{"id":30810,"date":"2026-02-11T19:37:23","date_gmt":"2026-02-11T18:37:23","guid":{"rendered":"https:\/\/jegharkraeft.dk\/stoette-ved-immunterapi\/"},"modified":"2026-06-05T20:03:40","modified_gmt":"2026-06-05T19:03:40","slug":"support-during-immunotherapy","status":"publish","type":"post","link":"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/","title":{"rendered":"1. Support during immunotherapy. immunotherapy support, microbiome cancer, Akkermansia, immunotherapy side effects, immune system cancer, gut flora"},"content":{"rendered":"\n<div class=\"wp-block-group alignfull is-style-section-5 has-contrast-color has-base-background-color has-text-color has-background has-link-color wp-elements-1a3d7bdb0b014b6b04dc0070340edcdb has-global-padding is-layout-constrained wp-block-group-is-layout-constrained is-style-section-5--2\" id=\"menu\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50)\">\n<div class=\"wp-block-columns alignwide is-layout-flex wp-container-core-columns-is-layout-ca2dd60b wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h2 class=\"wp-block-heading has-custom-int-link-p-sort-1-color has-text-color has-link-color wp-elements-85c9ab605a9af581478ba1bfba8fd611\"><span class=\"ez-toc-section\" id=\"Treatments\"><\/span><a href=\"https:\/\/jegharkraeft.dk\/en\/cancer-treatments-overview\/\">Treatments<\/a><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<div class=\"wp-block-group has-custom-interne-links-color has-text-color has-link-color wp-elements-5ba2ec205ccc53f44665320cec95e734 has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\">\n<h4 class=\"wp-block-heading has-custom-int-link-p-sort-1-color has-text-color has-link-color wp-elements-f5f8a1358227946fb2d513daa4f0c91b\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-custom-hvid-tekst-color\"><a href=\"https:\/\/jegharkraeft.dk\/en\/integrative-oncology\/\">Integrative Oncology<\/a><\/mark><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-int-link-p-sort-1-color has-text-color has-link-color wp-elements-379271b49b82f9aedc65879ba9c384fd\"><a href=\"https:\/\/jegharkraeft.dk\/en\/chemo-and-radiotherapy-support\/\">Chemo and Radiotherapy Support<\/a><\/li>\n\n\n\n<li class=\"has-custom-her-st-r-du-color has-text-color has-link-color wp-elements-89a40f9a161de4cfcff9017394f03b13\"><a href=\"#stoette-ved-immunterapi\">Support during Immunotherapy (scroll down)<\/a><\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-color has-text-color has-link-color wp-elements-f66f53358024ab88ea0217f8d8142540\"><a href=\"https:\/\/jegharkraeft.dk\/en\/safe-measures\/\">Safe measures<\/a><\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"720\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi.jpg\" alt=\"Support during Immunotherapy symbolised by some pink cells encapsulated in a clear gel-like mass.\" class=\"wp-image-29110\" style=\"aspect-ratio:3\/2;object-fit:cover;width:550px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-600x338.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-300x169.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-1024x576.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-768x432.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignfull is-style-default has-global-padding is-layout-constrained wp-container-core-group-is-layout-b040ace0 wp-block-group-is-layout-constrained has-background\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--60);padding-right:var(--wp--preset--spacing--20);padding-bottom:var(--wp--preset--spacing--60);padding-left:var(--wp--preset--spacing--20);background-image:url(&apos;https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi.jpg&apos;);background-position:44% 36%;background-size:cover;\">\n<div class=\"gb-element-906497af\">\n<h1 id=\"stoette-ved-immunterapi\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Support_during_Immunotherapy\"><\/span>Support during Immunotherapy<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained wp-container-3 is-position-sticky\">\n<div id=\"fast-soegeboks\">\n    <input type=\"text\" id=\"keyword\" placeholder=\"Search drug...\">\n    <button id=\"btn-prev\">\u2191 Previous<\/button>\n    <button id=\"btn-next\">\u2193 Next<\/button>\n    <span id=\"search-counter\"><\/span>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Contents:<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#What_is_support_during_immunotherapy\">What is support during immunotherapy<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Mechanisms_of_immune_support\">Mechanisms of immune support<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#How_to_use_the_article\">How to use the article<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Risk_assessment\">Risk assessment<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Clinical_decision_support_and_pharmacokinetics\">Clinical decision support and pharmacokinetics<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Biochemical_Overview_%E2%80%93_Table\">Biochemical Overview \u2013 Table<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Collaboration_offer_for_oncologists_and_healthcare_professionals\">Collaboration offer for oncologists and healthcare professionals<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Practical_suggestions_for_support_during_immunotherapy\">Practical suggestions for support during immunotherapy<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Microbiome_enhancers\">Microbiome enhancers<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Organ_protection_against_immune_inflammation\">Organ protection against immune inflammation<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Mitochondrial_support_energy_for_T_cells\">Mitochondrial support (energy for T cells)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Skin_and_mucous_membranes\">Skin and mucous membranes<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Immune-related_side_effects\">Immune-related side effects<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Biological_half-lives_%E2%80%93_Links\">Biological half-lives \u2013 Links<\/a><\/li>\n<\/ol>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-custom-sort-tekst-color has-alpha-channel-opacity has-custom-sort-tekst-background-color has-background\"\/>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-text-color has-link-color wp-elements-77027ba71c439b18ae314a2977926b78\">Summary of Support during Immunotherapy<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The microbiome as the engine:<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A healthy gut flora, including the bacterium <em>Akkermansia<\/em>, is crucial for immunotherapy (checkpoint inhibitors) to activate the immune system against cancer cells at all.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Managing side effects:<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>By identifying early signs of immune-related inflammation in the gut, lungs and skin, you can support the body\u2019s tolerance without weakening the treatment effect.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Selective protection:<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>With combination treatment (<a href=\"https:\/\/jegharkraeft.dk\/kemoterapi\/\">chemo<\/a> + <a href=\"https:\/\/jegharkraeft.dk\/immunterapi\/\">immunotherapy<\/a>), the support strategy must protect the organs from chemo toxicity while preserving the immune system\u2019s drive to attack.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Synergy through balance:<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Targeted use of prebiotics and specific antioxidants can optimise the therapeutic window and reduce the risk of treatment interruptions.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-custom-sort-tekst-color has-alpha-channel-opacity has-custom-sort-tekst-background-color has-background\"\/>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 id=\"organbeskyttelse\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_is_support_during_immunotherapy\"><\/span>What is support during immunotherapy<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"1440\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-scaled.jpg\" alt=\"yellow fruit with small particles.\" class=\"wp-image-31800\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-scaled.jpg 2560w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-300x169.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-1024x576.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-768x432.jpg 768w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-1536x864.jpg 1536w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi11-1-2048x1152.jpg 2048w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/figure>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-7a7dd251c7135c33f843de15645a492f wp-block-paragraph\">Immunotherapy has revolutionised oncology by not attacking the cancer directly, but by releasing the \u201cbrake\u201d on the body\u2019s own immune system. This mechanism requires a specific environment to function optimally. The immune system needs \u201cintelligence\u201d from the gut to work. A healthy microbiome sends chemical signals that activate T cells and teach them to recognise cancer cells. Without these bacteria, immunotherapy is like pressing the accelerator in a car without fuel\u2014the medicine releases the brake (PD-1), but the immune system has neither the energy nor the instruction to attack. [118].     <\/p>\n\n\n\n<h4 class=\"wp-block-heading\">The challenge is twofold<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">First, not all patients respond to treatment, which is often due to deficiencies in the gut flora. Second, the activated immune system can become overactive and attack healthy organs\u2014a condition known as immune-related adverse events [119]. