Therapy Caveats

evels of > 10,000-25,000 a day may cause congenital deformity, fatigue, headache, mouth fissures, and increased pressure on the brain.  Should be used with serum levels as guidance, and never during pregnancy.1  The dosage of vitamin A liquid drops used by cancer patients ranges between 100,000-200,000 IU a day.  The Foundation has cautioned that such high doses could produce toxicity if taken over extended periods of time.  See Appendix A:  Avoiding Vitamin A Toxicityfor details.

Arginine can elevate blood sugar by neutralizing insulin in some Type-II diabetics.  Those diabetics contemplating using arginine or Powermaker II (sugar-free) should check their blood sugar with a glucometer every time they take the supplement during the first 3 weeks of treatment.  Also, some nutritionists are concerned about using high doses of arginine in cancer patients because arginine promotes cellular growth and thus could cause cancer cells to grow faster.  Scientific studies show, however, that arginine provides beneficial effects to cancer patients.  Only one study in breast cancer patients hinted at a risk from arginine supplementation.

.Bee products should not be administered to children under the age of three, or to those with allergy to Hymenoptera species.

Watch for side effects and adjust dosage if necessary

Can cause hypercarotenemia (increased blood carotene) with yellowing of skin which is reversible on discontinuation and also harmless.2  Patients suffering from liver damage should avoid niacin, vitamin A, and beta-carotene because these nutrients can be harmful to such patients.  Also, the Life Extension Foundation recommends against high doses of beta-carotene in AIDS patients who have hepatitis

Generally free of adverse effects

One report of immune hemolysis is noted.3

Generally free of adverse effects

Do not use if you have kidney or liver disease.  May cause dizziness, headache, or diarrhea.

Generally free of adverse effects

Patients with uncontrolled hypertension, cardiac arrhythmias or palpitations should avoid caffeine, which promotes noradrenalin hypersecretion.

Watch for side effects and adjust dosage if necessary

More than 2 grams a day from supplementation is not recommended.

Generally free of adverse effects

L-carnitine generally recognized as safe (GRAS); DL-carnitine should notbe used because of muscle-weakening effect.

Generally free of adverse effects

Severe toxicity can occur because of contaminated water.  Mental and physical fatigue, depression, insomnia, etc., may result.  Copper may deplete zinc because they compete for absorption in the intestine.

Watch for side effects and adjust dosage if necessary

Some nutrients recommended by the Foundation to avoid thrombosis may interact with anticoagulation prescription drugs such as Coumadin and heparin.  It is suggested that patients taking physician-prescribed anticoagulation drugs be monitored by their physician when introducing such nutrients.  Weekly or biweekly blood tests are suggested to make sure the blood is within recommended levels for clotting factors and bleeding times.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

Do not use curcumin if you have biliary tract obstruction because curcumin could eliminate the flow of bile excreted through the bile duct.  High doses of curcumin on an empty stomach can cause stomach ulceration.

Generally free of adverse effects

High doses (10 mg a day) of Deprenyl may be detrimental to a patient with Parkinson’s disease, especially when the patient is taking L-dopa.

Watch for side effects and adjust dosage if necessary

Men and women with hormone-related cancer should avoid DHEA.  Generally, any hormone should be used with caution and under the direction of a physician.  See DHEA Replacement Therapy protocol.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

Use with caution in those with temporal lobe epilepsy or bipolar disease.

Generally free of adverse effects

Should be accompanied by mixed vitamin E tocopherols as an antioxidant.  Can decrease clotting factors.  Monitor if on anticoagulants.  Patients with leaky blood vessels should exercise extreme caution when taking essential fatty acids in the form of fish oil concentrates such as Mega-EPA because they inhibit blood clotting.  There is a chance that a cerebral hemorrhage could occur because the blood-thinning effects these nutrients can produce.  Blood tests that measure clotting time can be used to ensure these nutrients are not reducing the clotting factors in your blood to abnormal levels.

Generally free of adverse effects

Those with tendency to psychosis should avoid doses exceeding 15 mg/day.  A B12 deficiency with subacute combined degeneration of the spinal cord may be masked by folic acid; monitor B12 levels and always take supplemental vitamin B12 when taking folic acid.

Generally free of adverse effects

To determine whether forskolin can replace your antihypertensive drugs, extreme caution is mandatory and physician cooperation is essential.  Reduce the dosage of your antihypertensive drug very slowly while increasing your intake of forskolin and monitor your blood pressure on a daily basis.  If you do not exercise caution, an acute hypertensive event could occur, resulting in a stroke.

