Question: Hi there,

I currently take garlic (1100mg), fish oil (2g), and some other supplements in smaller quantities including CoQ10, quercetin, resveratrol, green tea, fruit/veggies (supplements + foods), arginine, bit of cayenne, reishi mushroom, etc. (plus a multivitamin). These are all approved by my primary care physician and have actually assisted me in getting my blood pressure to healthier levels (and help with cholesterol). They're also a more natural alternative (at 34) to aspirin therapy. I try to get a wide variety of everything, but in low-moderate quantities.

Three questions:

- I note that a lot of these are anti-angiogenesis. From my understanding, where cancer prevention is concerned, that's a great thing in regards to cancer risk, as it can help prevent cancer growth. But since that means new blood vessels are less likely to form or grow, can this be a bad thing too?

- I know antioxidants/anti-inflammatories are helpful, but I've read too many can have pro-oxidant effects. As far as I know, I'm not taking a huge amount of anything, and most of what I'm taking are whole-food based, with a few exceptions (and nothing without doctor approval). Is this something I need to worry about?

- I don't take any prescription blood-thinners or anything like aspirin, but I realize a lot of these inhibit platelet aggregation too, but probably to a much lesser extent than prescription options (I have no excess bleeding or bruising that I'm aware of). Would I have any concerns re hemorrhagic stroke/aneurysm risk?

Thanks!

Thanks so much for your detailed response!

I'd like to mention my doctor does know the supplements I take (and any changes I discuss with her the next visit), and I try to keep dosages moderate (the "biggest" at this time are definitely the 2g of fish oil and the 1.1g of garlic). I'm just looking for a professional opinion and have a few followups/clarifications:

1.) So from what you're saying, the anti-angiogenesis food-based supplements I'm taking (ie. the garlic, fish oil, quercetin, reishi, and others I mentioned) may help prevent tumor growth since it's unstructured, but shouldn't significantly harm normal (structured) necessary blood vessel growth? For example, angiogenesis is necessary for wound healing, cardiac function, and brain development. I want to lower my risk of cancer, but my concern is if there's any risk of these things taken synergistically impairing or interfering with what the body needs to do to stay healthy (as from what I've read, angiogenesis inhibitor drugs may have some risks...but that's a prescription medication, not a food). Is your opinion that this isn't a danger with the natural supplements?

2.) I reviewed the abstract/conclusions of the paper you cited - thank you. So do you feel that most of these food-based antioxidants (green tea included, and the others I mentioned above), taken synergistically and given the limited research, are more beneficial than risk of harm from "too much"?

3.) Understood re the low dose aspirin. My doctor actually gave me the option of taking it as my dad died of a heart attack fairly young (early 50's), but as I'm 34 and take natural supplements like the garlic and fish oil that thin the blood and I have no known high-risk factors apart from family history, I'm more comfortable sticking with natural remedies for now (since they have helped me bring my blood pressure down, etc.). I may consider low-dose aspirin after 45. My question was more about whether these herbal/food-based remedies have the same risks or if they are perhaps slightly safer (but potentially not as potent also).

Thanks again!

Thanks very much for the help! I appreciate your patience as I work this all out. =)

My takeaways are:

- Natural food-based supplements, in moderate amounts, are generally less likely to be prone to the same degree of side effects of medications such as aspirin.

- Antioxidants are good for you, and in general, although more studies need to be done, pro-oxidant effects from a lot of antioxidants aren't something to worry about at this time.

- At 34, it's not a mistake to hold off on taking aspirin in favor of these natural (preventative) measures until I have a good reason to take aspirin or another medication.

- Regarding my angiogenesis concern, most anti-angiogenesis supplements may help disrupt cancer, but shouldn't harm normal blood vessel function/development.

One last followup topic, and this has to do with aspirin as opposed to supplements as well. I've read there's a suspected link between aspirin and macular degeneration in older people, and it's thought it might be due to strengthening of the complement system of the immune system (to the point of being overactive if you have a certain gene). Some supplements (500mg mushroom complex of maitake, reishi, and shiitake, for example) are thought to enhance the immune system. Would this likely have the same type of risk for macular degeneration, or is it impossible to compare the risk of something like this vs. aspirin as their mechanisms might be different?

Thanks again for your patience in answering my questions. I'm trying to do the right things (including not smoking, exercising, and trying to eat healthier and drink more moderately) to cut down my risk factors, but sometimes it's difficult to know what the best thing to do is regarding supplementation, which is why I'm striving for a wide variety and moderation. What I do take has seemed to make a positive difference in certain aspects of my life, but I also want to be as sure as is reasonably possible I'm not doing any long-term damage at the same time.