Supplements

Question 1

Ginger

Answer 1

May help N/D, gas, heartburn, anorexia
Antioxidant/anti-inflammatory properties
May interfere with anticoagulants

Question 2

Up to __ g ginger/day is considered safe per the FDA

Answer 2

4g/day
1000mg fried ginger/day = safe (< 1500 mg for N)

Question 3

Major bioactive component in fresh ginger

Answer 3

Gingerols

Question 4

Ginko Biloba

Answer 4

May inhibit proliferation of cancer cells
May increase bleeding risk - interfere with anticoagulants/antiseizure meds

Question 5

When to discourage use of Ginko Biloba

Answer 5

with alkylating agents, antitumor antibiotics, and platinum analogues due to free radical scavenging effects

Question 6

Glutamine

Answer 6

May reduce inflammatory side effects from treatment
Plays a role in maintaining intestinal mucosal barrier
May interact with antiseizure meds
Depleted with stress (surgery, cancer, sepsis)

Question 7

Glutamine is converted to

Answer 7

Ammonia - may decrease the effectiveness of lactulose

Question 8

Glutamine is contraindicated with

Answer 8

those taking lactulose and antiseizure medications

Question 9

Green tea

Answer 9

hepatoprotective, cardioprotective, neuroprotective, anticancer, antiobesity, antidiabetic, antibacterial, antiviral, hypoglycemia effects

Question 10

Green tea is discouraged with

Answer 10

erlotinib + pazopanib due to possible effects on cytochrome P450 1AZ isozome induction

Question 11

Polyphenols are mainly composed of

Answer 11

Catechins
Major polyphenol = epogallocatechin-3-gallate (EGCG)

Question 12

Garlic

Answer 12

Known for its allium compounds
May stimulate apoptosis and help regular cell cycles
May interfere with some prescription drugs including saquinavir and antiplatelet medications

Question 13

N-acetylcysteine

Answer 13

Stimulates glytathione synthesis and scavenges for free radicals
Antioxidant properties
Prevents nuclear KB activation, which increases inflammatory response

Question 14

N-acetylcysteine dose amount

Answer 14

600-1800 mg doses daily
Most side effects when > 9g/day is used

Question 15

Melatonin

Answer 15

May increase risk of bleeding
1-5 mg/day for insomnia, up to 20 mg/day for anticancer effects

Question 16

Omega 3 fatty acids

Answer 16

Cardioprotective, anti-inflammatory, immunomodulatory
EPA and DHA may increase bleeding risk if taken in high doses - up to 3g/day = safe (up to 4 g if monitored by MD)

Question 17

Quercetin

Answer 17

May be beneficial in patients at risk for hemachromatosis
can bind with iron, which can decrease iron bioavailability

Question 18

Quercetin found in

Answer 18

Citrus fruits, apples, onions, parsley, tea

Question 19

Quercetin can cause

Answer 19

Flushing, sweating, N/V, dyspnea

Question 20

Reishi mushroom used for

Answer 20

Prevent aging, enhance immune system, HTN, HLD, viral infections, cancer, inflammatory disease, cardiovascular disease, DM

Question 21

Reishi mushroom safety

Answer 21

Possible unsafe when used > 1 mo
May increase bleeding risk when combined in high dose (>/= 3mg) with anticoagulant medications

Question 22

Resveratrol

Answer 22

Antioxidant, anti-inflammatory,antimutagenic, anticarcinogenic, antiprolferative
Has been reported to cause cell arrest, promote apoptosis, and inhibit cancer cell proliferation

Question 23

Resveratrol safety

Answer 23

Has antiplatelet effects, so could cause excessive bleeding with blood thinning medications

Question 24

Resveratrol food sources

Answer 24

The root of the knotweed, grapes (black > red/green, especially the skins)

Question 25

Selenium serves as a cofactor for

Answer 25

Glutathione peroxidase - an enzyme of the antioxidant defense system

Question 26

Excessive selenium can cause

Answer 26

Acute toxicity including N/V, abd pain, dermatitis, nail changes, fatigue, irritability, alopecia, impaired endocrine function, neurotoxicity, wt loss

Question 27

Selenium tolerable upper limit

Answer 27

400 mcg/day

Question 28

Preferred form of selenium

Answer 28

Selenomethionine

Question 29

Silymarin

Answer 29

Extract of milk thistle Antioxidant, anti-inflammatory, liver protective, anticancer

Question 30

Allergic reactions for silymarin > _____ mg/day

Answer 30

> 1500 mg/day

Question 31

Caution silymarin with

Answer 31

Tamoxifen

Question 32

Why are clinical applications limited with silymarin?

