Biologically Based Practices — Herbs and Nutritional Supplements

Introduction

Dietary supplements are products intended to supplement the diet. Specifically, nutritional supplements are products that may contain vitamins, minerals, amino acids, or enzymes whereas herbal supplements are products containing herbs or botanicals either alone or in mixtures (nccam.nih.gov). The term “herb” when used medically refers to any part of the plant used for therapeutic purposes.

Potential Application for Children with Cancer

Herbal and nutritional supplements are among the most commonly used CAM therapies by children with cancer. Careful assessment of the pharmacokinetics of dietary supplements and conventional chemotherapy is important to minimize risk of interactions.  Adherence to regimens that include biologic agents can be challenging for children. Protocols that require restricted diets, consumption of numerous supplements, or administration of supplements through alternative routes, such as inhalation or suppositories may not be feasible in children. Regimens that require the child to ingest multiple supplements may interfere with regular food intake and may have an adverse effect on the nutritional status of the child. 

Data from evidence based studies is limited for the use of nutritional supplements in children with cancer.  However, studies have shown safety and potential roles for l-carnitine, glutamine, whey protein, probiotics, Traumeel SÒ and essential fatty acids in children. Herbal supplements such as echinacea, ginger, chamomile, valerian, aloe vera, and lavender have been traditionally used in pediatrics, although research data is limited. 

How does the Integrative Therapies Program’s herbal and nutrition counseling service work in the hospital and outpatient clinic?

The Integrative Therapies Program’s nutritionist is available Monday thru Thursday, 9am-5pm, to meet with patients and their families regarding herbal and nutritional supplement inquiries. Our nutritionist works with patients and their families as well as their patient’s pediatric oncologist to determine if herbal and nutritional supplements are appropriate. Interest in the nutritional supplement, tolerance, risk of interactions, and prognosis are all considered prior to the initiation of any nutritional or herbal agent. Developments of nausea or vomiting, severe stomatitis, or cachexia are monitored closely to ensure that the supplementary regimens are not causing or enhancing any chemotherapy related toxicities. Caution is also advised in patients requiring nutrition intervention. 

Last updated: October 13, 2009