to meet FDA standards for drugs, which are more rigorous and require extensive testing for safety.

For more about vitamins and supplements, see our feature article: http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue4.cfm

The Vitamin D Council is a wonderful resource for all information on Vitamin D. Here is a link to a page that we have created to address some questions surrounding Vitamin D. http://www.breastinvestigators.com/breast_health::vitamin_d_and_breast_cancer.html Two great types of foods that contain vitamin D are fish and soy products. Good old fashioned cod liver oil, which can be taken in pill form too, is high in vitamin d. In addition herring, catfish, oysters, salmon, trout and halibut are also high in vitamin d.

If seafood is not your thing, tofu and soy milk are also high in vitamin D.

In the fruit and vegetable world, vitamin d does not exist (except for mushrooms but the numbers are low). However, some orange juices are now fortified with vitamin d.

If you are able to eat meat, beef and chicken contain vitamin D.

Drinking alcohol to excess for a week or more could cause a deficiency in B12. You might have a loss of memory, a bit of depression, and slowness in calculating, figuring out puzzles, adding, multiplying, etc.... A deficiency in B12 slows mental reaction, slower thinking. Girls like fellows who are good with conversation - if you're not making it, then a low level of B12 might be the cause, it'll bring out your sparkling personality. Drinking alcohol to excess for a week or more could cause a deficiency in B12. You might have a loss of memory, a bit of depression, and slowness in calculating, figuring out puzzles, adding, multiplying, etc.... A deficiency in B12 slows mental reaction, slower thinking. Girls like fellows who are good with conversation - if you're not making it, then a low level of B12 might be the cause, it'll bring out your sparkling personality.

Studies thus far are inconclusive as to whether taking Vitamin C cures, prevents, speeds recovery, or reduces the severity of the symptoms of the common cold.

Most studies have found that taking Vitamin C has no overall noticeable benefit for preventing or treating the common cold.

However, people living in extreme conditions or people under extreme circumstances have reported a 50% reduction in the risk of contracting a cold. The extreme conditions and circumstances include soldiers in sub-arctic exercises, skiers, and marathon runners. This evidence needs to be further investigated to verify these claims.

http://www.umm.edu/altmed/articles/vitamin-c-000339.htm
http://www.webmd.com/cold-and-flu/news/20070717/vitamin-c-cant-cure-common-cold
http://www.independent.co.uk/life-style/health-and-families/health-news/vitamin-c-does-not-protect-against-the-common-cold-457707.html
http://www.newsweek.com/2007/11/14/can-vitamin-c-cure-colds.
http://www.mayoclinic.com/health/vitamin-c/NS_patient-vitaminc
http://www.mayoclinic.com/health/vitamin-c/NS_patient-vitaminc/DSECTION=evidence Studies thus far are inconclusive as to whether taking Vitamin C cures, prevents, speeds recovery, or reduces the severity of the symptoms of the common cold.

Most studies have found that taking Vitamin C has no overall noticeable benefit for preventing or treating the common cold.

However, people living in extreme conditions or people under extreme circumstances have reported a 50% reduction in the risk of contracting a cold. The extreme conditions and circumstances include soldiers in sub-arctic exercises, skiers, and marathon runners. This evidence needs to be further investigated to verify these claims.

http://www.umm.edu/altmed/articles/vitamin-c-000339.htm
http://www.webmd.com/cold-and-flu/news/20070717/vitamin-c-cant-cure-common-cold
http://www.independent.co.uk/life-style/health-and-families/health-news/vitamin-c-does-not-protect-against-the-common-cold-457707.html
http://www.newsweek.com/2007/11/14/can-vitamin-c-cure-colds.
http://www.mayoclinic.com/health/vitamin-c/NS_patient-vitaminc
http://www.mayoclinic.com/health/vitamin-c/NS_patient-vitaminc/DSECTION=evidence

Folic acid is the man-made form of folate. Folate is essential and needed by everyone. Folate belongs to the family of B vitamins and it is a water-soluble vitamin. Folate is vital for the synthesis and production of red and white blood cells.

Folate plays a vital role in preventing diseases, such as heart disease, stroke, depression, cancer, diabetes, anemia, macular degeneration, and so on.

Some people who need folic acid are:
- In infancy because there is rapid cell growth and division.
- If you are planning for pregnancy, pregnant, or breast feeding.
- If you often consume more than one alcoholic drink per day.
- Certain medications may cause a depletion of folic acid.

For a diet that is not well balanced and does not include the foods listed below, Folic Acid 400 microgram tablets may be purchased over the counter at your local pharmacy.

Excellent sources of folic acid include:
- Grain products such as whole wheat, fortified flour, fortified cereals
- In meat and beans, such as eggs, beans, sunflower seeds, black-eye peas, great northern beans, legumes and liver
- Vegetables are an excellent source, such as asparagus, green peas, broccoli, and leafy green vegetables.
- Fruits such as oranges, strawberries, cantaloupes, and other melons.

http://ods.od.nih.gov/factsheets/folate/
http://ohioline.osu.edu/hyg-fact/5000/5553.html
http://www.womenshealth.gov/faq/folic-acid.cfm#a Folic acid is the man-made form of folate. Folate is essential and needed by everyone. Folate belongs to the family of B vitamins and it is a water-soluble vitamin. Folate is vital for the synthesis and production of red and white blood cells.

Folate plays a vital role in preventing diseases, such as heart disease, stroke, depression, cancer, diabetes, anemia, macular degeneration, and so on.

Some people who need folic acid are:
- In infancy because there is rapid cell growth and division.
- If you are planning for pregnancy, pregnant, or breast feeding.
- If you often consume more than one alcoholic drink per day.
- Certain medications may cause a depletion of folic acid.

For a diet that is not well balanced and does not include the foods listed below, Folic Acid 400 microgram tablets may be purchased over the counter at your local pharmacy.

Excellent sources of folic acid include:
- Grain products such as whole wheat, fortified flour, fortified cereals
- In meat and beans, such as eggs, beans, sunflower seeds, black-eye peas, great northern beans, legumes and liver
- Vegetables are an excellent source, such as asparagus, green peas, broccoli, and leafy green vegetables.
- Fruits such as oranges, strawberries, cantaloupes, and other melons.

http://ods.od.nih.gov/factsheets/folate/
http://ohioline.osu.edu/hyg-fact/5000/5553.html
http://www.womenshealth.gov/faq/folic-acid.cfm#a

Here are some daily activities to better manage anemia:
- Rest
- Eat high protein foods (i.e. meat, peanut butter, eggs)
- Eat foods with iron (i.e. red meat, collard greens, spinach, cooked dried beans, liver)
- Stay hydrated by drinking water, gatorade, etc.
- Make sure you are getting your vitamins from diet or multi-vitamins Here are some daily activities to better manage anemia:
- Rest
- Eat high protein foods (i.e. meat, peanut butter, eggs)
- Eat foods with iron (i.e. red meat, collard greens, spinach, cooked dried beans, liver)
- Stay hydrated by drinking water, gatorade, etc.
- Make sure you are getting your vitamins from diet or multi-vitamins