All about vitamin E

VITAMIN E Overview Information

Vitamin E is a vitamin that dissolves in fat. It is found in many foods including vegetable oils, cereals, meat, poultry, eggs, fruits, vegetables, and wheat germ oil. It is also available as a supplement.

Vitamin E is used for treating vitamin E deficiency, which is rare, but can occur in people with certain genetic disorders and in very low-weight premature infants.

Some people use vitamin E for treating and preventing diseases of the heart and blood vessels including hardening of the arteries, heart attack, chest pain, leg pain due to blocked arteries, and high blood pressure.

Vitamin E is also used for treating diabetes and its complications. It is used for preventing cancer, particularly lung and oral cancer in smokers; colorectal cancer and polyps; and gastric, prostate, and pancreatic cancer.

Some people use vitamin E for diseases of the brain and nervous system including Alzheimer’s disease and other dementias, Parkinson’s disease, night cramps, restless leg syndrome, and for epilepsy, along with other medications. Vitamin E is also used for Huntington’s chorea, and other disorders involving nerves and muscles.

Women use vitamin E for preventing complications in late pregnancy due to high blood pressure (pre-eclampsia), premenstrual syndrome (PMS), painful periods, menopausal syndrome, hot flashes associated with breast cancer, and breast cysts.

Sometimes vitamin E is used to lessen the harmful effects of medical treatments such as dialysis and radiation. It is also used to reduce unwanted side effects of drugs such as hair loss in people taking doxorubicin and lung damage in people taking amiodarone.

Vitamin E is sometimes used for improving physical endurance, increasing energy, reducing muscle damage after exercise, and improving muscle strength.

Vitamin E is also used for cataracts, asthma, respiratory infections, skin disorders, aging skin, sunburns, cystic fibrosis, infertility, impotence, chronic fatigue syndrome (CFS), peptic ulcers, for certain inherited diseases and to prevent allergies.

Some people apply vitamin E to their skin to keep it from aging and to protect against the skin effects of chemicals used for cancer therapy (chemotherapy).

The American Heart Association recommends obtaining antioxidants, including vitamin E, by eating a well-balanced diet high in fruits, vegetables, and whole grains rather than from supplements until more is known about the risks and benefits of taking supplements.

How does it work?

Vitamin E is an important vitamin required for the proper function of many organs in the body. It is also an antioxidant. This means it helps to slow down processes that damage cells.

Effective for:

• Vitamin E deficiency.

Possibly Effective for:

• Bladder cancer. Taking 200 IU of vitamin E by mouth for more than 10 years seems to help prevent death from bladder cancer.
• Alzheimer’s disease. Vitamin E might slow down the worsening of memory loss in people with moderately severe Alzheimer’s disease. Vitamin E might also delay the loss of independence and the need for caregiver assistance in people with mild-to-moderate Alzheimer’s disease. But vitamin E does not seem to prevent moving from mild memory problems to full-blown Alzheimer’s disease.
• Painful menstruation (dysmenorrhea). Taking vitamin E for 2 days before and for 3 days after bleeding begins seems to decrease pain severity and duration, and reduce menstrual blood loss.
• Premenstrual syndrome (PMS). Taking vitamin E by mouth seems to reduce anxiety, craving, and depression in some women with PMS.
• Chemotherapy-related nerve damage. Taking vitamin E before and after treatment with cisplatin chemotherapy might reduce the chance of getting nerve damage.
• Ischemic stroke. Some research shows that taking vitamin E might slightly decrease the chance of having a stroke caused by a blood clot (ischemic stroke). But taking vitamin E might also increase the chance of having a more severe type of stroke, called hemorrhagic stroke. This kind of stroke occurs when there is bleeding into the brain.
• Liver disease called nonalcoholic steatohepatitis. Taking vitamin E 400-1200 IU daily seems to significantly improve symptoms in adults and children after 4-24 months of treatment.
• Huntington’s chorea. Natural vitamin E (RRR-alpha-tocopherol) can significantly improve symptoms in people with early Huntington’s disease, but it doesn’t seem to help people with more advanced disease.
• Macular degeneration. Taking vitamin E by mouth in combination with vitamin C, beta-carotene and zinc might slow the worsening of advanced age-related macular degeneration (AMD). There isn’t enough information to know if this combination helps people with less advanced macular disease or prevents AMD. Zinc needs to be present in the combination for there to be any effect on AMD.
• Rheumatoid arthritis (RA). Vitamin E taken along with standard treatment is better than standard treatment alone for reducing pain in people with RA. But this combination doesn’t reduce swelling (inflammation).
• Male infertility.
• High blood pressure during pregnancy (pre-eclampsia).
• Movement disorders called tardive dyskinesia and dyspraxia.
• Parkinson’s disease.
• Kidney problems in children (glomerulosclerosis).
• Helping to treat an inherited disorder called G6PD deficiency.
• Beta-thalassemia.
• Dementia.
• Healing a type of skin sore called granuloma annulare when put on the skin.
• Uveitis.
• Sunburn.
• Helping the eyes heal after surgery.
• Treating a type of eye disease in newborns called retrolental fibroplasia.
• Decreasing brain and heart bleeding in premature babies.
• Helping some heart medications called “nitrates” work better.
• Improving physical performance and strength in the elderly.
• Fibrosis caused by radiation.