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/mikrobiomet-kost\/\">The Microbiome and Diet<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Mechanisms_of_immune_support\"><\/span>Mechanisms of immune support<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"2560\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-scaled.jpg\" alt=\"Hand hold up for stopping particles comming against it.\" class=\"wp-image-31801\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-scaled.jpg 2560w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-300x300.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-1024x1024.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-150x150.jpg 150w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-768x768.jpg 768w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-1536x1536.jpg 1536w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-immunterapi10-1-2048x2048.jpg 2048w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">The microbiome axis<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Research shows that the presence of specific bacteria such as <em>Akkermansia muciniphila<\/em> acts as a catalyst for treatment. Without these bacteria, the immune system may struggle to recognise the tumour [130]. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Reducing side effects: irAEs (immune toxicity)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">When the immune system attacks healthy tissue, inflammation occurs. The strategy here is to use specific substances that support tissue integrity (e.g., in the gut or skin) without suppressing the entire immune response [131]. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Combination synergy<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">When immunotherapy is given together with chemotherapy, support must be balanced. You must protect the organs from chemo toxicity (as described in the article on Organ Protection), but avoid high-dose antioxidants or anti-inflammatory agents within the \u201ccheckpoint window\u201d, as this can deactivate immune cells [28]. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Safety zones for immunotherapy<\/h4>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"832\" height=\"411\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-Skema-Engelsk.jpg\" alt=\"Sceme for visual orientation.\" class=\"wp-image-31808\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-Skema-Engelsk.jpg 832w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-Skema-Engelsk-300x148.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi-Skema-Engelsk-768x379.jpg 768w\" sizes=\"auto, (max-width: 832px) 100vw, 832px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/quality-of-life-and-shared-responsibility\/\">Quality of life and shared responsibility<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/safe-measures\/\">Safe measures<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-custom-menu-links-color\">\u2764<\/mark><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What you read on <\/strong><em><strong>I Have Cancer<\/strong><\/em><strong> is not a recommendation. Seek qualified guidance.<\/strong><\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignfull is-style-default has-global-padding is-layout-constrained wp-container-core-group-is-layout-b040ace0 wp-block-group-is-layout-constrained has-background\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--60);padding-right:var(--wp--preset--spacing--20);padding-bottom:var(--wp--preset--spacing--60);padding-left:var(--wp--preset--spacing--20);background-image:url(&apos;https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil13.jpg&apos;);background-position:44% 36%;background-size:cover;\">\n<div class=\"gb-element-906497af\">\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"How_to_use_the_article\"><\/span>How to use the article<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"851\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil3.jpg\" alt=\"M\u00e5lrettet samspil symboliseret ved nogle gyldne kapsler.\" class=\"wp-image-28624\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil3.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil3-600x399.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil3-300x199.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil3-1024x681.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil3-768x511.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">This article is based on the principles of safety distance (washout) and interaction risk described in Chemo- and Radiotherapy Support. The purpose is to ensure that the supplementary measures support blood formation without interfering with the oncological treatment. Two tools are used to ensure full treatment integrity:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Risk graduation <\/li>\n\n\n\n<li>Half-life <\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">First and foremost, one must look at the interaction risk. The higher this is, the more importance should be attributed to the half-life. That is to say, if there is no risk of interaction, the half-life is of less importance (however, the substance must still be broken down and excreted, which can burden the organism). And if there is a high risk of interaction, the half-life becomes extremely crucial.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Risk_assessment\"><\/span>Risk assessment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1070\" height=\"1280\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil51.jpg\" alt=\"M\u00e5lrettet samspil symboliseret ved et trafiklys med r\u00f8d, gul og gr\u00f8n.\" class=\"wp-image-28686\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil51.jpg 1070w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil51-600x718.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil51-251x300.jpg 251w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil51-856x1024.jpg 856w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil51-768x919.jpg 768w\" sizes=\"auto, (max-width: 1070px) 100vw, 1070px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Risk of interaction<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The risk is assessed for both Chemotherapy (impact on medication and liver) and Radiotherapy (impact on the sensitivity of tumor cells).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Grading:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>None<\/strong>: The preparation does not interfere with the treatment.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Low<\/strong>: Small risk, which is eliminated by following the safety distance.<\/li>\n\n\n\n<li class=\"has-custom-her-st-r-du-background-color has-background\"><strong>Moderate<\/strong>: Clear biological effect. Pauses must be strictly observed.<\/li>\n\n\n\n<li class=\"has-custom-menu-links-background-color has-background\"><strong>High<\/strong>: Large risk of interference. Must be kept far away from the active phase.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Biological half-life <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The color codes illustrate the pause based on how quickly the substance is broken down and excreted. [14, 27]:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Green<\/strong>: \u25ef Fast out of the body (under 4 hours). High degree of control.<\/li>\n\n\n\n<li class=\"has-custom-her-st-r-du-background-color has-background\"><strong>Yellow<\/strong>: \u2b24 Longer time to be broken down\/excreted (4\u201324 hours). Requires a pause of 1\u20135 days.<\/li>\n\n\n\n<li class=\"has-custom-menu-links-background-color has-background\"><strong>Red<\/strong>: \u25b2\u2716 Excreted slowly (over 24 hours). Requires a pause of 5\u201321 days.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"synergi\">Acute vs. accumulated dose <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"synergi\">Be aware that half-lives are often based on a single dose. With regular use of certain supplements (e.g., fat-soluble vitamins), the substance can accumulate in the tissues, which may require a longer washout period than specified.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Important<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Reduced kidney or liver function will likewise prolong this process, which is why there is a need for individual assessment by an oncologist or clinical pharmacologist, especially for patients with comorbidities.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Clinical_decision_support_and_pharmacokinetics\"><\/span>Clinical decision support and pharmacokinetics<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70.jpg\" alt=\"M\u00e5lrettet samspil symboliseret ved en masse nervetr\u00e5de der er revet over.\" class=\"wp-image-28667\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70-300x300.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70-100x100.jpg 100w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70-600x600.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70-150x150.jpg 150w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil70-768x768.jpg 768w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">To maintain dose intensity and protect the treatment response, a washout protocol of 5 \\times <em>t\u00bd<\/em> (half-life) is used. This ensures that the liver&#8217;s metabolic capacity is fully available for the conventional medication and that the risk of cell protection of the tumor cells is virtually eliminated.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Methodological basis for half-lives<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">To ensure clinical credibility, the specified values are determined through a hierarchical prioritization of data in four levels\u2014under Half-lives &#8211; Links (at the bottom of the page) called Level of Evidence:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Level 1 (white)<\/strong>: Direct evidence from human pharmacokinetic studies (measured in human blood).