Lymphoma Supplement Recommendations

Multiple nutritional supplements have been associated with reduced cancer occurrence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Vitamin D

  • Human trials have shown that low levels of vitamin D are related to a higher risk of developing T-cell lymphoma.[1] Epidemiological findings demonstrate that time of year of diagnosis of Hodgkin’s lymphoma affects survival rates, with 20% lower rates of fatality if diagnosed in autumn rather than winter. The survival rate was 60% better for those under 30 years old. This may reflect the positive influence vitamin D levels have on the immune system and cancer fatality.[2] In addition to monitoring 25(OH) levels, 1,25 dihydroxy-vitamin D levels also must be measured, as individuals with lymphoma may have a rapid conversion to this active form, and are at risk for vitamin D toxicity, even with modest doses of vitamin D.
  • Suggested dose is that sufficient to raise vitamin D blood levels to >40 ng/mL, which may require 5000 IU per day or more.[3] * Vitamin D must be used very cautiously at first in people who have lymphoma active in their body.

Indole-3-carbinol (IC3)

  • IC3 was found to increase cell death in adult T-cell leukemia/lymphoma (ATLL) cells in both human and cell studies.[4] Pregnant animals fed IC3 resulted in lower incidences of lymphoma in their offspring.[5]
  • Suggested dose: 200-400mg per day.

DIM (3,3′-diindolylmethane)

  • DIM significantly reduced human T-cell acute lymphoblastic leukemia (T-ALL) cells as well as reducing lymphoma tumors in mice by as much as 44%.[6]
  • Suggested dose: 250 mg per day.

Curcumin

  • The active extract from the spice turmeric, curcumin has high anti-cancer effects on many cell lines, including lymphoma. Curcumin inhibited the growth of HL cell lines and increased the sensitivity to the chemotherapy cisplatin.[7] Lymphoma tumor growth in mice was inhibited by curcumin.[8],[9]
  • Suggested dose: 1-2g per day of Meriva® or Longvida® curcumin.[10],[11]

Quercetin

  • Quercetin is a flavonoid which has shown to induce cell death in lymphoma cell lines.[12] One cell study showed that quercetin combined with the drug rituximab enhanced the effectiveness of this drug in inhibiting diffuse large B-cell lymphoma (DLBCL) cells.[13] TRAIL is an important cytokine needed for cell death that is often decreased in lymphoma cell lines. Quercetin restores TRAIL-induced cell death in resistant transformed follicular lymphoma B-cell lines.[14]
  • Suggested dose: 200-400mg, three times per day.

Resveratrol

  • This antioxidant found in red wine and grapes inhibited Epstein Barr Virus (EBV) in Burkitt’s lymphoma cells.[15] Additionally it induced cell death in Hodgkin lymphoma.[16]
  • Suggested dose: 100-200mg per day.

COQ10

  • This antioxidant has been stated to improve survival rates in various forms of cancer as well as having cardioprotective influence on children with lymphoma.[17] Cell studies show that coenzyme Q 10 reduced cell activity of malignant cells in Burkitt’s lymphoma.[18]
  • Suggested dose: 100 mg per day.

Forskolin

  • Forskolin appears to have an immune regulatory effect on lymphoma cell lines, and inhibits a key phase of cell division.[19],[20] Burkitt’s lymphoma cancer cells treated with Forskolin had higher rates of cell death.[21]
  • Suggested dose: 10 mg, two times per day.

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[1] Drake MT, Maurer MJ, Link BK, Habermann TM, Ansell SM, Micallef IN, Kelly JL, Macon WR, Nowakowski GS, Inwards DJ, Johnston PB, Singh RJ, Allmer C, Slager SL, Weiner GJ, Witzig TE, Cerhan JR. Vitamin D insufficiency and prognosis in non-Hodgkin’s lymphoma. J Clin Oncol. 2010 Sep 20;28(27):4191-8.

[2] Porojnicu AC, Robsahm TE, Ree AH, Moan J. Season of diagnosis is a prognostic factor in Hodgkin’s lymphoma: a possible role of sun-induced vitamin D. Br J Cancer. 2005 Sep 5;93(5):571-4.

[3] Garland CF, French CB, Baggerly LL, et al. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.

[4] Machijima Y, Ishikawa C, Sawada S, Okudaira T, Uchihara JN, Tanaka Y, Taira N, Mori N. Anti-adult T-cell leukemia/lymphoma effects of indole-3-carbinol. Retrovirology. 2009 Jan 16;6:7. doi: 10.1186/1742-4690-6-7.

