People love to be helpful.  Mention that you have been diagnosed with cancer, and you can potentially receive hundreds of ideas from well-meaning friends and loved ones. However, how do you know if a suggested vitamin, herb or supplement is safe to combine with your prescribed cancer treatment?

You might be fortunate to have an oncologist who is well versed in using supplements, but it is not commonly the case. Nevertheless, it is always advised that you let your oncologist know what you are taking, which includes vitamins, herbs and supplements.

Supplements have the potential to work synergistically with your treatment and reduce side effects, but they also have the potential to cause harm. Here are some possible ways that supplements can interact with your cancer treatment…

• Most commonly, they can change how fast liver enzymes eliminate a drug from your body. Too fast and you won’t get the full effect of the drug. Too slow and the drug stays in your body longer causing more side effects and toxicity. Many of these liver enzyme pathways are called “Cytochrome P450” and the enzyme names begin with “CYP.”

 
Example: Say your friend recommends an energy supplement for you after chemotherapy because you feel so exhausted. You are taking Taxol which is metabolized through the CYP3A4 pathway. This supplement has licorice which inhibits the CYP3A4 pathway. The combination of the two together could make the chemotherapy more toxic.
 

• Some supplements can decrease the absorption of oral medications when taken within a couple of hours of each other. Activated charcoal, fiber, and mucilaginous herbs like marshmallow root can either bind up the medication or put a thick slimy layer over your digestive tissues making the medication hard to absorb.

 

• If you are on a medication that is blocking the effects of estrogen (such as aromatase inhibitors), it is recommended to avoid herbs that may have an estrogenic effect, such as maca, soy protein isolate and licorice root. Note that soy in food form may be safe, but soy supplements and soy protein isolate may not be.

 

• Probiotics and probiotic foods (such as yogurt with active cultures, raw sauerkraut, kombucha, and kefir) contain beneficial strains of bacteria. There are two situations where they might cause harm. 
  

If your white blood cell count (CBC) is below 2.5 or if your absolute neutrophil count (ANC) is below 1.0, these beneficial bacteria may go rogue without the healthy checkpoints in your immune system working properly and cause a systemic infection in your body. It doesn’t happen all the time, but there have been over 200 case reports of this happening.

Second, there is some early research coming out that taking probiotics may decrease the effectiveness of certain immunotherapies, but taking prebiotics (thought of as the food that feeds the bacteria) may be helpful. You can get prebiotics naturally in your diet by eating foods higher in fiber.

• Next, there are the interactions we have discovered through scientific studies.  For example, we know that high dose vitamin A should be avoided with the drug 5-FU. We also know that certain antioxidants may interfere with certain chemotherapies and radiation. However, not all antioxidants have demonstrated harm, and many times it is dose dependent.

 
For example, melatonin is a well-known antioxidant that has been shown in meta-analyses to be beneficial for certain tumor types when combined with chemotherapy and radiation, but this is not true of every antioxidant.
 

• Certain supplements are well known to increase bleeding and bruising such as ginkgo and vitamin E. It is best to only use these under careful medical supervision and lab monitoring if you are on other medications that can cause easy bleeding such as Avastin or aspirin.

 

• Sometimes blood pressure can drop too low for a person to safely receive their treatment. You might think low blood pressure is a good thing, but it can cause people to pass out and experience traumatic falls. Many supplements can potentially lower blood pressure and make the problem worse, such as melatonin and certain mushroom extracts.

 
If you choose to integrate supplements into your care, it is recommended you let your oncologist know what you are taking and work with a professional who is knowledgeable in drug-supplement interactions and who knows how to evaluate the evidence so you can make an informed decision.

I have worked alongside oncologists and people undergoing cancer treatment for over 13 years helping people safely navigate these decisions, and I’m here for my clients to help them evaluate supplements when a friend or loved one suggests something new.