Possibly Ineffective for:

• Anemia in people having hemodialysis.
• Chest pain (angina).
• Hot flashes in people who have had breast cancer.
• Hardening of the arteries (atherosclerosis).
• Breathing problems in newborns.
• Lung infections in elderly persons.
• Heart failure.
• Treating muscle diseases called Duchenne muscular dystrophy and myotonic dystrophy.
• High blood pressure.
• Helping people walk without pain when they have a disease called intermittent claudication.
• A type of arthritis called osteoarthritis. Vitamin E does not seem to decrease pain or stiffness and does not seem to prevent osteoarthritis from getting worse.
• Head and neck cancer.
• Sores in the mouths of people who smoke.
• Cancer of the pancreas.
• Pharyngeal cancer.
• Reducing scarring after surgery.
• Colorectal cancer.
• An eye condition called retinitis pigmentosa.

Likely Ineffective for:

• Preventing heart disease. Taking vitamin E supplements does not prevent heart disease. But increasing vitamin E in the diet might be beneficial.
• Benign breast disease.
• Breast cancer.
• Lung cancer.
• Prostate cancer. Research on the effects of vitamin E on prostate cancer risk has produced results that don’t agree. Some studies suggest that taking more vitamin E seems to prevent prostate cancer. But other large studies find no benefit. Some research has also shown that taking vitamin E might increase the chance of developing prostate cancer. Overall, the best research indicates that vitamin E does not help prevent prostate cancer and might increase the chance of developing prostate cancer.

Insufficient Evidence for:

• Asthma. There is inconsistent evidence about the role of vitamin E in asthma. Some research suggests that getting more vitamin E from the diet seems to prevent asthma. But getting vitamin E from supplements doesn’t have the same benefit.
• Cancer. Some research suggests a combination of vitamin E with vitamin C, beta-carotene, selenium, and zinc lowers the risk of cancer in men, but not women. Researchers suspect that men get a lower amount of these vitamins from food, so they might benefit more from supplements.
• Stomach cancer. Taking vitamin E plus beta-carotene or vitamin C and beta-carotene does not seem to prevent stomach cancer. But there is limited evidence that getting more vitamin E from the diet might slow the progress of stomach cancer.
• Sickle cell disease. Taking vitamin E with aged garlic extract and vitamin C might be useful for sickle cell anemia.
• Stroke caused by a clot (ischemic stroke). There is some evidence that synthetic vitamin E (all-rac-alpha-tocopherol) might help prevent stroke in male smokers who have high blood pressure and diabetes.
• Skin disorders.
• Cloudy vision in older people (cataracts).
• Diabetes.
• Esophageal cancer.
• Allergies.
• Chronic fatigue syndrome (CFS).
• Oral cancer.
• Skin cancer.
• Epilepsy.
• Menstrual disorders.
• High blood fat levels.
• Leg cramps.
• Common cold.
• Other conditions.

More evidence is needed to rate vitamin E for these uses.

VITAMIN E Side Effects & Safety

Vitamin E is LIKELY SAFE for most healthy people when taken by mouth or applied to the skin. Most people do not experience any side effects when taking the recommended daily dose, which is 15 mg.

Vitamin E is POSSIBLY UNSAFE if taken in high doses. If you have a condition such as heart disease or diabetes, don’t take doses of 400 IU/day or more. Some research suggests that high doses might increase the chance of death and possibly cause other serious side effects. The higher the dose, the greater the risk of serious side effects.

There is some concern that vitamin E might increase the chance of having a serious stroke called hemorrhagic stroke, which is bleeding into the brain. Some research shows that taking vitamin E in doses of 300-800 IU each day might increase the chance of this kind of stroke by 22%. However, in contrast, vitamin E might decrease the chance of having a less severe stroke called an ischemic stroke.

There is contradictory information about the effect of vitamin E on the chance of developing prostate cancer. Some research suggests that taking large amounts of a multivitamin plus a separate vitamin E supplement might actually increase the chance of developing prostate cancer in some men.