<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Level 2 (green)<\/strong>: Extrapolation from the most potent active ingredients in complex extracts.<\/li>\n\n\n\n<li class=\"has-custom-her-st-r-du-background-color has-background\"><strong>Level 3 (yellow)<\/strong>: Pharmacological estimate based on biochemical degradation and enzymatic kinetics.<\/li>\n\n\n\n<li class=\"has-custom-orange-background-color has-background\"><strong>Level 4 (orange)<\/strong>: Conservative estimate based on preclinical data (in vitro\/in vivo) with a built-in safety margin.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">By respecting these intervals, biosupport can be used strategically in the recovery phase to optimize the overall course and minimize side effects, without the therapeutic index being compromised.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">See Biological half-lives &#8211; Links (at the bottom of the page)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>PS<\/strong>: Should you become aware of scientific articles that justify a higher ranking of the level of evidence for a preparation, I would be grateful for a tip.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Example_of_Interpretation_%E2%80%93_Artemisinin\"><\/span>Example of Interpretation &#8211; Artemisinin <span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Use this example as a guide for how to read the numbers and symbols in the table:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Validity (Evidence Level):<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-hvid-tekst-background-color has-background\">Marked as Level 1 (White). This means the data is based on direct measurements in humans, making the figures highly reliable.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life (<em>t\u00bd<\/em>):<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Listed here as 1\u20135 hours. This is the time it takes for the body to eliminate half of the substance from the blood.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout (Pause):<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\">The color is Green (\u25ef), and the pause is 1 day. This ensures that more than 96.8% of the substance has left the body once this time has passed. Treatment can be started thereafter.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Risk and Enzymes:<\/strong> <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Even though the pause is short, it is crucial for protecting liver enzymes (CYP450). The 1-day pause ensures that the liver is &#8220;available&#8221; to metabolize your medication correctly.<\/li>\n<\/ul>\n\n\n<h2 id=\"tablepress-87-name\" class=\"tablepress-table-name tablepress-table-name-id-87\"><span class=\"ez-toc-section\" id=\"Biochemical_Overview_%E2%80%93_Table\"><\/span>Biochemical Overview &#8211; Table<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<table id=\"tablepress-87\" class=\"tablepress tablepress-id-87\" aria-labelledby=\"tablepress-87-name\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Preparation<\/th><th class=\"column-2\">Clinical Timing<\/th><th class=\"column-3\">Sign<\/th><th class=\"column-4\">t1\/2<\/th><th class=\"column-5\">Washout<\/th><th class=\"column-6\">Preparation<\/th><th class=\"column-7\">Evidence Level*<\/th><th class=\"column-8\">Status<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\">AHCC<\/td><td class=\"column-2\">Immune surveillance (NK cells).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">approx. 5 hours<\/td><td class=\"column-5\">2 days<\/td><td class=\"column-6\">AHCC<\/td><td class=\"column-7\">2 (green)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\">Akkermansia<\/td><td class=\"column-2\">Strengthens intestinal barrier integrity.<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">1\u20132 days<\/td><td class=\"column-5\">5\u201310 days<\/td><td class=\"column-6\">Akkermansia<\/td><td class=\"column-7\">3 (yellow)<\/td><td class=\"column-8\">Control &amp; Maintenance<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\">Activated Charcoal<\/td><td class=\"column-2\">Binds drug residues in the gut.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">Not relevant<\/td><td class=\"column-5\">None<\/td><td class=\"column-6\">Activated Charcoal<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\">ALA (Alpha-Lipoic Acid)<\/td><td class=\"column-2\">Mitochondrial protection (nerves).<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">15-60 minutes<\/td><td class=\"column-5\">2 days<\/td><td class=\"column-6\">ALA (Alpha-Lipoic Acid)<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">Amygdalin (B17)<\/td><td class=\"column-2\">Enzymatic release of cytotoxin.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">1\u20132 hours<\/td><td class=\"column-5\">2 days<\/td><td class=\"column-6\">Amygdalin (B17)<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\">Andrographis<\/td><td class=\"column-2\">Dampens inflammation in brain tissue.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">2\u20137 hours<\/td><td class=\"column-5\">15-35 hours<\/td><td class=\"column-6\">Andrographis<\/td><td class=\"column-7\">2 (green)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">Apigenin<\/td><td class=\"column-2\">Reactivates p53 (genome guardian).<\/td><td class=\"column-3\">\u2b24 \/ \u2716<\/td><td class=\"column-4\">3-19 days<\/td><td class=\"column-5\">\u00bd-20 days<\/td><td class=\"column-6\">Apigenin<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">Artemisia<\/td><td class=\"column-2\">Oxidative attack on iron-rich cells.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">1\u20135 hours<\/td><td class=\"column-5\">1 day<\/td><td class=\"column-6\">Artemisia<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-10\">\n\t<td class=\"column-1\">Ashwagandha<\/td><td class=\"column-2\">Regulation of cortisol (stress hormone).<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">1\u20135 hours<\/td><td class=\"column-5\">24 hours<\/td><td class=\"column-6\">Ashwagandha<\/td><td class=\"column-7\">3 (yellow)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-11\">\n\t<td class=\"column-1\">Astragalus<\/td><td class=\"column-2\">Stem cell division in bone marrow.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">2.1\u20132.7 hours<\/td><td class=\"column-5\">1 day<\/td><td class=\"column-6\">Astragalus<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-12\">\n\t<td class=\"column-1\">Baicalin<\/td><td class=\"column-2\">DNA protection during radiotherapy.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">6-15 hours<\/td><td class=\"column-5\">2\u20134 days<\/td><td class=\"column-6\">Baicalin<\/td><td class=\"column-7\">3 (yellow)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-13\">\n\t<td class=\"column-1\">Berberine<\/td><td class=\"column-2\">Inhibits mTOR (growth switch).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">12-15 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">Berberine<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-14\">\n\t<td class=\"column-1\">Boron<\/td><td class=\"column-2\">Maintains bone mineralization.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">21 hours<\/td><td class=\"column-5\">5 days<\/td><td class=\"column-6\">Boron<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-15\">\n\t<td class=\"column-1\">Boswellia, Frankincense<\/td><td class=\"column-2\">Reduces edema (fluid retention).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">6.8-48 hours<\/td><td class=\"column-5\">4 days (see links)<\/td><td class=\"column-6\">Boswellia, Frankincense<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-16\">\n\t<td class=\"column-1\">Butyrate (Butyric Acid)<\/td><td class=\"column-2\">Energy for healthy colon cells.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">few minutes<\/td><td class=\"column-5\">1 hour<\/td><td class=\"column-6\">Butyrate<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-17\">\n\t<td class=\"column-1\">Cannabis (THC\/CBD)<\/td><td class=\"column-2\">Modulates pain signals (evening).<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">20\u201330 hours<\/td><td class=\"column-5\">5\u20137 days<\/td><td class=\"column-6\">Cannabis (THC\/CBD)<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-18\">\n\t<td class=\"column-1\">CoQ10, Coenzyme Q10<\/td><td class=\"column-2\">Mitochondrial energy in heart muscle.<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">33 hours<\/td><td class=\"column-5\">7 days<\/td><td class=\"column-6\">CoQ10, Coenzyme Q10<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-19\">\n\t<td class=\"column-1\">DCA (RD)<\/td><td class=\"column-2\">Restarts oxygen use in cancer cells.<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">24\u201348 hours<\/td><td class=\"column-5\">10 days<\/td><td class=\"column-6\">DCA<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-20\">\n\t<td class=\"column-1\">DIM<\/td><td class=\"column-2\">Converts estrogen to weak metabolite.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">4-8 hours<\/td><td class=\"column-5\">35 hours<\/td><td class=\"column-6\">DIM<\/td><td class=\"column-7\">2 (green)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-21\">\n\t<td class=\"column-1\">EGCG (Green Tea)<\/td><td class=\"column-2\">Inhibits tumor blood vessel formation.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">3\u20135 hours<\/td><td class=\"column-5\">1 day<\/td><td class=\"column-6\">EGCG (Green Tea)<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-22\">\n\t<td class=\"column-1\">Genistein<\/td><td class=\"column-2\">Blocks tyrosine kinase (growth signal).