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10.1007/s00125-017-4318-z 8 BaileyC

Understanding these mechanisms can help patients better manage gastrointestinal adverse events

Milk thistle (Silybum marianum): Supports liver cell protection and regeneration during medication stress N-acetylcysteine (NAC): Replenishes glutathione and reduces oxidative burden Vitamin C & zinc: Essential for collagen synthesis, immune recovery, and wound healing Vitamin D + K2: Support bone density, calcium balance, and immune regulation Adaptogens (e.g., ashwagandha, rhodiola): Help buffer adrenal stress and support circadian rhythm balance Nutritional & Lifestyle Foundations Emphasize adequate protein intake (collagen, eggs, wild-caught fish) to counter muscle and connective tissue loss Include antioxidant-rich foods such as citrus, berries, cruciferous vegetables, and green tea Support vitamin D status through sunlight exposure and appropriate D3 + K2 supplementation Incorporate weight-bearing exercise and supportive modalities (e.g., red-light therapy) to preserve bone and muscle Functional Medicine Monitoring and Recovery Considerations Assess and monitor: vitamin D, magnesium, zinc, selenium, fasting glucose, and bone density Support detoxification: use strategies such as sulforaphane and NAC to assist liver and mitochondrial function Taper thoughtfully: when appropriate, work with a qualified clinician to gradually reduce steroid use while restoring adrenal balance and nutrient status While corticosteroids exert their effects by overriding stress and immune signaling, other commonly used pain medicationssuch as acetaminophen (Tylenol)disrupt healing through different metabolic pathways

Enhancing the specificity of ferroptosis activators and regulating their dosage to minimize adverse effects on healthy tissues are anticipated to represent novel oncological therapeutic strategies