High doses can also cause nausea, diarrhea, stomach cramps, fatigue, weakness, headache, blurred vision, rash, and bruising and bleeding.

Special Precautions & Warnings:

Pregnancy and breast-feeding: When used in the recommended daily amount, vitamin E is POSSIBLY SAFE for pregnant and breast-feeding women. There has been some concern that taking vitamin E supplements might be harmful to the fetus when taken in early pregnancy. But it is too soon to know if this is an important concern. Until more is known, do no take vitamin E supplements during early pregnancy without talking with your healthcare provider.

Angioplasty, a heart procedure: Avoid taking supplements containing vitamin E or other antioxidant vitamins (beta-carotene, vitamin C) immediately before and following angioplasty without the supervision of a health care professional. These vitamins seem to interfere with proper healing.

Low levels of vitamin K (vitamin K deficiency): Vitamin E might worsen clotting problems in people whose levels of vitamin K are too low.

An eye condition called retinitis pigmentosa: All-rac-alpha-tocopherol (synthetic vitamin E) 400 IU seems to speed vision loss in people with retinitis pigmentosa. However, much lower amounts (3 IU) don’t seem to produce this effect. If you have this condition, it’s best to avoid vitamin E.

Bleeding disorders: Vitamin E might make bleeding disorders worse. If you have a bleeding disorder, avoid taking vitamin E supplements.

Head and neck cancer: Don’t take vitamin E supplements in doses of 400 IU/day or more. Vitamin E might increase the chance that cancer will return.

Prostate cancer: There is concern that taking vitamin E might increase the chance of developing prostate cancer. The effect of vitamin E in men who currently have prostate cancer is not clear. But, in theory, taking vitamin E supplements might worsen prostate cancer in men who already have it.

Surgery: Vitamin E might increase the risk of bleeding during and after surgery. Stop using vitamin E at least 2 weeks before a scheduled surgery.

VITAMIN E Interactions 

Moderate Interaction Be cautious with this combination

• Cyclosporine (Neoral, Sandimmune) interacts with VITAMIN E

Taking large amounts of vitamin E along with cyclosporine (Neoral, Sandimmune) might increase how much cyclosporine (Neoral, Sandimmune) the body absorbs. By increasing how much cyclosporine the body absorbs, vitamin E might increase the effects and side effects of cyclosporine (Neoral, Sandimmune).

• Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with VITAMIN E

Some medications are changed and broken down by the liver. Vitamin E might increase how quickly the liver breaks down some medications. Taking vitamin E along with some medications that are broken down by the liver can decrease the effectiveness of some medications. Before taking vitamin E talk to your healthcare provider if you are taking any medications that are changed by the liver.Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

• Medications for cancer (Chemotherapy) interacts with VITAMIN E

Vitamin E is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of some medications used for cancers. But it is too soon to know if the interaction occurs.

• Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with VITAMIN E

Vitamin E might slow blood clotting. Taking vitamin E along with medications that also slow clotting might increase the chances of bruising and bleeding.Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

• Medications used for lowering cholesterol (Statins) interacts with VITAMIN E

Taking vitamin E, beta-carotene, vitamin C, and selenium together might decrease the effectiveness of some medications used for lowering cholesterol. It is not known if taking vitamin E alone decreases the effectiveness of some medications used for lowering cholesterol.Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), and pravastatin (Pravachol).

• Niacin interacts with VITAMIN E

Taking vitamin E along with beta-carotene, vitamin C, and selenium might decrease some of the beneficial effects of niacin. Niacin can increase the good cholesterol. Taking vitamin E along with these other vitamins might decrease the good cholesterol.

• Warfarin (Coumadin) interacts with VITAMIN E

Warfarin (Coumadin) is used to slow blood clotting. Vitamin E can also slow blood clotting. Taking vitamin E along with warfarin (Coumadin) can increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

VITAMIN E Dosing

The following doses have been studied in scientific research:

BY MOUTH:

