I wish there was more information about the benefits of supplements out there especially in relation to Sickle Cell warriors. Dietary supplements are products designed to augment your daily intake of nutrients, including vitamins and minerals. Many are safe and offer significant health benefits, but there are some that pose health risks, especially if overused. Dietary supplements include amino acids, fatty acids, enzymes, probiotics, herbals, botanicals, and animal extracts.

Normally, you should be able to get all the nutrients you need from a balanced diet. However, supplements can provide you with extra nutrients when your diet is lacking or certain health conditions trigger a deficiency.

While most dietary supplements are safe as long as you follow the product instructions, large doses of certain nutrients can have adverse effects. You can even overdose on certain supplements, risking serious harm and death.7

Among some the harmful interactions or dosing concerns:

• Vitamin K can reduce the effectiveness of blood thinners like Coumadin (warfarin).8
• Vitamin E can increase the action of blood thinners, leading to easy bruising and nosebleeds.
• St. John’s wort can accelerate the breakdown of many drugs, including antidepressants and birth control pills, thereby reducing their effectiveness.
• Antioxidants like vitamins C and vitamin E can reduce the effectiveness of some types of cancer chemotherapy.8
• High-dose vitamin B6 (pyridoxine), when used for a year or more, can cause severe nerve damage. Vitamin B6 can also reduce the effectiveness of the anti-seizure drug Dilantin (phenytoin) and levodopa (used to treat Parkinson’s disease).
• Vitamin A used with retinoid acne medications such as Accutane (isotretinoin) and Soriatane (acitretin) can causes vitamin A toxicity.8
• Vitamin B3 (niacin), when used with statins, may increase the risk of rhabdomyolysis (the abnormal breakdown of muscle tissue).
• Iron and calcium supplements can reduce the effectiveness of antibiotics, namely tetracyclines and fluoroquinolones, by as much as 40 percent.
• Vitamin C, when taken in doses exceeding 2,000 milligrams, can cause nausea and severe diarrhea.

Advise your healthcare provider about any supplements you plan to take as well as any medications you are currently taking, whether they be pharmaceutical, over-the-counter, herbal, traditional, or homeopathic.

Now for supplements that are really benefit Sicklers.

Arginine 100 mg per 2.2 lbs (1 kg) of body weight, three times per day.

Something I’ve personally had a scare from. People with pulmonary hypertension (a life-threatening complication of Sickle Cell) who received L-arginine had significant improvement in one study. In a preliminary study, individuals with pulmonary hypertension received L-arginine in the amount of 100 mg per 2.2 pounds of body weight, three times per day for five days. L-arginine treatment resulted in a significant improvement in pulmonary hypertension, as determined by a 15% decline in the pulmonary artery systolic pressure. Longer-term studies are needed to confirm these preliminary results.

Fish Oil 250 mg of oil per 2.2 lbs (1 kg) of body weight daily.

Supplementing with fish oil appears to reduce the frequency of severe pain episodes. Fish oil has been studied. In a double-blind trial, supplementation with menhaden oil, in the amount of 250 mg per 2.2 pounds of body weight per day for one year, reduced the frequency of severe pain episodes by approximately 45%, compared with placebo. This treatment may work by correcting an imbalance between omega-3 and omega-6 fatty acids that occurs in people with Sickle Cell. The beneficial effect of the omega-3 fatty acids present in fish oil was confirmed in another double-blind study.

Folic Acid.

In one trial, patients with Sickle Cell who were given folic acid plus aged garlic extract, vitamin C, and vitamin E saw significant improvement and less painful crises.

In a preliminary trial, 20 patients with Sickle Cell were given either 1 mg of folic acid per day or folic acid plus 6 grams of aged garlic extract, 6 grams of vitamin C, and 1,200 mg of vitamin E per day for six months. Patients taking the combination had a significant improvement in their hematocrit (an index of anemia) and less painful crises than those taking just folic acid.

Preliminary research has found that patients with Sickle Cell are more likely to have elevated blood levels of homocysteine compared to healthy people. Elevated homocysteine is recognized as a risk factor for cardiovascular disease. In particular, high levels of homocysteine in Sickle Cell patients have been associated with a higher incidence of stroke. Deficiencies of vitamin B6, vitamin B12, and folic acid occur more frequently in people with Sickle Cell than in others and are a cause of high homocysteine levels. A controlled trial found homocysteine levels were reduced 53% in children with Sickle Cell receiving a 2–4 mg supplement of folic acid per day, depending on age, but vitamin B6 or B12 had no effect on homocysteine levels. A double-blind trial of children with Sickle Cell found that children given 5 mg of folic acid per day had less painful swelling of the hands and feet compared with those receiving placebo, but blood abnormalities and impaired growth rate associated with Sickle Cell were not improved. In the treatment of Sickle Cell, folic acid is typically supplemented in amounts of 1,000 mcg daily. Anyone taking this amount of folic acid should have vitamin B12 status assessed by a healthcare professional.

