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Nutrition and daily life

Omega-3 and probiotics: popular, but with care

Omega-3 (fish oil) and probiotics are among the best-selling supplements. They may help in some situations, but during leukemia treatment they carry particular risks. This section covers both.

Last updated: ~1 min read
Baked salmon, walnuts and flax.
Figure 1.Omega-3 foods — Omega-3 and probiotics: popular, but with care

01Short answer

Omega-3 is safer from food: cooked fish, walnuts, flaxseed. Fish-oil capsules can increase bleeding when platelets are low, so take them only with your team's approval. Probiotic capsules contain live bacteria or yeasts; during neutropenia, with a central line or after transplant they can enter the blood and cause infection. So avoid probiotic supplements in these periods unless your team says otherwise. Ask your team about sealed pasteurised yogurt too.

02Simple explanation

Omega-3 from food.

Capsules: bleeding risk.

Probiotics: not in neutropenia.

Ask your team.

03Scientific explanation

NCCIH: serious infections after probiotics have been reported in very ill and immunocompromised people.

NCCIH: "natural" does not mean "safe"; the contents and quality of supplements are not checked as strictly as medicines.

04What happens in the body?

Omega-3 and appetite

Some studies suggest help with weight loss; your team may prescribe it if needed.

Capsules in shadow, fish in light.
Figure 2.Capsules aside — Omega-3 and probiotics: popular, but with care

Fermented foods

Homemade pickles, kefir and kombucha carry live microbes; see the rules in “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”.

Sealed yogurts and a bottle in shadow.
Figure 3.Yogurt and probiotics.

Interactions

Supplements can change medicine levels in the blood through liver enzymes such as CYP3A4.

Food first

A varied diet usually provides the vitamins you need; supplements only when there is a need.

05Supplements: four steps

List them, show your team, check the evidence, take only with agreement.

List — Write everything down.1ListWrite everything down.
Show — Doctor and pharmacist.2ShowDoctor and pharmacist.
Check — Evidence and risk.3CheckEvidence and risk.
Agree — Only with approval.4AgreeOnly with approval.
OpennessTell everything.
FoodPlate first.
SafetyInteractions.

06Key points at a glance

TopicIn brief
Omega-3 and appetiteSome studies suggest help with weight loss; your team may prescribe it if needed.
Fermented foodsHomemade pickles, kefir and kombucha carry live microbes; see the rules in “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”.
InteractionsSupplements can change medicine levels in the blood through liver enzymes such as CYP3A4.
Food firstA varied diet usually provides the vitamins you need; supplements only when there is a need.

07Key terms

Omega-3
Fatty acids from fish and some plants.
Probiotic
A product with live beneficial microbes.
Dietary supplement
A product of vitamins, minerals, herbs or other substances.
Interaction
One substance changing the effect of another.

08Key points

  • Food first.
  • Capsules only with approval.
  • No probiotics in neutropenia.
  • A supplement is not a treatment.
  • Report every one.

09Frequently asked questions

Do I need a probiotic after antibiotics?

Not on your own during treatment; ask your team.

Is flaxseed OK?

Usually yes, cooked into food or toasted.

Is a "natural" supplement harmless?

No. Natural substances can also act strongly and interact.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Do I need a probiotic after antibiotics?

  2. Is flaxseed OK?

  3. Is a "natural" supplement harmless?

My questions

12Sources

  1. NCCIH. Probiotics: What You Need To Know
  2. NIH Office of Dietary Supplements. Dietary Supplement Fact Sheets
  3. NCCIH. Using Dietary Supplements Wisely
  4. National Cancer Institute. Complementary and Alternative Medicine
  5. Memorial Sloan Kettering. About Herbs, Botanicals and Other Products
  6. World Health Organization (WHO). Listeriosis — fact sheet
  7. U.S. Food and Drug Administration (FDA). What You Need to Know About Egg Safety
  8. U.S. Food and Drug Administration (FDA). Raw Milk Misconceptions and the Danger of Raw Milk Consumption
  9. NHS. Listeriosis
  10. American Diabetes Association. Food & Nutrition
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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