• For vitamin E deficiency: a typical dose in adults is RRR-alpha tocopherol (natural vitamin E) 60-75 IU per day.
• For the movement disorder called tardive dyskinesia: RRR-alpha-tocopherol (natural vitamin E) 1600 IU daily.
• For improving male fertility: vitamin E 200-600 IU daily.
• For Alzheimer’s disease: up to 2000 IU daily. Combination therapy of donepezil (Aricept) 5 mg and vitamin E 1000 IU per day has been used for slowing memory decline in people with Alzheimer’s disease.
• For liver disease called non-alcoholic steatohepatitis: 800 IU daily in adults has been used; 400-1200 IU daily has been used in children.
• For early Huntington’s chorea: RRR-alpha-tocopherol (natural vitamin E) 3000 IU.
• For rheumatoid arthritis pain: vitamin E 600 IU twice daily.
• For preventing nerve damage caused by cisplatin: vitamin E (alpha-tocopherol) 300 mg daily with each chemotherapy treatment and for up to 3 months after stopping cisplatin therapy.
• For improving effectiveness of nitrates used for heart disease: vitamin E 200 mg three times daily.
• To reduce protein in the urine of children with a kidney disease called focal segmental glomerulosclerosis: vitamin E 200 IU.
• For G6PD deficiency: vitamin E 800 IU daily.
• For premenstrual syndrome (PMS): RRR-alpha-tocopherol (natural vitamin E) 400 IU daily.
• For painful menstrual periods: vitamin E 200 IU twice or 500 IU daily starting 2 days before the menstrual period and continuing through the first 3 days of bleeding.
• For healing the eyes after a surgery called keratectomy: 230 mg vitamin E (alpha-tocopheryl nicotinate) and vitamin A (retinol palmitate) 25,000 units have been used 3 times daily for 30 days, followed by twice daily for 2 months.
• For fibrosis caused by radiation: vitamin E 1000 IU daily in combination with pentoxifylline 800 mg.
• For beta-thalassemia: vitamin E 750 IU daily.
• For preventing sunburn: RRR-alpha-tocopherol (natural vitamin E) 1000 IU in combination with 2 grams of ascorbic acid.
• For preventing high blood pressure during pregnancy (pre-eclampsia) in high risk women: vitamin E 400 IU with vitamin C 1000 mg daily.

For the most benefit, it’s best to take vitamin E that has been made in a lab (all-rac-alpha-tocopherol) with food.

Dosing for vitamin E can be confusing. Current guidelines show recommended dietary allowance (RDA) and upper tolerable limits (UTL) for vitamin E in milligrams. However, most products are still labeled in International Units (IUs).

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Know Dental Health and Dry Mouth

What Causes Dry Mouth?

Causes of dry mouth include:

• Side effect of certain medications. Dry mouth is a common side effect of many prescription and nonprescription drugs, including drugs used to treat depression, anxiety, pain, allergies, and colds (antihistamines and decongestants), obesity, acne, epilepsy, hypertension (diuretics), diarrhea, nausea, psychotic disorders, urinary incontinence, asthma (certain bronchodilators), and Parkinson's disease. Dry mouth can also be a side effect of muscle relaxants and sedatives.

• Side effect of certain diseases and infections. Dry mouth can be a side effect of medical conditions, including Sjögren's syndrome, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps.

• Side effect of certain medical treatments. Damage to the salivary glands, the glands that make saliva, can reduce the amount of saliva produced. For example, the damage could stem from radiation to the head and neck, and chemotherapy treatments, for cancer.

• Nerve damage. Dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery.

• Dehydration. Conditions that lead to dehydration, such as fever, excessive sweating, vomiting, diarrhea, blood loss, and burns can cause dry mouth.

• Surgical removal of the salivary glands.

• Lifestyle. Smoking or chewing tobacco can affect how much saliva you make and aggravate dry mouth. Breathing with your mouth open a lot can also contribute to the problem.

What Are the Symptoms of Dry Mouth?

Common symptoms include:

• A sticky, dry feeling in the mouth
• Frequent thirst
• Sores in the mouth; sores or split skin at the corners of the mouth; cracked lips
• A dry feeling in the throat
• A burning or tingling sensation in the mouth and especially on the tongue
• A dry, red, raw tongue
• Problems speaking or trouble tasting, chewing, and swallowing
• Hoarseness, dry nasal passages, sore throat
• Bad breath

Why Is Dry Mouth a Problem?

Besides causing the symptoms mentioned above, dry mouth also raises your risk of gingivitis (gum disease), tooth decay, and mouth infections, such as thrush.

Dry mouth can also make it hard to wear dentures.

How Is Dry Mouth Treated?

If you think your dry mouth is caused by certain medication you're taking, talk to your doctor. The doctor may adjust the dose you're taking or switch you to a different drug that doesn't cause dry mouth.

The doctor may also prescribe an oral rinse to restore mouth moisture. If that doesn't help, he or she may prescribe a medication that boosts saliva production called Salagen.

You can also try these other steps, which may help improve saliva flow:

• Suck on sugar-free candy or chew sugar-free gum.
• Drink plenty of water to help keep your mouth moist.
• Brush with a fluoridetoothpaste a fluoride rinse, and visit your dentist regularly.
• Breathe through your nose, not your mouth, as much as possible.
• Use a room vaporizer to add moisture to the bedroom air.
• Use an over-the-counter artificial saliva substitute.

