Alternative Therapy

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  Herbs, Vitamins, Diet
  Folic Acid

Herbs, Vitamins, Diet

Are there other therapies such as herbs, vitamins, and diet for treating these diseases?

Complementary and alternative therapies are not effective treatment for aplastic anemia (AA), myelodysplastic syndromes (MDS), or paroxysmal nocturnal hemoglobinuria (PNH). They can actually worsen the condition and hinder treatment. If you currently are taking herbal or supplemental therapies, or if you are considering taking this approach, it is important to tell your doctor.

Patients and caregivers should keep in mind that proper nutrition is important for optimal blood production. Individual nutritional needs should be discussed with your doctor. Nutritional needs can be impacted by disease and medications. For instance, magnesium depletion may occur during administration of

cyclosporine.

We are aware of several supplements that may worsen blood counts in patients with bone marrow disease or interact with medicines taken by AA, MDS, or PNH patients. These include Ginko-Biloba, which has been associated with increased bleeding time; Ginseng, which can interact with warfarin, decreasing the anticoagulant (blood thinning) activity or decreasing INR; St. John's Wort, which can decrease the effectiveness of many medications; and Garlic and Astragalus (Huang-Qu), which may interact with cyclosporine and warfarin.

Your doctor may recommend a neutropenic diet if your

The most numerous of the white blood cells, important for helping the body fight infections (particularly bacterial and fungal infections; see also bands, PMNs, polys, stabs, and segs).

neutrophilcount is very low. (Neutrophils are the most numerous of the white cells and are important in helping the body fight infections.) A neutropenic diet reduces risk of bacterial contamination. For instance, patients with very low neutrophil counts should not eat at the local salad bar, should wash and peel all fresh fruits and vegetables. All cooked foods should be eaten promptly or refrigerated before cooling to avoid bacterial contamination. Foods containing living fungi, such as any of the blue cheeses, other aged cheeses, and unpasteurized dairy or fermentation productions should be avoided.

Folic Acid

Does folic acid (folate) play a role in the treatment of these diseases - aplastic anemia, myelodysplastic syndromes, and PNH?

Folic acid plays a key role in the treatment of any hemolytic anemia where there is increased destruction and as compensation, increased production of red cells. The marrow under these circumstances has a significantly increased requirement for folate to synthesize DNA. One can easily develop a situation where folic acid levels are the limiting factor, which can cause a worsening of anemia - a megaloblastic crisis. A doctor will prescribe folic acid for patients with hemolytic anemia. It is also important to be sure that there are adequate body stores of Vitamin B12. Since iron stores can be either increased or decreased, a serum iron panel is also checked periodically.

PNH results in hemolysis and thus should be treated with folic acid to avoid a megaloblastic crisis. For patients found to have small PNH clones, the doctor will give folic acid in case their PNH clone size increases and they develop more significant hemolysis.

For patients with AA or MDS without PNH clone, unless there is some other reason why there is increased red cell destruction and production, folic acid requirements should be normal and they should not be at risk of a megaloblastic crisis.