L-Carnitine 50 mg per 2.2 lbs (1 kg) of body weight daily

In a study of children with Sickle Cell, supplementing with L-carnitine reduced the number of painful crises and improved abnormal heart function and pulmonary hypertension. In a preliminary study of children with Sickle Cell, supplementing with L-carnitine (50 mg per 2.2 pounds of body weight per day for six months) significantly reduced the number of painful crises and significantly improved the abnormal heart function (diastolic dysfunction) that was present in most of the children. L-carnitine supplementation also significantly improved pulmonary hypertension in the children who had this abnormality prior to treatment.

Zinc. Take under medical supervision: 100 mg of zinc (plus 2 mg of copper daily to protect against depletion)

Supplementing with zinc appears to help prevent cell damage and speed healing of leg ulcers associated with Sickle Cell.

Antioxidant nutrients protect the body’s cells from oxygen-related damage. Many studies show that Sickle Cell patients tend to have low blood levels of antioxidants, including carotenoids, vitamin A, vitamin E, and vitamin C, despite adequate intake. Low blood levels of vitamin E in particular have been associated with higher numbers of diseased cells in children and with greater frequency of symptoms in adults. A small, preliminary trial reported a 44% decrease in the average number of diseased cells in six Sickle Cell patients given 450 IU vitamin E per day for up to 35 weeks. This effect was maintained as long as supplementation continued.

The zinc deficiency associated with Sickle Cell appears to play a role in various aspects of the illness. For example, preliminary research has correlated low zinc levels with poor growth in children with Sickle Cell. In a preliminary trial, 12 people with Sickle Cell received 25 mg of zinc every four hours for 3 to 18 months. The number of damaged red blood cells fell from 28% to 18.6%. Addition of 2 mg of copper per day did not inhibit the effect of zinc. (Zinc supplementation in the absence of copper supplementation induces a copper deficiency.) Patients with the highest number of damaged red blood cells had a marked response to zinc, but those with lower levels of damaged cells (less than 20% irreversibly sickled cells) had little or no response.

Chronic leg ulcers occur in about 75% of adults with Sickle Cell. In a controlled trial, Sickle Cell patients with low blood levels of zinc received 88 mg of zinc three times per day for 12 weeks. Ulcer healing rate was more than three times faster in the zinc group than in the placebo group. Zinc supplementation (25 mg 3 times per day for 3 months) also decreased the number of infections in adults with Sickle Cell.

L-glutamine (Endari). Refer to label instructions

Endari is an oral L-glutamine therapy for Sickle Cell Anemia and Sickle Cell Thalassemia developed by Emmaus Life Sciences.

It was approved for use by patients age 5 and older by the U.S. Food and Drug Administration (FDA) on July 7, 2017, making Endari the first approved pediatric treatment for Sickle Cell, and the first new treatment for adults in almost 20 years.

Glutamine, an amino acid, plays various and fundamental roles in cell metabolism, including protein synthesis, chemical energy production, and anti-oxidant formation. The most abundant amino acid in the body, glutamine is naturally produced (largely in the lungs), and usually in sufficient amounts for our needs. But is often used as a supplement to counter infection, injury, stress, and to treat certain diseases.

Patients with Sickle Cell have an altered form of the hemoglobin protein (which carries oxygen, via the blood, to tissues) that renders red blood cells susceptible to oxidation damage.

High oxidative stress has been associated with an increased stiffness in these red blood cells, leading to their sickle-like shape. Less flexible than healthy (and round) red blood cells, these abnormal cells often stick to vessel walls, blocking or slowing blood flow and oxygen transport.

Endari increases the amount of free glutamine circulating in the blood, which is taken up by the sickle cells and used to generate anti-oxidant molecules as a product of glutamine degradation.

These new antioxidants help neutralize the oxidative stress in sickle red blood cells, allowing them to regain the flexibility needed to travel through blood vessels and capillaries, carrying oxygen to tissues throughout the body.

Note: This is a personal blog and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.