Nutraceuticals are also called "nutritional supplements". These products are derived from food sources and are transformed into a form which is easier to ingest such as pills, tablets, powders, or liquids. Nutritional supplements may be beneficial in certain aspects of diseases or illnesses however it can also have no effect or even bring harm so choosing the right nutritional supplement to take is actually quite important. If you choose right this can make your body healthier and can even make the treatments that you are going through more effective. If you choose wrongly, it can have no effect and just be a financial drain or worse, even bring harm to you.
So how do you choose the right supplement to take? There is no hard and fast rule for this as your choice would entirely depend on your lifestyle and where you are in your life right now. This would depend on your age, the foods that you eat everyday, how active you are physically, and how much you sleep. So going for a consult with your physician is very important so you will be guided on which to take and how to select. However, I understand that not everyone has the time to do this because of your busy schedule. So I formulated a guideline on how you can decide whether the nutritional supplement is right for you and how much to take for specific vitamins and minerals.
1. Whole food supplements
Whole food supplements are those nutraceuticals where they powderize the food and convert it into capsules or tablets. Some examples would be microalgae tablets, moringa "malunggay" capsules, mangosteen capsules, garlic capsules, green tea powders, turmeric powders, etc. These types of nutraceuticals should be in your top consideration when purchasing food supplements. The reason being is that these are moderately processed. Meaning, only some of the original contents were removed. This preserves the antioxidants and phytonutrients that the unprocessed or unrefined (whole food) version of the food so you would still be able to benefit from the effects of the whole food form. In some cases, like microalgae, the unprocessed and unrefined version is the one packed into tablets and/or capsules after it is washed and dried up. Fruits, vegetables, and microalgae contain thousands of phytonutrients that work in synergy to benefit us once we eat them. Some of them can even reverse some of the common lifestyle-related chronic illnesses that we have today like hypertension, diabetes, gouty arthritis and to a certain extent, cancer. That is the power of whole foods.
2. Vitamin B12
Vitamin B12 is a vitamin that bacteria creates. There are no plants nor animals that creates this vitamin. We, humans, get this vitamin naturally through animal food products like meat. However, studies have shown that even the individuals that have high animal food product consumption can have vitamin B12 deficiency. This is because as we age, the absorption of vitamin B12 from our intestines decrease. Vitamin B12 deficiency can produce numbness, cramps, anemia, and fatigue among others. You might think that to increase the vitamin B12 from the diet, you just have to eat more animal food products. However by doing so you will also increase your risk of developing heart disease, diabetes, and cancer. So the solution to this is to take a vitamin B12 supplement. There are various forms of vitamin B12 like cyanocobalamin, methylcobalamin, adenosylcobalamin, and hydroxycobalamin. For the general public, I recommend cyanocobalamin since it is shelf-stable, the most studied, and cheap. 500mcg per day of cyanocobalamin would suffice. For those with chronic kidney disease with an estimated GFR of less than 50, I recommend 500mcg of methylcobalamin once a day. For the other forms of vitamin B12 I would follow 500mcg once a day. As much as possible take this on an empty stomach to minimize interaction with other nutrients.
3. Vitamin D
Vitamin D is a fat-soluble vitamin that is produced by our skin when exposed to the sun and processed by our kidneys so that our intestine can absorb calcium from the food that we eat. For the general population, 15-30 minutes once a day exposure to the sun would be enough for our body's vitamin D daily requirements. However, for people who don't get exposed to the sun due to lifestyle issues, geographical reasons, or those who have skin diseases that gets exacerbated by sun exposure or chronic kidney disease, the amount of vitamin D that these people receive would definitely lower. Therefore, we rely on supplementation to correct this. My recommendation is 2000 IU once a day of vitamin D3 to be taken with meals.
Calcium is a mineral that our muscles use to move and for our bones to be strong. However, excessive amounts of calcium in our blood can increase the risk of heart disease, stroke, and death especially if the source of calcium came from supplements. Therefore, it is very important to know when or when not to take calcium supplements. It would be better to consult with your lifestyle medicine physician to be guided about this. I would recommend at least 600mg daily of calcium preferably from plant sources while avoiding high oxalate vegetables like spinach, chard, and beet greens to prevent the development of kidney stones.
Iron is an important mineral that is part of the protein hemoglobin. Without iron, hemoglobin will not be able to form properly and red blood cells will be dysfunctional. However, the body does not have a way to eliminate iron in our body except through bleeding. Therefore, one has to be careful not to use iron supplements irresponsibly because iron can accumulate inside our body and cause problems in your heart, liver, and pancreas. I would always prefer a multivitamin supplement that does not have iron in it for the general public. However, if you are someone who is anemic, I would recommend you to take an iron supplement together with vitamin C because vitamin C helps with the absorption of iron. You may stop taking the iron supplement once the anemia is corrected.
Melatonin is a hormone that the brain secretes to put us to sleep. It is also a very potent antioxidant that scavenges free radicals that are present inside the brain which can cause damage to the cells. If you have difficulty sleeping, interrupted sleep, or you are traveling and crossing time zones, taking melatonin can help you sleep better. The recommended dose is 1mg once a day at night in sublingual form or 3mg once a day at night taken orally. This is best taken 30min to an hour from your scheduled sleep.
These are the nutraceutical recommendations that you need to take note of. If you have questions or conditions that you need guidance in, don't hesitate to contact us for a consultation so you can have the right recommendations.
Your partner in your cancer journey,
Jansen T. Calalan, MD, DPCLM, DipIBLM