It's 6:30 in the morning. I peek out my bedroom window and a chicken pops its head up to gaze at me. I am awake and giddy with ideas for the day. Where should I start - baking sweet potatoes, weeding the garden, writing in my journal? I let my English Shepherd out and warm air tumbles toward me. I settle on starting with my outdoor work before it becomes too hot.

This year, I decided to let most of the gardening go. When most people were pouring over seed catalogs in the winter and early spring, I was preparing to have major surgery and training my new employee Lindsay. Now, I return to the overgrown asparagus bed and begin pulling a wheelbarrow-full of overgrown plants. I slowly break apart a stubborn patch of grass from the roots with my garden trowel. The ground is hard, and I tear away one small bit of root at a time.

In time, I empty my wheelbarrow, and head over to the old piglet hut. I pause to allow our ducks Iris and Hilly to parade their newly hatched 19 ducklings to the old piglet wallow for the morning. Life on the farm is filled with moments like these, where you are invited to pause, marvel, and observe instead of constantly just barreling through life. It is the fertilizer for a life well lived.

It has been many months since piglets have lived at this farm. The hut is filled with a finely ground dust of manure, straw, and dirt - perfect for a garden bed. I am slowly amending my garden beds and preparing them once again for the year to come. I carefully navigate my wheelbarrow around the volunteer curcubits coming up in the yard, which our pigs inadvertently planted. I scoop up the precious garden gold and haul it over to the garlic bed.

Next, I settle down with my journal and a cuppa on the porch. Most days, my cuppa is a good cup of tea, but today I whiz up a fresh peach with dark leafy greens and some ice. The complexities of my inner world seem to settle themselves out on the lines of my journal, and I feel more at peace.

Today, I spend most of my time in and out of the kitchen preparing food for the week to come. It shouldn't take this long but I allow it to become a meandering task doing a little here and a little there. I enjoy the aroma of toasty millet, make a rather basic pot of beans (forgetting salt & seasoning all together), whip up a batch of veggie soup, and put up turkey meat from the lovely bird we raised here on the farm. As I gather herbs for the quinoa salad, I find a few hidden blackberries left to eat that have reached perfection.
...and I let myself rest and work slowly in the kitchen, an indulgent pleasure fit for a weekend.

My sweet farm dog, Gilly and I make it out to the side porch for a "spa session" while the storms roll in for the afternoon. This girl has been collecting all kinds of seed heads in her fur, so I sit and comb her out. She's a rough and tumble farm dog. She's also my heart dog and always by my side every moment she can get. When I do video consults, she's not allowed in the room so she sits right outside the door waiting. The spray from the storms start to blow over her coat and we head inside.

As the sky darkens with storms, I think I'll make myself a cup of tea and watercolor to the sound of music and thunder rumbling. This is how I unwind on the farm. Nothing out of the ordinary, yet all very extraordinary at the same time. Oh happy day!

I was surprised to find myself in the position of needing surgery this past winter. I had tried several, non-surgical approaches, but slowly I came to realize that surgery would be my best option. I can sincerely say that this has been one of the most powerful healing journeys I have ever walked because of the opportunity to fully lean into an integrative approach. 
 
First and foremost, I am grateful for the amazing technology and expertise that even allowed me to have access to surgery. It’s quite a miracle when you consider what surgery looked like even just 100 years ago.
 
While essential in this case, cutting out the disease was only part of the healing process. I could have left it at that, but I would have missed out on the richness of growing as a person and probably would have healed more slowly.  I spent a lot of time examining what my body was trying to tell me.  The answer led me through my family history, my personal history, and sitting with Divine Love. I sat with what it meant to be female through the many layers of our culture. I sorted through all the stuff I had been emotionally holding onto and decided a lot of it wasn’t mine to hold.  And, I got a lot of practice resting and receiving help from others. Wise and loving women guided me through this journey.
 
I lost a sacred part of my body and the rhythms that went with it, so I worked with an artist to honor that part of me and process the loss.  This piece of art is helping me heal and still honors the cycles in my life as I adjust to this new normal.
 