[5] Yu Z, Mahadevan B, Löhr CV, Fischer KA, Louderback MA, Krueger SK, Pereira CB, Albershardt DJ, Baird WM, Bailey GS, Williams DE. Indole-3-carbinol in the maternal diet provides chemoprotection for the fetus against transplacental carcinogenesis by the polycyclic aromatic hydrocarbon dibenzo[a,l]pyrene. Carcinogenesis. 2006 Oct;27(10):2116-23. Epub 2006 May 16.

[6] Shorey LE, Hagman AM, Williams DE, Ho E, Dashwood RH, Benninghoff AD. 3,3′-Diindolylmethane induces G1 arrest and apoptosis in human acute T-cell lymphoblastic leukemia cells. PLoS One. 2012;7(4):e34975. doi: 10.1371/journal.pone.0034975. Epub 2012 Apr 13.

[7] Kewitz S, Volkmer I, Staege MS. Curcuma Contra Cancer? Curcumin and Hodgkin’s Lymphoma. Cancer Growth Metastasis. 2013 Aug 8;6:35-52. doi: 10.4137/CGM.S11113. eCollection 2013.

[8] Das L, Vinayak M. Curcumin attenuates carcinogenesis by down regulating proinflammatory cytokine interleukin-1 (IL-1α and IL-1β) via modulation of AP-1 and NF-IL6 in lymphoma bearing mice. Int Immunopharmacol. 2014 May;20(1):141-7.

[9] Zhu G, Zhang Q, Dai H, Shen Q. [Effect of curcumin on expressions of mitogen-activated protein kinases and matrix metalloproteinases in Jurkat cells]. Nan Fang Yi Ke Da Xue Xue Bao. 2013 Dec;33(12):1792-5.

[10] Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Cancer Chemother Pharmacol. 2007 Jul;60(2):171-7

[11] DiSilvestro RA1, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79. doi: 10.1186/1475-2891-11-79.

[12] Peng X, Yu DY, Feng BM, Wang YQ, Shi LY. A new acylated flavonoid glycoside from the flowers of Camellia nitidissima and its effect on the induction of apoptosis in human lymphoma U937 cells. J Asian Nat Prod Res. 2012;14(8):799-804.

[13] Li X, Wang X, Zhang M, Li A, Sun Z, Yu Q. Quercetin Potentiates the Antitumor Activity of Rituximab in Diffuse Large B-Cell Lymphoma by Inhibiting STAT3 Pathway. Cell Biochem Biophys. 2014 Jun 6.

[14] Jacquemin G, Granci V, Gallouet AS, Lalaoui N, Morlé A, Iessi E, Morizot A, Garrido C, Guillaudeux T, Micheau O. Quercetin-mediated Mcl-1 and survivin downregulation restores TRAIL-induced apoptosis in non-Hodgkin’s lymphoma B cells. Haematologica. 2012 Jan;97(1):38-46. doi: 10.3324/haematol.2011.046466. Epub 2011 Sep 20.

[15] De Leo A, Arena G, Lacanna E, Oliviero G, Colavita F, Mattia E. Resveratrol inhibits Epstein Barr Virus lytic cycle in Burkitt’s lymphoma cells by affecting multiple molecular targets. Antiviral Res. 2012 Nov;96(2):196-202.

[16] Frazzi R, Valli R, Tamagnini I, Casali B, Latruffe N, Merli F. Resveratrol-mediated apoptosis of hodgkin lymphoma cells involves SIRT1 inhibition and FOXO3a hyperacetylation. Int J Cancer. 2013 Mar 1;132(5):1013-21.

[17] Bryant J, Picot J, Levitt G, Sullivan I, Baxter L, Clegg A. Cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review. Health Technol Assess. 2007 Jul;11(27):iii, ix-x, 1-84.

[18] Bruge F, Virgili S, Cacciamani T, Principi F, Tiano L, Littarru GP. NAD(P)H:quinone oxidoreductase (NQO1) loss of function in Burkitt’s lymphoma cell lines. Biofactors. 2008;32(1-4):71-81.

[19] Darfler FJ, Mahan LC, Koachman AM, Insel PA. Stimulation of forskolin of intact S49 lymphoma cells involves the nucleotide regulatory protein of adenylate cyclase. J Biol Chem. 1982 Oct 25;257(20):11901-7.

[20] Gützkow KB1, Naderi S, Blomhoff HK. Forskolin-mediated G1 arrest in acute lymphoblastic leukaemia cells: phosphorylated pRB sequesters E2Fs. J Cell Sci. 2002 Mar 1;115(Pt 5):1073-82.

[21] Taga S, Carlier K, Mishal Z, Capoulade C, Mangeney M, Lécluse Y, Coulaud D, Tétaud C, Pritchard LL, Tursz T, Wiels J. Intracellular signaling events in CD77-mediated apoptosis of Burkitt’s lymphoma cells. Blood. 1997 Oct 1;90(7):2757-67.

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