Watch for side effects and adjust dosage if necessary

Garlic taken in high doses (eg., 6000-8000mg to lower cholesterol) can cause stomach irritation if taken on an empty stomach.

Generally free of adverse effects

Some nutritionists are concerned about the use of high doses of glutamine in cancer patients.  Because glutamine promotes cellular growth, this amino acid could cause cancer cells to grow faster.  Scientific studies show, however, that glutamine provides beneficial effects to cancer patients.

Generally free of adverse effects

Trauma involving massive bleeding may preclude the use of flavonoids, such as gingko that could accelerate hemorrhaging.

Generally free of adverse effects

See Valerian.

Watch for side effects and adjust dosage if necessary

Liquid hydergine should be avoided in treating hemorrhagic stroke because of hydergine’s high alcohol content.

Watch for side effects and adjust dosage if necessary

Nausea, vomiting, and diarrhea may occur at higher dosage levels.  Avoid by increasing dose slowly.

Watch for side effects and adjust dosage if necessary

Imitrex, a drug used to block migraine headaches, may have dangerous side effects in the middle-aged and the elderly.

Watch for side effects and adjust dosage if necessary

Although melatonin is strongly recommended for breast cancer patients, interleukin-2, which is often combined with melatonin, should be avoided by breast cancer patients.  Interleukin-2 may promote breast cancer cell division.

Watch for side effects and adjust dosage if necessary

Supplement only if deficient―excess may cause increased oxidation leading to inflammation.

Watch for side effects and adjust dosage if necessary

KH3 is an antiaging drug used to improve brain functioning and is available from many off-shore pharmacies.  KH3 contains procaine and hematoporphyrin.  People allergic to procaine or taking sulfa drugs should not take KH3.

Watch for side effects and adjust dosage if necessary

This amino acid may not be as effective if person has high levels of arginine in the diet.

Generally free of adverse effects

Serious neurological toxicity may occur with large doses or from occupational exposure.

Watch for side effects and adjust dosage if necessary

Some doctors are under the impression that patients with leukemia, Hodgkin’s disease, or lymphoma should avoid melatonin until more is known about its effects on these forms of cancer.  If melatonin is tried  in these types of cancer, tumor blood markers should be closely monitored for signs that melatonin is promoting tumor growth.  Use melatonin cautiously when treating autoimmune diseases, such as rheumatoid arthritis.  Some scientists have speculated that melatonin could increase the severity of an autoimmune disease.

Watch for side effects and adjust dosage if necessary

When used in large doses (>500 mg a day) for lipid control), hepatotoxicity may occur, especially if reparation is sustained release.  Monitor liver function tests.  May increase uric acid.  (The flush found after ingestion of even small amounts is harmless and not an allergic reaction.)  Patients suffering from a severely damaged liver should avoid niacin, vitamin A, and beta-carotene because these nutrients can be harmful to patients with such conditions.  Some people with liver disease cannot take niacin.

Watch for side effects and adjust dosage if necessary

The side effects of niacin are generally not present, but neither is the hypolipidemic therapeutic efficacy.

Generally free of adverse effects

See Valerian.

May cause anxiety, high blood pressure, and headache.  Do not use if you have phenylketonuria.  Persons with hypertension should use phenylalanine with caution because it can elevate blood pressure in hypertensives.  Cancer patients should avoid taking extraphenylalanine and tyrosine because these amino acids can contribute to cancer cell proliferation.  Muscular dystrophy patients should avoid both phenylalanine and tyrosine.

Watch for side effects and adjust dosage if necessary

See DHEA Dosing and Safety Precautions in the DHEA Replacement Therapy protocol.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

People allergic to procaine (the active ingredient in KH3) or taking sulfa drugs should not take KH3.

Watch for side effects and adjust dosage if necessary

Those with very low blood pressure or certain forms of congestive heart failure or asthma should not take propranolol or other beta-blocking drugs.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

Side effects can include insomnia, vivid dreams, restlessness, anxiety, agitation, irritability, gastointestinal discomfort, fatigue, dry mouth, dizziness, headache, and parasthesias.  Concomitant use may reduce the therapeutic effects of digitalis.  St. John’s wort extract decreases digoxin serum levels by about 25% in healthy people.  When using St. John’s wort, avoid prolonged sunlight exposure.  Doses of 1800 mg or more a day of St. John’s wort extract can be unsafe because of the risk of severe phototoxic skin reactions.  Concomitant use with oral contraceptives may decrease steroid concentrations, resulting in breakthrough bleeding and irregular menstrual bleeding.  Effectiveness of antiretroviral drugs such as nevirapine (Viramune), delavirdine (Rescriptor), and efavirenz (Sustiva) may be reduced.  There is a report of a serotonin-like syndrome (extreme anxiety, nausea, hypertension, tachycardia) associated with the use of St. John’s wort, especially if combined with tryptophan or SSRIs and other antidepressants.