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LISINOPRIL

GENERIC NAME(S): LISINOPRIL

Uses

Lisinopril is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat heart failure and to improve survival after a heart attack.

Lisinopril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to help protect the kidneys from harm due to diabetes.

How to use lisinopril

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

If you are using the suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

For the treatment of high blood pressure, it may take 2 to 4 weeks before you get the full benefit of this medication. For the treatment of heart failure, it may take weeks to months before you get the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).

What conditions does lisinopril treat?

Side Effects

Dizziness, lightheadedness, tiredness, or headache may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat), signs of infection (such as fever, chills, persistent sore throat), change in the amount of urine.

This drug may rarely cause serious (possibly fatal) liver problems. Tell your doctor right away if you notice any of the following rare but serious side effects: yellowing eyes/skin, dark urine, severe stomach/abdominal pain, persistent nausea/vomiting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

List lisinopril side effects by likelihood and severity.

Precautions

Before taking lisinopril, tell your doctor or pharmacist if you are allergic to it; or to other ACE inhibitors (such as benazepril); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: history of an allergic reaction which included swelling of the face/lips/tongue/throat (angioedema), blood filtering procedures (such as LDL apheresis, dialysis), high level of potassium in the blood, collagen vascular disease (such as lupus, scleroderma).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of lightheadedness. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This product may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

Older adults may be more sensitive to the side effects of this drug, including dizziness and increases in potassium level.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details. (See also Warning section.)

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

What should I know regarding pregnancy, nursing and administering lisinopril to children or the elderly?

Interactions

See also Precautions section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: aliskiren, lithium, drugs that may increase the level of potassium in the blood (such as ARBs including losartan/valsartan, birth control pills containing drospirenone).

Check the labels on all your medicines (such as cough-and-cold products, diet aids, or NSAIDs such as ibuprofen, naproxen) because they may contain ingredients that could increase your blood pressure or worsen your heart failure. Ask your pharmacist for more details.

A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking lisinopril. Make sure all your doctors know which medicines you are using.

Does lisinopril interact with other medications?

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

Notes

Do not share this medication with others.

Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests (such as kidney function, potassium levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

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Cancer prevention nutrition or diet tips and Cancer-Fighting Foods

Whether you have a history of cancer in your family, or are currently battling the disease, lifestyle factors, including your diet, can make a huge difference in helping you fight off cancer. Some foods actually increase your risk of cancer, while others support your body and strengthen your immune system. By making smart food choices, you can protect your health, feel better, and boost your ability fight off cancer and other disease

What you need to know about cancer and diet

Not all health problems are avoidable, but you have more control over your health than you may think. Research shows that a large percentage of cancer-related deaths—maybe even the majority—are directly linked to lifestyle choices such as smoking, drinking, a lack of exercise, and an unhealthy diet. Avoiding cigarettes, limiting alcohol, and getting regular exercise are a great start to an anti-cancer lifestyle. But to best support your health, you also need to look at your eating habits.
What you eat—and don’t eat—has a powerful effect on your health, including your risk of cancer. Without knowing it, you may be eating many foods that fuel cancer, while neglecting the powerful foods and nutrients that can protect you. If you change your diet and behaviors, you can minimize your risk of disease and possibly even stop cancer in its tracks.

Cancer prevention diet tip # 1: Focus on plant-based foods

The best diet for preventing or fighting cancer is a predominantly plant-based diet that includes a variety of vegetables, fruits, and whole grains. A plant-based diet means eating mostly foods that come from plants: vegetables, fruits, nuts, grains, and beans. 
The less processed these foods are—the less they’ve been cooked, peeled, mixed with other ingredients, stripped of their nutrients, or otherwise altered from the way they came out of the ground—the better.
There are many ways to add plant-based foods to your diet. A nice visual reminder is to aim for a plate of food that is filled at least two-thirds with whole grains, vegetables, beans, or fruit. Dairy products, fish, and meat should take up no more than a third of the plate. Keep in mind that you don’t need to go completely vegetarian. Instead, focus on adding “whole” foods, which are foods close to their original form. Just as important, try to minimize or reduce the amount of processed foods you eat. Eat an apple instead of drinking a glass of apple juice, for example. Or enjoy a bowl of oatmeal with raisins instead of an oatmeal raisin cookie.

