Last week I wrote about how taking nutritional supplements ^[1] is like walking through a mine field for multiple myeloma patients.  So this week, I’ll describe my nutritional supplement plan.

First, let me describe the prescription medications that I take:

Revlimid ^[2] (lenalidomide) is my monthly chemotherapy drug.

Warfarin (Coumadin) is a generic blood thinner. I use it to prevent blood clots that may be caused by Revlimid.

Oxycodone and Tylenol help my bone pain.

Gabapentin (Neurontin) helps my peripheral neuropathy symptoms.

My peripheral neuropathy ^[3] (pain and tingling in the extremities) seems to be caused by my multiple myeloma and is aggravated by my regular use of Revlimid.

Neuropathy is my most prominent and problematic side effect. A number of supplements, including alpha lipoic acid, magnesium, super B complex, and L-glutamine, are all supposed to help minimize my symptoms—and I do think they help.

But gabapentin helps the most. I take one 200 mg capsule in the morning and two at night. If I miss one day, I notice the difference big time! Miss two days and my symptoms are two or three times worse than when I take the drug. It doesn't work this well for everyone who tries it. But it sure works for me.

So now, here’s my long list of oncologist-approved supplements I take every day:

Alpha lipoic acid 400 mg
Magnesium 800 mg
Super B complex - one daily

As I already mentioned, I take alpha lipoic acid, magnesium, and super B complex to help with my peripheral neuropathy.

Vitamin D 1000 IU
Calcium 600 mg

Vitamin D is the “in” vitamin lately. One of its most important functions is to help calcium work better.

Three years ago, one of the myeloma specialists at Mayo Clinic, Dr. Suzanne Hayman, recommended I take 500 mg of calcium and 1000 IU of vitamin D daily. I have followed her advice ever since.

Selenium 200 mcg

My father got me started taking selenium over thirty years ago. At the time, it was thought to help prevent prostate cancer. Researchers have since concluded that is not the case. But selenium helps protect cells from free-radical damage, helps the thyroid function better, and can help prevent inflammation in your body's joints.

Selenium is inexpensive and there’s no evidence that taking it hurts—so I still do.

Chromium 400 mcg
Zinc 50 mg

The minerals chromium and zinc are both thought to help bolster one's immune system. Chromium enhances the action of insulin and helps the body regulate blood sugar. Zinc is often recommended to help fight colds. It may also help prevent osteoporosis.

I had been taking extra zinc when I felt a cold coming on for a decade. But I added zinc and chromium to my daily list of supplements after a nutritionalist recommended them at the first International Myeloma Foundation patient and family seminar I attended a few months after I was initially diagnosed in the late spring of 2007.

Glucosamine 2000 mg

My family doctor, Dr. Kari Smith, recommended taking glucosamine after I complained of knee pain five or six years ago. Was that pain related to my multiple myeloma? Who knows? But I experimented with it and found it really helped.

Dr. Smith made a point of telling me to skip chondroitin, a supplement often combined with glucosamine and sold to help joint pain. She told me research had proven chondroitin didn't really help—and it was expensive.

Research has since cast doubt on whether glucosamine works as well. All I know is if I stop taking it for a few days my knees start to hurt.

Multi vitamin - one daily

Most physicians recommend taking a good, multi-vitamin daily, so I do.

This might be a good time to pause and comment on supplement quality and cost. I'm not a “nutrition snob.” I don't pay extra for “natural” vitamins or supplements. I specifically asked a pharmacist I know a number of years back whether it made a difference if the vitamins I took were natural or not. He responded with an emphatic “NO!” and recommended I not pay extra for so called “natural” vitamins in powdered or liquid form. “Save your money!” he said. “Your body doesn't know the difference—a vitamin is a vitamin. It’s all about chemistry.”

That was good enough for me. I buy the cheap store brand vitamins. I break them in half and take one half in the morning and one half before my evening meal. I do the same with any other supplements that I can easily break in two. I figure spreading out the doses might help my body better absorb the nutrients. Who knows?

Potassium 100mg

Potassium is thought to help prevent muscle cramping—one of the more annoying side effects associated with taking Revlimid. I take extra potassium and magnesium during the 14 days when I take Revlimid.

Vitamin E 400 IU

Vitamin E is thought to help protect your cell membranes, as well as keeping your skin, heart, nerves, and red blood cells healthy. Nothing wrong with that!

Flaxseed oil 1000 mg
Fish oil 1000 mg

I take fish and flaxseed oil for the omega 3s. Omega 3 fatty acids are the “good fats” our body needs and can't produce on its own. Omega 3s are touted to do everything from helping prevent heart disease, maintain optimum blood pressure and cholesterol levels, to helping relieve joint pain, migraines, depression, and autoimmune diseases.

Hyperbole aside, most nutritional experts agree omega 3 fatty acids are important for heart health and are a known anti-inflammatory. I take fish oil and flaxseed oil because I read recently our bodies metabolize them differently.

The capsules certainly are inexpensive. I take the fish oil capsule in the evening with my meal to avoid the fishy aftertaste that can occur when you take them on an empty stomach.

From time to time, I also include:

L-glutamine 1000 mg

L-glutamine, as I mentioned already is supposed to help with peripheral neuropathy.  However, it’s expensive and hard to find, so I have gotten away from using it recently. I haven't noticed any difference in my peripheral neuropathy symptoms.

Ultra Meal protein powder - 2 scoops

I have battled muscle loss and wasting ever since I started taking Revlimid. Taking dexamethasone ^[4] (Decadron) caused noticeable muscle wasting when I was taking it daily at the start of my treatment.

After losing 20 pounds of muscle in one month, I began taking dexamethasone weekly, along with my Revlimid. I was able to prevent any further muscle loss, but was not able to re-build the muscle I had lost.

Later, even after I dropped dexamethasone, I still was not able to build muscle.

My nutritionalist suggested Ultra Meal, a vitamin and nutrient-reinforced powder. She recommended it due to its low glycemic index and high concentration of several forms of calcium. It seems like a good, quality product, and it may have helped. I just haven't found a new source since I moved to Florida last year.  But to this day I have trouble adding muscle mass—even with regular workouts.

So that’s the laundry list of pills I take each day.  Next week I’ll write about some things to consider as you work with your physician to decide on a list of supplements to take.

Until then, have a happy holiday, feel good, and keep smiling! Pat