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">7\u20139 hours<\/td><td class=\"column-5\">2 days<\/td><td class=\"column-6\">Genistein<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-23\">\n\t<td class=\"column-1\">Shark Liver Oil<\/td><td class=\"column-2\">General hematopoiesis (blood formation).<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">Several days<\/td><td class=\"column-5\">15 days<\/td><td class=\"column-6\">Shark Liver Oil<\/td><td class=\"column-7\">3 (yellow)<\/td><td class=\"column-8\">Control &amp; Maintenance<\/td>\n<\/tr>\n<tr class=\"row-24\">\n\t<td class=\"column-1\">Honokiol<\/td><td class=\"column-2\">Increases permeability in the brain.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">2.5-5 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">Honokiol<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-25\">\n\t<td class=\"column-1\">I3C (Indole-3-carbinol)<\/td><td class=\"column-2\">Hormone balance (from cruciferous).<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">1 hour or less<\/td><td class=\"column-5\">5 hours<\/td><td class=\"column-6\">I3C<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-26\">\n\t<td class=\"column-1\">Ginger<\/td><td class=\"column-2\">Blocks nausea receptors in the stomach.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">0.6-2.4 hours<\/td><td class=\"column-5\">15 hours<\/td><td class=\"column-6\">Ginger<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-27\">\n\t<td class=\"column-1\">L-Carnitine \/ ALC<\/td><td class=\"column-2\">Transports energy to heart muscle.<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">25.7\u2013119 hours<\/td><td class=\"column-5\">14 days<\/td><td class=\"column-6\">L-Carnitine \/ ALC<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-28\">\n\t<td class=\"column-1\">LDN (RD), Low Dose Naltrexone<\/td><td class=\"column-2\">Increases immune system and endorphins.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">4\u201313 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">LDN (RD), Low Dose Naltrexone<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-29\">\n\t<td class=\"column-1\">L-Glutamine<\/td><td class=\"column-2\">Restores enterocytes (gut mucosa).<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">1-2 hours<\/td><td class=\"column-5\">10 hours<\/td><td class=\"column-6\">L-Glutamine<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-30\">\n\t<td class=\"column-1\">Liposomal Curcumin<\/td><td class=\"column-2\">Blocks P-gp (efflux pumps).<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">6-180 minutes<\/td><td class=\"column-5\">10 hours<\/td><td class=\"column-6\">Liposomal Curcumin<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-31\">\n\t<td class=\"column-1\">Luteolin<\/td><td class=\"column-2\">Inhibits NF-kB (inflammation signal).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">5-9 hours<\/td><td class=\"column-5\">2 days<\/td><td class=\"column-6\">Luteolin<\/td><td class=\"column-7\">4 (orange)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-32\">\n\t<td class=\"column-1\">Lysine<\/td><td class=\"column-2\">Maintains collagen in connective tissue.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">15-16 hours<\/td><td class=\"column-5\">3\u00bd days<\/td><td class=\"column-6\">Lysine<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-33\">\n\t<td class=\"column-1\">Magnesium<\/td><td class=\"column-2\">Supports heart rhythm, nerves, muscle.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">5.2h (plasma)<\/td><td class=\"column-5\">1-2 days<\/td><td class=\"column-6\">Magnesium<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-34\">\n\t<td class=\"column-1\">Milk Thistle<\/td><td class=\"column-2\">Repair of hepatocytes (liver tissue).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">1-8 hours<\/td><td class=\"column-5\">\u00bd-2 days<\/td><td class=\"column-6\">Milk Thistle<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-35\">\n\t<td class=\"column-1\">Melatonin (RD)<\/td><td class=\"column-2\">Radioprotector (healthy cells) \/ sleep.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">40\u201360 minutes<\/td><td class=\"column-5\">5 hours<\/td><td class=\"column-6\">Melatonin<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-36\">\n\t<td class=\"column-1\">Metformin (RD)<\/td><td class=\"column-2\">Activates AMPK (insulin regulation).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">1.5\u201323 hours<\/td><td class=\"column-5\">5 days<\/td><td class=\"column-6\">Metformin<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-37\">\n\t<td class=\"column-1\">Probiotics<\/td><td class=\"column-2\">Restores bacterial diversity.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">12\u201324 hours<\/td><td class=\"column-5\">2 days<\/td><td class=\"column-6\">Probiotics<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-38\">\n\t<td class=\"column-1\">NAC<\/td><td class=\"column-2\">Precursor to glutathione (detox).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">2-6 (19) hours<\/td><td class=\"column-5\">1\u00bd days<\/td><td class=\"column-6\">NAC<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-39\">\n\t<td class=\"column-1\">Niacin (B3)<\/td><td class=\"column-2\">Raw material for DNA repair enzymes.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">20 min &#8211; 4.3h<\/td><td class=\"column-5\">1 day<\/td><td class=\"column-6\">Niacin (B3)<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-40\">\n\t<td class=\"column-1\">Nigella Sativa<\/td><td class=\"column-2\">Activates caspase (death enzyme).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">Not detectable<\/td><td class=\"column-5\">4 days<\/td><td class=\"column-6\">Nigella Sativa<\/td><td class=\"column-7\">3 (yellow)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-41\">\n\t<td class=\"column-1\">Omega-3<\/td><td class=\"column-2\">Counteracts cachexia (inflammation).<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">37-46 hours<\/td><td class=\"column-5\">21 days<\/td><td class=\"column-6\">Omega-3<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Control &amp; Maintenance<\/td>\n<\/tr>\n<tr class=\"row-42\">\n\t<td class=\"column-1\">Pao Pereira<\/td><td class=\"column-2\">Selective inhibition of tumor replication.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">12\u201324 hours<\/td><td class=\"column-5\">5 days<\/td><td class=\"column-6\">Pao Pereira<\/td><td class=\"column-7\">4 (orange)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-43\">\n\t<td class=\"column-1\">Papaya Leaf Extract<\/td><td class=\"column-2\">Modulates megakaryocytes (marrow).<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">24-48 hours<\/td><td class=\"column-5\">5-10 days<\/td><td class=\"column-6\">Papaya Leaf Extract<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-44\">\n\t<td class=\"column-1\">Pau D\u2019Arco<\/td><td class=\"column-2\">Disrupts tumor DNA repair.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">24-48 hours<\/td><td class=\"column-5\">5-10 days<\/td><td class=\"column-6\">Pau D\u2019Arco<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-45\">\n\t<td class=\"column-1\">Quercetin<\/td><td class=\"column-2\">Stabilizes mast cells (inflammation).<\/td><td class=\"column-3\">\u25b2<\/td><td class=\"column-4\">11 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">Quercetin<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-46\">\n\t<td class=\"column-1\">Resveratrol<\/td><td class=\"column-2\">Dampens inflammation. Cell repair.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">2-10 hours<\/td><td class=\"column-5\">\u00bd-2\u00bd days<\/td><td class=\"column-6\">Resveratrol<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Control &amp; Maintenance<\/td>\n<\/tr>\n<tr class=\"row-47\">\n\t<td class=\"column-1\">Rhodiola Rosea<\/td><td class=\"column-2\">Improves cognitive endurance.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">4-6 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">Rhodiola Rosea<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-48\">\n\t<td class=\"column-1\">Mushrooms (Medicinal)<\/td><td class=\"column-2\">Broad-spectrum immune activation.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">\u00bd\u201324 hours<\/td><td class=\"column-5\">5 days<\/td><td class=\"column-6\">Mushrooms<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-49\">\n\t<td class=\"column-1\">Sulforaphane<\/td><td class=\"column-2\">Phase 2 detox (Nrf2 system).<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">2-3 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">Sulforaphane<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-50\">\n\t<td class=\"column-1\">TUDCA<\/td><td class=\"column-2\">Liver strengthening; prevents cholestasis.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">3.5-5.8 hours<\/td><td class=\"column-5\">4 weeks<\/td><td class=\"column-6\">TUDCA<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-51\">\n\t<td class=\"column-1\">Vitamin A<\/td><td class=\"column-2\">Ensures correct cellular maturation.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">13.5 hours<\/td><td class=\"column-5\">3 days<\/td><td class=\"column-6\">Vitamin A<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-52\">\n\t<td class=\"column-1\">Vitamin B-complex<\/td><td class=\"column-2\">Restores deficiencies after treatment.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">1-2h (B6: 15-25d)<\/td><td class=\"column-5\">3d (B6: 4 weeks)<\/td><td class=\"column-6\">Vitamin B-complex<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-53\">\n\t<td class=\"column-1\">Vitamin D<\/td><td class=\"column-2\">Regulates genes for immune system.