Simple tips for getting more plant-based foods in your diet

• Breakfast: Add fruit and a few seeds or nuts to your whole grain breakfast cereal (such as oatmeal).
• Lunch: Eat a big salad filled with your favorite beans and peas or other combo of veggies. Always order lettuce and tomato (plus any other veggies you can) on your sandwiches. Order whole grain bread for your sandwiches. Have a side of veggies like cut up carrots, sauerkraut, or a piece of fruit.
• Snacks: Fresh fruit and vegetables. Grab an apple or banana on your way out the door. Raw veggies such as carrots, celery, cucumbers, jicama, peppers, etc. are great with a low-fat dip such as hummus. Keep trail mix made with nuts, seeds, and a little dried fruit on hand.
• Dinner: Add fresh or frozen veggies to your favorite pasta sauce or rice dish. Top a baked potato with broccoli and yogurt, sauteed veggies, or with salsa. Replace creamy pasta sauces, with sauteed vegetables or tomato sauce made with healthy olive oil.
• Dessert: Choose fruit instead of a richer dessert. Or a single square of dark chocolate.

Cancer prevention diet tip # 2: Bulk up on fiber

Another benefit of eating plant-based foods is that it will also increase your fiber intake. Fiber, also called roughage or bulk, is the part of plants (grains, fruits, and vegetables) that your body can’t digest. Fiber plays a key role in keeping your digestive system clean and healthy. It helps keep food moving through your digestive tract, and it also moves cancer-causing compounds out before they can create harm.
Fiber is found in fruits, vegetables, and whole grains. In general, the more natural and unprocessed the food, the higher it is in fiber. There is no fiber in meat, dairy, sugar, or “white” foods like white bread, white rice, and pastries.

Simple ways to add more fiber to your diet:

• Use brown rice instead of white rice
• Substitute whole-grain bread for white bread
• Choose a bran muffin over a croissant or pastry
• Snack on popcorn instead of potato chips
• Eat fresh fruit such as a pear, a banana, or an apple (with the skin)
• Have a baked potato, including the skin, instead of mashed potatoes
• Enjoy fresh carrots, celery, or bell peppers with a hummus or salsa, instead of chips and a sour cream dip
• Use beans instead of ground meat in chili, casseroles, tacos, and even burgers (bean burgers can taste great)

  

High-fiber, cancer-fighting foods
Whole grains--	whole-wheat pasta, raisin bran, barley, oatmeal, oat bran muffins, popcorn, brown rice, whole-grain or whole-wheat bread
Fruit-------------	raspberries, apples, pears, strawberries, bananas, blackberries, blueberries, mango, apricots, citrus fruits, dried fruit, prunes, raisins
Legumes--------	lentils, black beans, split peas, lima beans, baked beans, kidney beans, pinto, chick peas, navy beans, black-eyed peas
Vegetables-----	broccoli, spinach, dark green leafy vegetables, peas, artichokes, corn, carrots, tomatoes, Brussels sprouts, potatoes

Cancer prevention diet tip # 3: Cut down on meat

Research shows that vegetarians are about fifty percent less likely to develop cancer than those who eat meat. So what’s the link between meat and cancer risk? First, meat lacks fiber and other nutrients that have been shown to have cancer-protective properties. What it does have in abundance, however, is fat—often very high levels of saturated fat. High-fat diets have been linked to higher rates of cancer. And saturated fat is particularly dangerous. Finally, depending on how it is prepared, meat can develop carcinogenic compounds.

Making better meat and protein choices

You don’t need to cut out meat completely and become a vegetarian. But most people consume far more meat than is healthy. You can cut down your cancer risk substantially by reducing the amount of animal-based products you eat and by choosing healthier meats.

• Keep meat to a minimum. Try to keep the total amount of meat in your diet to no more than fifteen percent of your total calories. Ten percent is even better.
• Eat red meat only occasionally. Red meat is high in saturated fat, so eat it sparingly.
• Reduce the portion size of meat in each meal. The portion should be able to fit in the palm of your hand.
• Use meat as a flavoring or a side, not the entree. You can use a little bit of meat to add flavor or texture to your food, rather than using it as the main element.
• Add beans and other plant-based protein sources to your meals.
• Choose leaner meats, such as fish, chicken, or turkey. If possible, buy organic.
• Avoid processed meats such as hot dogs, sausage, deli meats, and salami.

Cancer prevention diet tip #4: Choose your fats wisely

A major benefit of cutting down on the amount of meat you eat is that you will automatically cut out a lot of unhealthy fat. Eating a diet high in fat increases your risk for many types of cancer. But cutting out fat entirely isn’t the answer, either. In fact, some types of fat may actually protect against cancer. The trick is to choose your fats wisely and eat them in moderation.