I’ll admit that going through the experience of the conventional medical system as a patient feels daunting to me. I feel rushed to say everything succinctly in my appointments. I have a lot of seemingly peculiar questions for them from a different paradigm.  Most importantly, I’m giving up control and trusting them with my life. I needed help to find and use my voice effectively in these situations. I also used a book called “Prepare for Surgery, Heal Faster.” It is an evidence-based, mind-body approach, and the techniques really helped me to be calm and at deep peace as I prepared for surgery.
 
This process has taught me that no one system has all the answers for healing, and I get the most benefit when I integrate them all together.  For example, my skin tore during the surgery.  I made a calendula preparation and used it to help heal the tear. Upon application, it immediately felt better. While conventional medicine has pain relievers I could take, I can’t think of a medication that would heal and soothe the tissue like calendula would.  I’ll be working with gifted practitioners in the months to come to help reduce scar tissue and rebuild physical integrity in my body. I have been making sure I have the nutrition I need to heal well, such as increasing my protein intake and drinking lots of homemade, farm-raised bone broth.
 
With so much preparation, I feel I might have been trying to bring some sense of control to the situation. In the end, one of the greatest “gifts” was a side effect of the surgery I hadn’t planned or prepared for. It taught me to literally let go and to accept not being in control.
 
I sit in wonder and amazement in how my body is healing.  It is simply miraculous. I don’t quite have all my stamina back, but I feel quite good otherwise. I am doing my best to honor the concept of convalescence and rest. My body will continue to heal and rebuild for the months to come, and I am here sorting through the deeper lessons this process is teaching me.  
 
Although surgery would not have been my first choice, I’m grateful for what I am learning and see it benefiting the people I continue to serve.

With the current situation in the U.S. it is more important now than ever to make sure we are doing our best to keep ourselves and our families safe.  That means we need to be aware that not all cleaning products are effective in killing the virus.  The CDC offers some great tips and guidelines to help us make sure we are choosing the proper disinfectants. 
 
CDC Recommended Hand Sanitizers
The CDC recommends that any alcohol-based disinfectant be at least 70 percent alcohol.  Make sure to follow the instructions on the package to ensure that you are using it properly in order to kill the bacteria and viruses on your hands.   If you are making your own hand sanitizer, make sure you are absolutely doing the math correctly to get the correct alcohol percentage; please don’t go by just any recipe you find on the internet.
 
Hand Soaps
The truth of the matter is that any soap will work to aid in prevention.  While some soaps contain additional antibacterial ingredients, it does not make them any more effective against the virus.  What does matter is the process of how you wash your hands.  It is the physical act of lathering, rinsing, and washing for at least 20 seconds that helps to rapidly reduce the number of bacteria and viruses on your hands.
 
Disinfectants 
The CDC recommends disinfecting high-touch surfaces daily in common household areas.  These areas include tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks, and other areas.  The CDC states that most EPA registered disinfectants will work against the virus.  Lysol, Clorox, and hydrogen peroxide products, along with the off-name brands are among the many products that are approved for use against the virus.  For those who are looking for a more natural cleaning solution, Nixall disinfectant is a great recommendation, but don’t mix it up with Nixall cleaner.  Suggested use for it to be effective against the virus is to spray it on the surface undiluted and let it sit for at least 10 minutes before wiping it down.  You can easily check to see if your product is EPA approved against the COVID-19 virus by following this link and typing in the EPA registered code located on your product. 
https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
 
Please be cautious when using disinfectants and follow the instructions for use. Use proper ventilation and gloves where necessary; avoid contact with your eyes or mucus membranes. Do not use disinfectants internally or externally on your body.
 
Homemade Disinfectants
While making your own household cleaners and disinfectants can be a great way to avoid harmful chemicals for you and your family, caution is advised in using them against the virus because there is not enough evidence to prove that they are in fact effective enough to kill the virus.  Essential oils and vinegar products are not included in the EPA approved list, so be aware of that when using them.
 