<\/td><td class=\"column-3\">\u2716<\/td><td class=\"column-4\">12-24 hours<\/td><td class=\"column-5\">3 days (note)<\/td><td class=\"column-6\">Vitamin D<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Control &amp; Maintenance<\/td>\n<\/tr>\n<tr class=\"row-54\">\n\t<td class=\"column-1\">Vitamin E<\/td><td class=\"column-2\">Protects cell membranes (fat tissue).<\/td><td class=\"column-3\">\u2716<\/td><td class=\"column-4\">20 hours<\/td><td class=\"column-5\">4 days<\/td><td class=\"column-6\">Vitamin E<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Control &amp; Maintenance<\/td>\n<\/tr>\n<tr class=\"row-55\">\n\t<td class=\"column-1\">Vitamin K (K2)<\/td><td class=\"column-2\">Binds calcium to bone matrix.<\/td><td class=\"column-3\">\u2b24<\/td><td class=\"column-4\">72 hours<\/td><td class=\"column-5\">14 days<\/td><td class=\"column-6\">Vitamin K (K2)<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<tr class=\"row-56\">\n\t<td class=\"column-1\">Zinc<\/td><td class=\"column-2\">Necessary for immune cell division.<\/td><td class=\"column-3\">\u25ef<\/td><td class=\"column-4\">5 hours<\/td><td class=\"column-5\">3 days (note)<\/td><td class=\"column-6\">Zinc<\/td><td class=\"column-7\">1 (white)<\/td><td class=\"column-8\">Recovery<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"These_conditions_are_reviewed\"><\/span>These conditions are reviewed<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"720\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Bevar-muskelmasse4.jpg\" alt=\"Part of a rope\" class=\"wp-image-31911\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Bevar-muskelmasse4.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Bevar-muskelmasse4-300x169.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Bevar-muskelmasse4-1024x576.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Bevar-muskelmasse4-768x432.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<ol class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/detoxification-and-metabolism-2\/\">Detoxification and metabolism<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/detoxification-and-metabolism-2\/#afgiftning-leverstoette\">Detoxification and liver support (cleansing)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/detoxification-and-metabolism-2\/#metabolisme-pres-og-kakeksi\">Metabolic stress and cachexia (muscle preservation)<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/barriers-and-chemotherapy-uptake\/\">Barriers and chemo uptake<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/barriers-and-chemotherapy-uptake\/#The_blood%E2%80%93brain_barrier\">The blood\u2013brain barrier (brain protection)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/barriers-and-chemotherapy-uptake\/#Chemosensitization_and_increased_uptake\">Chemosensitization and increased uptake (susceptibility)<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/blood-support-and-synergy\/\">Blood support and synergy<\/a>\n<ul class=\"wp-block-list\">\n<li>Bone marrow and blood counts:\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/blood-support-and-synergy\/#Leukocytes_white_blood_cells\">Leukocytes (immune system)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/blood-support-and-synergy\/#Platelets\">Platelets (clotting ability)<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/hormonal-and-dna-support\/\">Hormonal and DNA support<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/hormonal-and-dna-support\/#Hormonal_balance_and_specific_growth_inhibitors\">Hormonal balance and specific growth inhibitors: (growth brake)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/hormonal-and-dna-support\/#Bone_and_mineral_support\">Bone and mineral support (bone strength)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/hormonal-and-dna-support\/#Signal_modulation_and_DNA_protection\">Signal modulation and DNA protection (cell death\/DNA protection)<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/immune-response-and-inflammation\/\">Immune response and inflammation<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/immune-response-and-inflammation\/#Strengthen_the_bodys_resilience\">Strengthen the body\u2019s resilience (resilience)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/immune-response-and-inflammation\/#Anti-inflammatory_agents_and_antioxidants\">Anti-inflammatory substances and antioxidants (reducing inflammation)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/immune-response-and-inflammation\/#Digestion_and_gut_flora\">Digestion and gut flora (gut balance)<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/organ-protection-and-toxicity\/\">Organ protection and toxicity<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/organ-protection-and-toxicity\/#Heart_and_kidneys\">Heart and kidneys: (organ protection)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/organ-protection-and-toxicity\/#Nerves_neuropathynerve_damage\">Nerves (neuropathy): (nerve protection)<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/symptom-relief-and-quality-of-life\/\">Symptom relief and quality of life<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/symptom-relief-and-quality-of-life\/#Well-being\">Well-being<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/symptom-relief-and-quality-of-life\/#Supplementary_plant_extracts_and_systemic_support\">Supplementary plant extracts and systemic support (extra help)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/jegharkraeft.dk\/en\/symptom-relief-and-quality-of-life\/#Essential_vitamins_and_metabolic_support\">Essential vitamins and supplementary bio-support (basic support)<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Collaboration_offer_for_oncologists_and_healthcare_professionals\"><\/span>Collaboration offer for oncologists and healthcare professionals<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"853\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil8.jpg\" alt=\"M\u00e5lrettet samspil symboliseret ved nogle klare glas med pr\u00e6parater i. Linet op p\u00e5 r\u00e6kke.\" class=\"wp-image-28619\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil8.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil8-600x400.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil8-300x200.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil8-1024x682.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil8-768x512.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">based practice, I hereby invite oncologists, pharmacologists, and other professionals to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Suggest preparations for inclusion or updating. <\/li>\n\n\n\n<li>Share clinical experiences with interactions or effects. <\/li>\n\n\n\n<li>Engage in professional dialogues regarding implementation and optimization. <\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Purpose:<\/strong> To create a practical, safe tool that supports clinical decision-making and minimizes risks for patients supplementing their treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Site created:<\/strong><br>March 07, 2026<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-custom-menu-links-color\">\u2764<\/mark><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><strong><em>This is not a recommendation. Seek competent guidance.<\/em><\/strong><\/strong><\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignfull is-style-default has-global-padding is-layout-constrained wp-container-core-group-is-layout-b040ace0 wp-block-group-is-layout-constrained has-background\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--60);padding-right:var(--wp--preset--spacing--20);padding-bottom:var(--wp--preset--spacing--60);padding-left:var(--wp--preset--spacing--20);background-image:url(&apos;https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi.jpg&apos;);background-position:44% 36%;background-size:cover;\">\n<div class=\"gb-element-ceda49c8\">\n<h2 id=\"maalrettet-samspil\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Practical_suggestions_for_support_during_immunotherapy\"><\/span>Practical suggestions for support during immunotherapy<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 id=\"hjerte-nyrer\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Microbiome_enhancers\"><\/span>Microbiome enhancers <span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"926\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi8.jpg\" alt=\"Support during Immunotherapy symbolised by a collection of green, elongated bacteria.\" class=\"wp-image-29113\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi8.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi8-600x434.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi8-300x217.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi8-1024x741.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi8-768x556.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Focus on optimising response to immunotherapy by modulating bacterial composition. Optimising the gut flora is crucial for <a href=\"https:\/\/jegharkraeft.dk\/checkpoint-haemmere\/\">checkpoint inhibitors<\/a> to activate T cells against the tumour. Optimising the gut flora is also crucial for the <a href=\"https:\/\/jegharkraeft.dk\/immunsystemet\/\">immune system<\/a> to recognise and attack cancer cells effectively [118, 122].  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/immune-response-and-inflammation\/\">Immune response and inflammation<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/ernaering-ved-neutropeni\/\">Neutropenia \u2013 low immune system<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/styrk-immunforsvaret-og-cellulaer-udrensning\/\">Strengthen the immune system and cellular clearance<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/jegharkraeft.dk\/en\/akkermansia\/\">Akkermansia<\/a> optimisation<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Although <em>Akkermansia<\/em> is now available as a specialised dietary supplement (both pasteurised and live), the most well-documented and natural way to increase its abundance is through specific polyphenols from pomegranate and green tea (see below), which act as \u201cfuel\u201d for the bacterium\u2019s growth.