• Fats that increase cancer risk – The two most damaging fats are saturated fats and Trans fats. Saturated fats are found mainly in animal products such as red meat, whole milk dairy products, and eggs. Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid vegetable oils to make them more solid and less likely to spoil—which is very good for food manufacturers, and very bad for you.
• Fats that decrease cancer risk – The best fats are unsaturated fats, which come from plant sources and are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados. Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flax seeds.

Tips for choosing cancer-fighting fats and avoiding the bad

• Reduce your consumption of red meat, whole milk, butter, and eggs, as these are the primary source of saturated fats.
• Cook with olive oil instead of regular vegetable oil. Canola oil is another good choice, especially for baking.
• Check the ingredient list on food labels and avoid anything with hydrogenated or partially hydrogenated oils, which are usually found in stick margarines, shortenings, salad dressings, and other packaged foods.
• Trim the fat off of meat when you do eat it, and avoid eating the skin of the chicken.
• Choose nonfat dairy products and eggs that have been fortified with omega-3 fatty acids.
• Add nuts and seeds to cereal, salads, soups, or other dishes. Good choices include walnuts, almonds, pumpkin seeds, hazelnuts, pecans, and sesame seeds.
• Use flax seed oil in smoothies, salad dressings, or mixed in snacks such as applesauce. But do not cook with flax seed oil, as it loses its protective properties when heated.
• Limit fast food, fried foods, and packaged foods, which tend to be high in trans fats. This includes foods like potato chips, cookies, crackers, French fries, and doughnuts.
• Eat fish once or twice a week. Good choices include wild salmon, sardines, herring, and black cod. But be conscious of mercury, a contaminant found in many types of fish. 

Cancer prevention diet tip #5: Choose cancer-fighting foods

Your immune system keeps you healthy by fighting off unwanted invaders in your system, including cancer cells. There are many things you can eat to maximize the strength of your immune system, as well as many cancer-fighting foods. But keep in mind that there is no single miracle food or ingredient that will protect you against cancer. Eating a colorful variety gives you the best protection.

• Boost your antioxidants. Antioxidants are powerful vitamins that protect against cancer and help the cells in your body function optimally. Fruits and vegetables are the best sources of antioxidants such as beta-carotene, vitamin C, vitamin E, and selenium.
• Eat a wide range of brightly colored fruits and vegetables. Colorful fruits and vegetables are rich in phytochemicals, a potent disease–fighting and immune–boosting nutrient. The greater the variety of colors that you include, the more you will benefit, since different colors are rich in different phytochemicals.
• Flavor with immune-boosting spices and foods. Garlic, ginger, and curry powder not only add flavor, but they add a cancer-fighting punch of valuable nutrients. Other good choices include turmeric, basil, rosemary, and coriander. Use them in soups, salads, casseroles, or any other dish.
• Drink plenty of water. Water is essentially to all bodily processes. It stimulates the immune system, removes waste and toxins, and transports nutrients to all of your organs. 

Cancer prevention diet tip #6: Prepare your food in healthy ways

Choosing healthy food is not the only important factor. It also matters how you prepare and store your food. The way you cook your food can either help or hurt your anti-cancer efforts.

Preserving the cancer-fighting benefits of vegetables

Here are a few tips that will help you get the most benefits from eating all those great cancer-fighting vegetables:

• Eat at least some raw fruits and vegetables. These have the highest amounts of vitamins and minerals, although cooking some vegetables can make the vitamins more available for our body to use.
• When cooking vegetables, steam until just tender using a small amount of water. This preserves more of the vitamins. Overcooking vegetables removes many of the vitamins and minerals. If you do boil vegetables, use the cooking water in a soup or another dish to ensure you’re getting all the vitamins.
• Wash all fruits and vegetables. Use a vegetable brush for washing. Washing does not eliminate all pesticide residue, but will reduce it. Choose organic produce if possible, grown without the use of pesticides.

Cooking and carcinogens

Carcinogens are cancer-causing substances found in food. Carcinogens can form during the cooking or preserving process—mostly in relation to meat—and as foods start to spoil. Examples of foods that have carcinogens are cured, dried, and preserved meats (e.g. bacon, sausage, beef jerky); burned or charred meats; smoked foods; and foods that have become moldy. Here are some ways reduce your exposure to carcinogens:

• Do not cook oils on high heat. Low-heat cooking or baking (less than 240 degrees) prevents oils or fats from turning carcinogenic. Instead of deep-frying, pan-frying, and sauteing, opt for healthier methods such as baking, boiling, steaming, or broiling.
• Go easy on the barbecue. Burning or charring meats creates carcinogenic substances. If you do choose to barbecue, don’t overcook the meat and be sure to cook at the proper temperature (not too hot).
• Store oils in a cool dark place in airtight containers, as they quickly become rancid when exposed to heat, light, and air.
• Choose fresh meats instead of cured, dried, preserved, or smoked meats.
• Avoid foods that look or smell moldy, as they likely contain aflatoxin, a strong carcinogen. Aflatoxin is most commonly found on moldy peanuts. Nuts will stay fresh longer if kept in the refrigerator or freezer.
• Be careful what you put in the microwave. Use waxed paper rather than plastic wrap to cover your food in the microwave. And always use microwave-safe containers. 