Answer 32

It is water soluble - poor absorbance Combine with Silybin _ phosphatidylochline (PC) for enhanced bioavailability

Question 33

St. John's Wart

Answer 33

Used for pain May interact with many medications, including Warfarin Increases cytochrome P450 (CYP) 3A4, resulting in lower plasma levels of drugs that are CYP 3A4 substrates AVOID with all concurrent chemo

Question 34

Theanine is found in

Answer 34

Tea and mushrooms

Question 35

Theanine

Answer 35

Antioxidant May enhance efficacy of Doxorubicin and Idarubicin May reduce BP

Question 36

Theanine common dose

Answer 36

200-400 mg/day or BID with a max dose of 1200 mg

Question 37

Turkey tail mushroom/Yun zhi

Answer 37

Bioactive component from the cultured mycelia including the protein bound polysaccharide-K (PSK) and polysaccharopeptide (PSP) Antimicrobial, antiviral, immunomodulatory, antitumor

Question 38

Turkey tail mushroom/Yun zhi common dose

Answer 38

3 mg/day

Question 39

Vit D

Answer 39

Fat soluble Anti-inflammatory, immunomodulatory, bone protective, anticancer Replicates genes that influence cell proliferation and apoptosis

Question 40

Vit D toxicity can result in

Answer 40

Hypercalcemia

Question 41

Upper intake level of vit D

Answer 41

4000 IU/day

Question 42

Vit D maintenance blood level

Answer 42

40-60 ng/mL (up to 100 ng/mL is safe)

Question 43

Aloe

Answer 43

May be useful for constipation May delay radiation dermatitis

Question 44

A-lipoic acid

Answer 44

Cellular antioxidant improved for energy production Improved insulin sensitivity/DM management Aids with HTN May mitigate radiation damage May reduce symptoms of neurotoxicity Inhibits growth of breast, colon, lung, liver, and pancreatic cancer cells Fat and water soluble

Question 45

A-lipoic acid dietary sources

Answer 45

Spinach, broccoli, brewers yeast

Question 46

Black cohosh

Answer 46

Suppresses symptoms associated with menopause (hot flashes) and cancer treatment may interfere with the biological activity of atorvastatin, azathioprine, and cyclosporine

Question 47

Coenzyme Q10

Answer 47

Fat soluble Structurally similar to menaquinone (K2) May have procoagulant effects, influencing the efficacy of Warfarin

Question 48

Coenzyme Q10 causes

Answer 48

Mild GI side effects (N/V/D)

Question 49

Coenzyme Q10 levels _____ with aging

Answer 49

Decline

Question 50

Curcumin

Answer 50

Found naturally in tumeric May inhibit growth of cancer cells May prolong activated patyial thromboplastin time and prothrombin time

Question 51

Curcumin supplements are combined with

Answer 51

Piperine (in black pepper) to improve absorption

Question 52

3,3 Diindolylmethane (DIM) and indole-3-carbinol (I3C)

Answer 52

Found in cruciferous vegetables Proposed chemoprevention for breast and lung SCC

Question 53

Flaxseed

Answer 53

Excellent source of a-linolenic acid Rich in ligans Provides soluble and insoluble fibers May affect absorption of some medications

Question 54

Flaxseed may cause

Answer 54

N/D, gas Possible contraindicated in those with IBD

Question 55

Flaxseed:meds relationship timing

Answer 55

Meds should be taken 1-2 hours before/after consuming flaxseed to reduce effects on drug absorption

Question 56

Flaxseed dose

Answer 56

1-2 tbsp/day = safe