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Increases the amount of bacteria that correlate (are associated) with a positive response to PD-1 inhibitors.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef Rapid metabolism.<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-7282d8700a7fa773599a0085a62bb365 wp-block-paragraph\"><strong>Article: [121]<\/strong> <a href=\"https:\/\/www.mdpi.com\/2304-8158\/14\/13\/2392\" target=\"_blank\" rel=\"noopener\">Prebiotic Potential of Dietary Polyphenols in Colorectal Cancer Immunomodulation<\/a> (MDPI, 2025) <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of polyphenols\u2019 ability to function as prebiotics; this is not a randomised study. The research documents that these plant compounds can <strong>counteract imbalance in the gut flora and influence the signalling pathways<\/strong> involved in the development of cancer cells. The study shows that the prebiotic effect supports a healthy microbiome, which <strong>creates an important foundation for optimising the body\u2019s own defence mechanisms<\/strong> and improving overall health management during illness.  <\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Polyphenols (<a href=\"https:\/\/jegharkraeft.dk\/en\/pomegranate\/\">pomegranate<\/a> and <a href=\"https:\/\/jegharkraeft.dk\/en\/egcg\/\">green tea<\/a>)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">These act as prebiotics that specifically promote the growth of <em>Akkermansia muciniphila<\/em>, which is directly linked to better treatment response.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Selective stimulation of beneficial bacterial strains.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef Rapid metabolism.<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n\n\n\n<li><strong>Comment:<\/strong> Without the polyphenols, the right bacteria do not thrive\u2014and without the bacteria, the polyphenols are of no benefit. They depend on each other to create the therapeutic effect.<br>You cannot just look at isolated substances; you must consider the entire gut environment to optimise treatment. <\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-26df4573ede06179fc14cbf1ecaf1390 wp-block-paragraph\"><strong>Article: [128]<\/strong> <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mnfr.70360?af=R\" target=\"_blank\" rel=\"noopener\">Synergistic Effects of Polyphenols and Gut Microbiota<\/a> (Wiley Online Library, 2026) <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A new scientific study of the interaction between dietary polyphenols and the gut microbiome; this is not a randomised study. The research documents that polyphenols have a strengthening <strong>mutual effect on the gut\u2019s bacterial composition, resulting in the production of bioactive metabolites.<\/strong> The study shows that <strong>this synergistic effect is crucial for maintaining the body\u2019s homeostasis and strengthening the metabolic processes that support immunotherapy<\/strong>. <\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Partially hydrolysed guar gum (PHGG) <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Specific fibres that support the gut\u2019s production of protective fatty acids (SCFAs).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Increases the bacteria needed for a healthy immune response without causing bloating.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef Not relevant (metabolised via bacterial fermentation over approx. 12\u201324 hours). <\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n\n\n\n<li><strong>Comment:<\/strong> The protective effect requires daily intake to maintain production of the beneficial fatty acids (SCFAs).<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4872654c8c4df05d21a2a028a3fbfd9b wp-block-paragraph\"><strong>Article: [122]<\/strong> <a href=\"https:\/\/www.mdpi.com\/2072-6694\/18\/2\/203\" target=\"_blank\" rel=\"noopener\">Dietary fiber and Melanoma: Exploring Microbiome-Driven Immunotherapy Response<\/a> (MDPI, 2026) <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of how dietary fibre affects melanoma immunity; this is not a randomised study. The research documents that fibre fermentation produces short-chain fatty acids (SCFAs) that regulate T-cell activation and cytokine signalling. The study shows that a <strong>high-fibre intake is associated with markedly improved response to PD-1 inhibitors and longer progression-free survival<\/strong> in patients, likely by increasing the prevalence of beneficial bacteria such as <em>Bifidobacterium<\/em> and <em>Akkermansia<\/em>.  <\/li>\n<\/ul>\n\n\n\n<h3 id=\"nerver\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Organ_protection_against_immune_inflammation\"><\/span>Organ protection against immune inflammation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"651\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi5.jpg\" alt=\"Support during Immunotherapy symbolised by a hand held up defensively against a virus-like molecule. Blue background. \" class=\"wp-image-29116\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi5.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi5-600x305.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi5-300x153.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi5-1024x521.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi5-768x391.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Protection of the organs most often affected by immune-related <a href=\"https:\/\/jegharkraeft.dk\/inflammation\/\">inflammation<\/a>. The goal is to reduce overactive immune attacks on healthy organs without using broad-spectrum immunosuppressive medication. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The goal is to spare healthy organs from overactive immune attacks without blocking the treatment effect [119, 123].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/daemp-inflammation\/\">Reduce inflammation<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/immune-response-and-inflammation\/\">Immune response and inflammation<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/inflammation\/\">Inflammation and cancer<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/jegharkraeft.dk\/en\/omega-3\/\">Omega-3<\/a> (high dose)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Fatty acids that help reduce inflammation in the skin and joints. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">High-dose Omega-3 means a daily intake of 3 g or more of the active fatty acids EPA and DHA. This level is used to achieve a medical anti-inflammatory effect. <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Relieves immune-related side effects without being generally immunosuppressive.<\/li>\n\n\n\n<li class=\"has-custom-menu-links-background-color has-background\"><strong>Half-life:<\/strong> \u25b2 Washout should be aimed for before surgery\/biopsy. (5\u20137 days, as the fatty acids are incorporated into cell membranes throughout the body). <\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Interaction risk:<\/strong> Low. (primarily related to bleeding risk during surgery). <\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-cc7ecf83b32be06039acf68e99b4bc03 wp-block-paragraph\"><strong>Article: [120]<\/strong> <a href=\"https:\/\/www.researchgate.net\/publication\/361511295_Fatty_Acids_as_a_Tool_to_Boost_Cancer_Immunotherapy_Efficacy\" target=\"_blank\" rel=\"noopener\">Fatty Acids as a Tool to Boost Cancer Immunotherapy Efficacy<\/a> (ResearchGate, 2022) <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of the importance of fatty acids for the effect of immunotherapy; this is not a randomised study. The research documents that omega-3 (PUFA)<strong> helps preserve the patient\u2019s body weight and muscle mass<\/strong> during the course of illness. The study shows that these fatty acids directly <strong>affect immune cells and have the potential to strengthen the clinical benefit of treatment<\/strong> through optimised nutritional status.  <\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/jegharkraeft.dk\/en\/boswellia\/\">Boswellia Serrata<\/a><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">A potent herb for protecting the intestinal mucosa in immune-related inflammation.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Reduces inflammation locally in the gut without suppressing the overall immune system.<\/li>\n\n\n\n<li class=\"has-custom-her-st-r-du-background-color has-background\"><strong>Half-life:<\/strong> \u2b24 approx. 6 hours.<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None known.<\/li>\n\n\n\n<li><strong>Comment:<\/strong> Requires dosing 2\u20133 times daily for a stable effect.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ee2d457992bf518d614755da700b55f8 wp-block-paragraph\"><strong>Article: [123]<\/strong> <a href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0125375\" target=\"_blank\" rel=\"noopener\"><em>Boswellia serrata<\/em> Preserves Intestinal Epithelial Barrier from Oxidative and Inflammatory Damage<\/a> (PLOS, 2015) <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific study of Boswellia\u2019s ability to protect the intestinal barrier; this is not a randomised study. The research documents that the herb <strong>counteracts the breakdown of the proteins that seal the intestinal mucosa when exposed to inflammation<\/strong>. The study shows that Boswellia acts as an antioxidant that <strong>protects gut integrity and is therefore suitable as safe supportive care to prevent damage to the intestinal wall.