I've been getting a lot of questions lately about "What can I take for this?" and I've been seeing a lot of information circulating on the internet on this topic. In case you are wondering, I want to take a moment to share my thoughts...
 
Foremost, we do NOT have the results of any scientific trials on natural products showing what works and doesn't work for COVID-19 at this time. This is a new/novel virus. Viruses are pieces of changing genetic information, and what may be effective against one virus will not be effective against another viruses. Just because something has anti-viral action against herpes or flu, it does not mean that it will have anti-viral action against COVID-19. Please exercise caution  when companies are trying to sell you natural products with claims that they fight COVID-19. Such claims are NOT validated at this time. 
 
So, what can you do?  True to naturopathic principles, I believe prevention is the best medicine.
 
First, the most important measure to take is to follow good public health policy and stay informed.

• If it has been awhile, it doesn’t hurt to brush up on hand washing information. It’s always good to review-- https://www.cdc.gov/handwashing/when-how-handwashing.html.
• Cover your mouth and nose when you sneeze or cough with a tissue or your elbow. Throw the tissue away and wash your hands at least 20 seconds.
• Clean and disinfect frequently touched surfaces. This includes your cell phone. Did you know that not all disinfectants have been approved for COVID-19? You can find more information here-https://www.cdc.gov/coronavirus/2019-ncov/prepare/cleaning-disinfection.htm.  A link for how to clean your iPhone can be found here-- https://support.apple.com/en-us/HT207123. 
• If you are in a high-risk group, have been potentially exposed, or if you are having symptoms, please stay home and limit your exposure as much as possible.
• Practice social distancing. Try to stay at least 6 feet away from other people.
• Information on the virus is changing every day. The more you know accurate and up-to-date information, the better off you will be.
• Try to get your information from credible sources, such as from a health department, the CDC, or an article published in a peer-reviewed scientific journal. If you read something on social media, question it and make sure the claims can be backed up by a reliable source.

 
Second, take measures to care for your health and your immune system. This always begins with a foundation of good sleep, a healthy diet, managing your stress, and avoiding smoking.

• Prioritize your sleep schedule. Go to bed and get up at the same time every day.
• This is a particularly important time to focus on a well-balanced diet, stay hydrated and avoid excess amounts of refined sugars, alcohol and refined foods. Avoid foods that you know make you feel unwell. This is an important time to have healthy food stocked in your freezer and pantry—think frozen vegetables, canned diced tomatoes, extra onions and garlic, beans, broths, and whole grains.
• Situations like this one can cause a lot of disruption in people’s lives and add to stress you may be experiencing. Prioritize down-time for yourself to relax and have some light-hearted fun. If you have seen a practitioner for stress or anxiety in the past, this is a great time to put what you learned with that professional into practice. Don’t feel shy to reach out for help if this situation is getting to you.
• We know that people who smoke have a worse outcome with COVID-19. If you or a loved one are looking for a good reason to quit, COVID-19 is a great reason. If you need smoking cessation support, please don’t hesitate to reach out.

 
Third, please be very careful using over-the-counter supplements or medicines. More is not always better. While zinc can help support the immune system, you can also overdose on it. Be aware that just because something is natural that it is not automatically safe to use. Several supplements can interact with medications and pre-existing health conditions, so check with a qualified professional before adding new supplements on your own. Make sure they are right for you.
 
Fourth, if you suffer with allergies, now is the time to take care of your respiratory health. If your doctor has prescribed medicine for your allergies, use it. Naturopathic care also offers several options for people to support respiratory health as well. 

Finally, you may consider trying some immune balancing supplements in addition to,
​NOT in place of public health and good lifestyle practices. Be aware-these immune supplements can interact with several medications, pre-existing health conditions (such as autoimmune disease), and potentially may have adverse effects, especially at high doses. For my clients, I'm happy to discuss the safety of these items at your next consult.