Order supplements in Canada

Lesezeit 7 Minuten

The following supplements were classified as recommended or conditionally recommended in the R-CHOP Supportive Care daily plan. For each supplement, specific preparations are listed that are available in Canada. The selection takes into account, in particular, the bioavailability of the respective formulation. All product names are direct links to the respective product.

Distributor Well.ca (well.ca) – Canada’s largest online health retailer, free shipping on orders over $14. Vitasave.ca – Canada’s leading supplement retailer. iHerb Canada (iherb.ca) – international retailer shipping to Canada.

Vitamin D3

Recommendation: HIGHLY RECOMMENDED

Dosage: 2,000-4,000 IU daily (or 25,000 IU weekly for deficiency)

Bioavailability Softgel form with oil (MCT, sunflower oil) significantly more bioavailable than tablets or powder capsules; prefer D3 (cholecalciferol), not D2

Note: Measure vitamin D levels before supplementation (goal: >30 ng/ml, optimal >40 ng/ml). Combination with vitamin K2 (MK-7, 100-200 mcg) recommended to direct calcium to bones.

Omega-3 Fatty Acids (EPA/DHA)

Recommendation: RECOMMENDED

Dosage: 1-2 g EPA/DHA daily (equivalent to 2-3 fish oil capsules)

Bioavailability The triglyceride (TG) form has approximately 70% times higher bioavailability than the ethyl ester (EE) form. Choose liquid preparations or softgels with a high EPA/DHA content. Take with meals that contain fat.

Note: With thrombocytopenia <50,000/µL, exercise caution (mild blood thinning). Prefer intake through diet (fatty fish 2-3x/week).

magnesium

Recommendation: RECOMMENDED

Dosage: 300-400 mg elemental magnesium daily, in the evening

Bioavailability Magnesium glycinate (bisglycinate) and magnesium citrate have significantly better bioavailability than magnesium oxide (which is absorbed at only about 41%). The glycinate form is best tolerated and rarely causes diarrhea.

Note: Especially for neuropathy symptoms or sleep disturbances. Take in the evening for better sleep.

Probiotics

Recommendation: Conditionally recommended

Dosage: Multi-strain preparation with 10-20 billion KBE daily

Bioavailability Acid-resistant capsules (enteric-coated) or lyophilized preparations are preferred. Cooling preserves the viable cell count. Preparations with documented strain identity (CFU guarantee until expiration date).

Note: CAUTION: During nadir phase (days 8-14 after chemotherapy), pause or discuss with your doctor. Prefer high-quality preparations with clinically tested strains.

Vitamin B-Complex (activated forms)

Recommendation: Conditionally recommended

Dosage: Low dose (1x RDA), especially B1, B6, B12

Bioavailability Prefer activated forms: Methylcobalamin (B12) instead of Cyanocobalamin, Pyridoxal-5-Phosphate (B6) instead of Pyridoxine, Methylfolate (B9) instead of Folic Acid. These are utilized directly without a conversion step.

Note: Low doses are safe. High doses of B6 (>100 mg/day) can paradoxically cause neuropathy – absolutely avoid.

Zinc

Recommendation: Conditionally recommended

Dosage: 15-30 mg daily (not >40 mg long-term)

Bioavailability Zinc bisglycinate and zinc picolinate have significantly better bioavailability than zinc oxide or zinc sulfate. The bisglycinate form is the most stomach-friendly. Do not take at the same time as calcium or iron (inhibits absorption).

Note: High doses can cause copper deficiency. With long-term intake >25 mg: consider copper supplementation (2 mg).

Melatonin

Recommendation: Conditionally recommended

Dosage: 3-5 mg each evening, 30-60 minutes before bedtime

Bioavailability Sublingual tablets or rapidly dissolving forms have a faster onset of action than capsules. For sleep onset problems: rapidly dissolving form (0.5-3 mg). For sleep maintenance problems: sustained-release form (3-5 mg). Health Canada allows a maximum of 10 mg.

Note: Available over-the-counter in Canada as an NHP (Natural Health Product). Low to moderate doses (0.5-5 mg) are well-tolerated. Discuss with a doctor.

Ginger

Recommendation: RECOMMENDED (for nausea)

Dosage: 1-2 g daily (fresh, as tea, or capsules), especially days 1-7 of each cycle

Bioavailability Prefer standardized extracts with a defined gingerol/shogaol content. Fresh ginger (2-3 cm/day) or ginger tea are also effective. Capsules containing 500-550 mg of ginger root powder are equivalent to approx. 1 g of fresh ginger.

Note: With thrombocytopenia <50,000/µL, be cautious (mild blood thinning). As tea or fresh in food is the safest option.

Selenium

Recommendation: CONDITIONAL RECOMMEND (only if deficiency is proven)

Dosage: 50-200 mcg daily (not >400 mcg)

Bioavailability Selenomethionine has significantly better bioavailability than inorganic sodium selenite or sodium selenate. Selenomethionine is incorporated into proteins, like methionine, and is better stored.

Note: Only supplement if a deficiency is proven. Measure levels. High doses (>400 mcg) are toxic (selenosis). Do not supplement routinely.

Important Notes

• All preparations are NHP (Natural Health Product) certified and legally available in Canada.
• Bioavailability notes are based on pharmacological comparative studies of supplement formulations.
• Prices and availability may change – check product links for the current status.
• Free shipping at Well.ca on orders of $135 or more, and at Vitasave.ca on orders of $149 or more.
• iHerb Canada ships from the USA to Canada – delivery time approximately 5-10 business days.