<\/strong>  <\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Lactobacillus rhamnosus GG (LGG) <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Well-documented probiotic for preventing immune-related diarrhoea.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Stabilises the intestinal barrier and reduces the need for immunosuppressive medication.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef Continuously excreted.<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-f216361f4a696e5170b13b6982a1a0e1 wp-block-paragraph\"><strong>Article: [124]<\/strong> <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10626011\/\" target=\"_blank\" rel=\"noopener\">Gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis: a review<\/a> (PubMed, 2023).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of the link between the gut microbiome and side effects of immunotherapy; this is not a randomised study. The research documents that <strong>manipulating the gut flora via probiotics can be an effective method to reduce the risk of immune-related colitis<\/strong>. The study shows that balancing the gut flora is a <strong>practical way to protect the patient from toxic reactions that might otherwise necessitate stopping cancer treatment<\/strong>.  <\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/jegharkraeft.dk\/en\/melatonin\/\">Melatonin<\/a><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Helps target the immune system and protect healthy cells from oxidative damage.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Regulates the immune response and reduces toxicity to the body\u2019s healthy tissues. Weakens cancer cells\u2019 ability to \u201chide\u201d from the immune system by lowering PD-L1 levels (the cancer cells\u2019 <em>shield<\/em>). <\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef 30\u201350 minutes.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Interaction risk:<\/strong> Low<\/li>\n\n\n\n<li><strong>Comment:<\/strong> Should be taken in the evening to support the circadian rhythm.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3294729afd95189f23b12c4d78e7c0e2 wp-block-paragraph\"><strong>Article: [125]<\/strong> <a href=\"https:\/\/www.mdpi.com\/1999-4923\/15\/6\/1616\" target=\"_blank\" rel=\"noopener\">Therapeutic Potential of Melatonin Counteracting Chemotherapy-Induced Toxicity in Breast Cancer Patients: A Systematic Review<\/a> (MDPI, 2023)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of melatonin\u2019s <strong>ability to counteract side effects<\/strong> in breast cancer patients; this is not a randomised study. The research documents that <strong>doses of 20 mg daily increase the rate of partial response and 1-year survival<\/strong>. The study shows that the <strong>combination of melatonin and standard chemotherapy significantly improves patients\u2019 quality of life and has a high safety profile as supportive care<\/strong>.  <\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-538ff3f82da5c0da32663a0ad73a4d35 wp-block-paragraph\"><strong>Article: [125A]<\/strong> <a href=\"https:\/\/www.nature.com\/articles\/s41598-025-93486-4\" target=\"_blank\" rel=\"noopener\">Melatonin suppresses PD-L1 expression and exerts antitumor activity in hepatocellular carcinoma<\/a> (Nature, 2025)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific study of melatonin\u2019s ability to inhibit cancer cells\u2019 escape mechanisms; this is not a randomised study. The research documents that melatonin <strong>reduces PD-L1 expression in cancer cells, preventing them from deactivating the immune system<\/strong>. The study shows that melatonin both <strong>directly inhibits cancer cell growth while also increasing T-lymphocyte activity, making it a valuable support for immunotherapy.<\/strong>  <\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Mitochondrial_support_energy_for_T_cells\"><\/span>Mitochondrial support (energy for T cells)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"951\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi6.jpg\" alt=\"Support during Immunotherapy symbolised by some cactus plants.\" class=\"wp-image-29115\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi6.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi6-600x446.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi6-300x223.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi6-1024x761.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi6-768x571.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Treatment requires high metabolic energy for immune cells to fight the tumour effectively [126].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/metaboliske-principper-kraeftbehandling\/\">Metabolic principles in cancer research<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/om-mitokondrier-forskning\/\">About mitochondria \u2013 what are they<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">PQQ (Pyrroloquinoline quinone) <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">A micronutrient that optimises energy production specifically in white blood cells. It does not remove fatigue like a cup of coffee, but rather works as a slow recharge of the body\u2019s batteries from the ground up. <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Counteracts T-cell \u201cfatigue\u201d (exhaustion) by stimulating the formation of new powerhouses and increasing their energy (ATP), so they retain the ability to attack cancer cells for longer.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef Rapid excretion.<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c5458733486b51e818b6feb706991430 wp-block-paragraph\"><strong>Article: [126]<\/strong><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12347488\/\" target=\"_blank\" rel=\"noopener\"> Mitochondrial Metabolism in T-Cell Exhaustion<\/a> (PubMed, 2025).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of T-cell energy metabolism; this is not a randomised study. The research documents that chronic disease leads to immune exhaustion due to failing cellular energy production. The study shows that <strong>by stimulating the formation of new powerhouses (mitochondria) and increasing ATP production (the cell\u2019s fuel), this exhaustion can be prevented and reversed, allowing cells to regain their ability to fight cance<\/strong>r.  <\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Skin_and_mucous_membranes\"><\/span>Skin and mucous membranes<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"852\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi3.jpg\" alt=\"Support during Immunotherapy symbolised by a woman\u2019s upper body in the bath.\" class=\"wp-image-29118\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi3.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi3-600x399.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi3-300x200.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi3-1024x682.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi3-768x511.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Protecting the body\u2019s external and internal barriers is crucial to avoid treatment interruptions. When the immune system is overstimulated, it can attack healthy tissue, leading to painful sores and inflammatory conditions in the mouth and gastrointestinal tract [127] <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/mundtoerhed-smerter-saar\/\">Dry mouth, pain and mouth sores<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/refluks-og-mavesar-mavekatar\/\">Reflux and stomach ulcers\/gastritis<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/jegharkraeft.dk\/en\/zink\/\">Zinc<\/a>-carnosine <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">A specific mineral compound that binds directly to mucosal damage and acts as a protective layer.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Repair of the oral cavity and stomach in immune-related inflammation.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> \u25ef A few hours (primarily acts through local contact).<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d501239a560bb1fca4b7e5ccceec77b7 wp-block-paragraph\"><strong>Article: [127]<\/strong> <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7146259\/\" target=\"_blank\" rel=\"noopener\">A Review of Zinc-L-Carnosine and Its Positive Effects on Oral Mucositis, Taste Disorders, and Gastrointestinal Disorders <\/a>(PubMed, 2020).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of zinc-L-carnosine\u2019s ability to <strong>repair damage in epithelial cells<\/strong>; this is not a randomised study. The research documents that, through <strong>local antioxidant and anti-inflammatory functions, the substance rebuilds mucous membranes in both the mouth and stomach<\/strong>. The study shows that the agent effectively <strong>prevents and treats mucositis<\/strong> (inflammation of the mucous membranes), which is crucial to avoid reduced quality of life and treatment interruptions.  <\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Immune-related_side_effects\"><\/span>Immune-related side effects<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"960\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi2.jpg\" alt=\"Support during Immunotherapy symbolised by a plant with light-coloured seeds.\" class=\"wp-image-29108\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi2.jpg 1280w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi2-600x450.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi2-300x225.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi2-1024x768.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi2-768x576.jpg 768w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Protecting gut balance is crucial to avoid the inflammatory conditions that treatment can trigger.