Dosing Guidelines

Sources of information about dosing regarding herbs and natural products

Knowing that an herb or other natural product may be helpful for relieving your symptoms, improving your quality of life or treating your cancer is the first step. But then you also need to know how to take the product—how much to take, when, what to eat or not eat with it, and other details.

Unfortunately, many of these questions cannot easily be answered with confidence. Research isn’t far enough along to know for sure how some products may interact with each other or with prescribed drugs, with foods and with other treatments. For many products, optimal doses haven’t been established. Sources we check may recommend different doses.

The strength or concentration of active ingredients in products can also vary from one manufacturer to another, from one plant to the next, or from one teacup to the next.

We provide guidance on finding quality herbs and supplements, including links to independent rating services

For many products, we provide sources—books and websites we regard as reliable and supported by evidence—where you and your physician can find more information about specific doses. This information is listed on our review of each natural product therapy in the subpage titled How do experts use [therapy]?

Finding professional guidance

Having a trained professional monitor your response, look for side effects, and track progress is important for your success and well-being. We encourage you to find a health professional with training and experience in your cancer type and integrative therapies to guide you.

We provide guidance and directories for finding a practitioner or physician who may be able to help you assess therapies in light of your specific cancer and your health status.

Sharing information with your healthcare team

Some supplements and products can interact with other therapies and substances:

  • Pharmaceuticals, such as prescription drugs, acting to decrease or increase a drug’s main effects or side effects
  • Surgery, decreasing blood clotting or increasing or decreasing sedative effects of anesthesia
  • Some foods
  • Other supplements

Disclosing all products in use to your health care team is crucial to your well-being.

Your healthcare team need to know of any supplements you take and their doses. Consider taking pictures of the ingredient labels of your supplements, for some may contain a number of ingredients that your doctors might need to know about.

Commentary

Choosing therapies wisely

CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS: I have worked with many people with cancer who have thought that “more is better” when deciding on complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies, including natural products and supplements.

Though it makes sense to integrate a variety of therapies and lifestyle practices, the key is to choose therapies that will complement each other, will target imbalances in your particular body terrainthe internal conditions of your body, including nutritional status, fitness, blood sugar balance, hormone balance, inflammation and more and tumor microenvironmentthe noncancerous cells and tissues and their processes that directly interact with your tumor, will not interfere with nor increase toxicity of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy treatments, and will fit your goals. When thinking about natural products and supplements, these points are important:

  1. Although these products may be “natural” and tend to have fewer effects across your whole body than drugs, supplements and other natural products can have side effects and be toxic in some doses or when taken for long periods of time.
  2. Some people may be allergic to ingredients in some products.
  3. Some natural products can affect absorption of other herbs and drugs.
  4. Some may affect enzymes in the liver that are used to detoxify and clear drugs and other substances from the body. As a result, the amount of active drug in the system can increase, raising the risk of drug side effects and toxicity. The effects of other herbs and drugs could also be blocked or diminished. Paying attention to interactions is important.
  5. In the US, the quality of natural products and supplements is not well regulated. Some products have been found to be tainted with drugs or with toxic metals and other chemicals. Some supplements are poor quality and may not contain any of the natural product claimed. Some filler materials may not be listed on labels, so anticipating how these will interact with other products is nearly impossible.
  6. The more substances taken into your body, whether drugs, natural products, or a combination, the bigger the chemical load on your body’s detoxification system.

For these reasons and more, we strongly urge you to seek guidance from a licensed health professional who can help you choose the natural products and supplements that are right for you and will most likely safely complement your conventional therapy.

Authors

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Last update: May 12, 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.