Watch for side effects and adjust dosage if necessary

Dosages of 200 mcg a day are considered safe.  Some people take doses in excess of 400 mcg a day.  Toxic levels probably starting at more than 1000mcg a day, cause hair loss, muscle soreness, nausea, fatigue, and brittle nails.

Generally free of adverse effects

Do not take shark liver oil for more than 30 days because it may cause the overproduction of blood platelets.

Generally free of adverse effects

The genistein in soy can interfere with the ability of the radiation to kill cancer cells, though there are contradictory studies on this issue.

Generally free of adverse effects

People allergic to procaine (the active ingredient in KH3) or taking sulfa drugs should not take KH3.

Watch for side effects and adjust dosage if necessary

Users are cautioned that thalidomide――which  may be useful in treating wet macular degeneration and cancer―causes severe birth defects and must never be used by pregnant women or by women who may become pregnant.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

Injection may cause allergic reaction.  Side effects are flushing, shortness of breath, and rapid heartbeat (tachycardia).

Watch for side effects and adjust dosage if necessary

You must be careful not to overdose on thyroid hormones.  The advice of a physician is important when considering thyroid hormone therapy.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

Eosinophilia myalgia, a lethal hepatitis, was attributable to a tryptophan polymer contaminant made by a particular Japanese manufacturer in the 1980s.  Properly manufactured tryptophan may have side effects of a serotonergic syndrome―nausea, excitability, and tremor.  Use with caution with SSRIs or other antidepressant drugs or herbs.  Doses under 1 gram are usually safe.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

See Phenylalanine

Watch for side effects and adjust dosage if necessary

In very high doses (more than 300-500 mg a day), this vitamin may cause a reversible neuropathy with symptoms of tingling and numbness in the extremities.  High doses (more than 500 mg a day) should be used only when a blood test documents the failure of folic acid, vitamin B12, and TMG to lower homocysteine levels.  Never take high doses of vitamin B6 without also taking the other B complex vitamins.

Generally free of adverse effects

No reports of overdosing in the literature.

Generally free of adverse effects

In large doses that vary from one person to the next, vitamin C may cause diarrhea.  Doses > 6 grams a day may increase urinary output of oxalic acid.  There is no proof that large doses cause renal stones.

Generally free of adverse effects

Large doses (>1400-2000 IU a day) may cause hypercalcemia, a decrease in renal function, and nephrocalcinosis.  Monthly blood tests to monitor serum calcium and parathyroid hormone levels should be done to protect against vitamin D3 toxicity.  Underlying kidney disease precludes high-dose vitamin D3 supplementation.  Although some research indicates that dosages up to 10,000 IU a day are safe, healthy people should stay below 1500-2000 IU a day.

Watch for side effects and adjust dosage if necessary

GRAS―Because vitamin E inhibits blood clotting, it should not be used if excessive bleeding is occurring.

Generally free of adverse effects

Some people use the herb valerian to fall asleep.  Valerian produces a drug-like, hypnotic effect, similar to that of benzodiazepine drugs, such as Valium and Halcion.  Because valerian-containing products are often promoted as natural herbal remedies, the public mistakenly believes they are safe to take on a regular basis.  Studies indicate, however, that there is a significant toxicity risk when valerian is taken over an extended period of time.  Patients can develop tolerance to valerian because of its Valium-like properties, and people often need to take increasing amounts of it as time goes by to continue to obtain the desired hypnotic effect.  The chronic use of valerian could result in permanent liver damage and potential central nervous system impairment.

Monitor serum levels of the vitamin or other marker and/or physician supervision only

Large doses of zinc (> 75 mg a day) will displace copper from absorption in the gastrointestinal tract, leading to copper deficiency.  Chronic doses of more than 100-125 mg a day may suppress immune function.

Generally free of adverse effects

Large doses (>1400-2000 IU a day) may cause hypercalcemia, a decrease in renal function, and nephrocalcinosis.