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Take cancer prevention into your own hands

Take cancer prevention into your own hands
You've probably heard conflicting reports about cancer prevention. Sometimes the specific cancer-prevention tip recommended in one study or news report is advised against in another.
In many cases, what is known about cancer prevention is still evolving. However, it's well accepted that your chances of developing cancer are affected by the lifestyle choices you make.
So if you're concerned about cancer prevention, take comfort in the fact that some simple lifestyle changes can make a big difference. Consider these seven cancer prevention tips.

1. Don't use tobacco

Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, bladder, cervix and kidney. And chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don't use tobacco, exposure to secondhand smoke might increase your risk of lung cancer.
Avoiding tobacco — or deciding to stop using it — is one of the most important health decisions you can make. It's also an important part of cancer prevention. If you need help quitting tobacco, ask your doctor about stop-smoking products and other strategies for quitting.

2. Eat a healthy diet

Although making healthy selections at the grocery store and at mealtime can't guarantee cancer prevention, it might help reduce your risk. Consider these guidelines:

• Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
• Limit fat. Eat lighter and leaner by choosing fewer high-fat foods, particularly those from animal sources. High-fat diets tend to be higher in calories and might increase the risk of overweight or obesity — which can, in turn, increase cancer risk.
• If you choose to drink alcohol, do so only in moderation. The risk of various types of cancer — including cancer of the breast, colon, lung, kidney and liver — increases with the amount of alcohol you drink and the length of time you've been drinking regularly.

3. Maintain a healthy weight and be physically active

Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney.
Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer.
Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic physical activity. You can also do a combination of moderate and vigorous activity. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better.

4. Protect yourself from the sun

Skin cancer is one of the most common kinds of cancer — and one of the most preventable. Try these tips:

• Avoid midday sun. Stay out of the sun between 10 a.m. and 4 p.m., when the sun's rays are strongest.
• Stay in the shade. When you're outdoors, stay in the shade as much as possible. Sunglasses and a broad-brimmed hat help, too.
• Cover exposed areas. Wear tightly woven, loose fitting clothing that covers as much of your skin as possible. Opt for bright or dark colors, which reflect more ultraviolet radiation than pastels or bleached cotton.
• Don't skimp on sunscreen. Use generous amounts of sunscreen when you're outdoors, and reapply often.
• Avoid tanning beds and sunlamps. These are just as damaging as natural sunlight.

5. Get immunized

Cancer prevention includes protection from certain viral infections. Talk to your doctor about immunization against:

• Hepatitis B. Hepatitis B can increase the risk of developing liver cancer. The hepatitis B vaccine is recommended for certain high-risk adults — such as adults who are sexually active but not in a mutually monogamous relationship, people with sexually transmitted infections, intravenous drug users, men who have sex with men, and health care or public safety workers who might be exposed to infected blood or body fluids.
• Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical and other genital cancers as well as squamous cell cancers of the head and neck. The HPV vaccine is available to both men and women age 26 or younger who didn't have the vaccine as adolescents.

6. Avoid risky behaviors

Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, might increase the risk of cancer. For example:

• Practice safe sex. Limit your number of sexual partners, and use a condom when you have sex. The more sexual partners you have in your lifetime, the more likely you are to contract a sexually transmitted infection — such as HIV or HPV. People who have HIV or AIDS have a higher risk of cancer of the anus, liver and lung. HPV is most often associated with cervical cancer, but it might also increase the risk of cancer of the anus, penis, throat, vulva and vagina.
• Don't share needles. Sharing needles with an infected drug user can lead to HIV, as well as hepatitis B and hepatitis C — which can increase the risk of liver cancer. If you're concerned about drug abuse or addiction, seek professional help.

7. Get regular medical care

Regular self-exams and screenings for various types of cancers — such as cancer of the skin, colon, prostate, cervix and breast — can increase your chances of discovering cancer early, when treatment is most likely to be successful. Ask your doctor about the best cancer screening schedule for you.

Take cancer prevention into your own hands, starting today. The rewards will last a lifetime. 

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