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"https:\/\/jegharkraeft.dk\/en\/bifido\/\">Lactic acid bacteria and Bifido <\/a><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The natural, beneficial bacteria that live in the gut and help regulate the immune system\u2019s activity level.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Effect:<\/strong> Restores balance in the gut flora and reduces local inflammatory reactions in the digestive system.<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Half-life:<\/strong> Not relevant (must be taken daily).<\/li>\n\n\n\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Interaction risk:<\/strong> None.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5f31ebf7a2e1a9420197780c105cd7c4 wp-block-paragraph\"><strong>Article: [129]<\/strong> <a href=\"https:\/\/www.nature.com\/articles\/s41423-025-01326-2\" target=\"_blank\" rel=\"noopener\">The gut microbiota in cancer immunity and immunotherapy<\/a> (Nature, 2025) <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> A scientific review of the interaction between the gut\u2019s microorganisms and the immune system; this is not a randomised study. The research documents that <strong>beneficial bacteria such as lactic acid bacteria and bifido act as important allies that both enhance treatment and reduce the risk of side effects<\/strong>. The study shows that targeted use of these bacteria can <strong>restore balance in the gut and prevent cancer cells from escaping the immune system<\/strong>.  <\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Conclusion\"><\/span>Conclusion<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"841\" height=\"842\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1.jpg\" alt=\"Support during Immunotherapy symbolised by a purple-pink flower on semi-golden soil.\" class=\"wp-image-29121\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1.jpg 841w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1-300x300.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1-100x100.jpg 100w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1-600x601.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1-150x150.jpg 150w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/02\/Stoette-ved-Immunterapi9-1-768x769.jpg 768w\" sizes=\"auto, (max-width: 841px) 100vw, 841px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Support during immunotherapy is about creating the optimal conditions for the body\u2019s own defences. By nurturing the microbiome and monitoring the body\u2019s inflammatory response, you can both increase the likelihood that treatment works and reduce the risk of serious immune-related damage.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This requires precise timing, especially when immunotherapy is combined with traditional chemotherapy, to ensure that you neither block the immune system\u2019s attack nor allow chemo toxicity to run out of control.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/safe-measures\/\">Safe measures during a cancer course<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/integrative-oncology\/\">Integrative oncology<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/en\/quality-of-life-and-shared-responsibility\/\">Quality of life and shared responsibility<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/jegharkraeft.dk\/antioxidanter-for-og-imod\/\">Antioxidants \u2013 pros and cons<\/a><\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-485790e51077e9636b3d4b79d3c87ead wp-block-paragraph\"><a href=\"#menu\">(to menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Links<\/h4>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c1d79040213eba31f9950a16e606f534 wp-block-paragraph\">[14] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40624553\/\" target=\"_blank\" rel=\"noreferrer noopener\">Herb-drug interactions in oncology: pharmacodynamic\/pharmacokinetic mechanisms and risk prediction<\/a> (PMC, 2025).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Content: The scientific foundation for risk assessment and calculating washout periods.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1cb04b13abc46ec1e9b07dde71b90bd9 wp-block-paragraph\">[27] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11922982\/\" target=\"_blank\" rel=\"noreferrer noopener\">Clinical pharmacology\u2014how it shapes the drug development journey<\/a> (PMC, 2025)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Content: The article explains how pharmacokinetic models and an understanding of half-lives are crucial for determining the correct timing and dose in oncology treatment pathways.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8b92a026a23f56a7efac080c89afe7db wp-block-paragraph\">[29] <a href=\"https:\/\/news.cancerresearchuk.org\/2025\/12\/19\/our-defining-research-stories-of-2025\/\" target=\"_blank\" rel=\"noreferrer noopener\">Our defining research stories of 2025<\/a> (Cancer Research UK, 2025)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Content: A summary of the year\u2019s most important breakthroughs, including the importance of exercise for survival and new methods to predict chemo-resistance via DNA testing.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-efbaa583eb459f00632f9b73674e6493 wp-block-paragraph\">[118] <a href=\"https:\/\/www.nature.com\/articles\/s41591-024-02823-z\" target=\"_blank\" rel=\"noopener\">A gut microbial signature for combination immune checkpoint blockade across cancer types<\/a> (Nature, 2024)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> Scientific study of the importance of bacterial strains; not randomised. Documents that specific microbes are crucial for the immune system\u2019s ability to respond to PD-1 inhibitors and predict treatment success. <\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-722c613675e229c5fda3b9ee50eea76b wp-block-paragraph\">[119] <a href=\"https:\/\/www.researchgate.net\/publication\/359136029_Dual_contribution_of_the_gut_microbiome_to_immunotherapy_efficacy_and_toxicity_supportive_care_implications_and_recommendations\" target=\"_blank\" rel=\"noopener\">Dual contribution of the gut microbiome to immunotherapy efficacy and toxicity: supportive care implications and recommendations <\/a>(Research Gate, 2022)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> Scientific study of the microbiome\u2019s dual role; not randomised. The research documents a strong correlation between treatment efficacy and the risk of adverse events (IrAEs). The study confirms that the same bacteria that increase efficacy often also trigger inflammation, requiring a balanced strategy to avoid toxicity.  <\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4d7f7ae2be1247b96befe682730b50a9 wp-block-paragraph\">[120] <a href=\"https:\/\/www.researchgate.net\/publication\/361511295_Fatty_Acids_as_a_Tool_to_Boost_Cancer_Immunotherapy_Efficacy\" target=\"_blank\" rel=\"noopener\">Fatty Acids as a Tool to Boost Cancer Immunotherapy Efficacy<\/a> (ResearchGate, 2022) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-909e313630ae59848fe7b69d6b20d2cd wp-block-paragraph\">[121] <a href=\"https:\/\/www.mdpi.com\/2304-8158\/14\/13\/2392\" target=\"_blank\" rel=\"noopener\">Prebiotic Potential of Dietary Polyphenols in Colorectal Cancer Immunomodulation<\/a> (MDPI, 2025) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-41a7f35f7524a0fd4e29a889a64a3f41 wp-block-paragraph\">[123] <a href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0125375\" target=\"_blank\" rel=\"noopener\"><em>Boswellia serrata<\/em> Preserves Intestinal Epithelial Barrier from Oxidative and Inflammatory Damage<\/a> (PLOS, 2015) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-568b08fc20d04c6c71c40d9c74bf13e2 wp-block-paragraph\">[124] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10626011\/\" target=\"_blank\" rel=\"noopener\">Gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis: a review<\/a> (PubMed, 2023).<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-56222cc69b4b7f5354820dc4b6630a43 wp-block-paragraph\">[125] <a href=\"https:\/\/www.mdpi.com\/1999-4923\/15\/6\/1616\" target=\"_blank\" rel=\"noopener\">Therapeutic Potential of Melatonin Counteracting Chemotherapy-Induced Toxicity in Breast Cancer Patients: A Systematic Review<\/a> (MDPI, 2023)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-60b92e0e9a15f73b2e94c624709848bf wp-block-paragraph\">[125A] <a href=\"https:\/\/www.nature.com\/articles\/s41598-025-93486-4\" target=\"_blank\" rel=\"noopener\">Melatonin suppresses PD-L1 expression and exerts antitumor activity in hepatocellular carcinoma<\/a> (Nature, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3868bf236215d6bcd5e902ef305ec9f7 wp-block-paragraph\">[126]<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12347488\/\" target=\"_blank\" rel=\"noopener\"> Mitochondrial Metabolism in T-Cell Exhaustion<\/a> (PubMed, 2025).<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-7a49b1c53797abaa1892fad4420cd476 wp-block-paragraph\">[127] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7146259\/\" target=\"_blank\" rel=\"noopener\">A Review of Zinc-L-Carnosine and Its Positive Effects on Oral Mucositis, Taste Disorders, and Gastrointestinal Disorders <\/a>(PubMed, 2020).<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5b3e2d70e2333d57ee04147b86935938 wp-block-paragraph\">[128] <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mnfr.70360?af=R\" target=\"_blank\" rel=\"noopener\">Synergistic Effects of Polyphenols and Gut Microbiota<\/a> (Wiley Online Library, 2026) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e6d8cb21e3c5ec6446c7ab87f6324c70 wp-block-paragraph\">[129] <a href=\"https:\/\/www.nature.com\/articles\/s41423-025-01326-2\" target=\"_blank\" rel=\"noopener\">The gut microbiota in cancer immunity and immunotherapy<\/a> (Nature, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-180fa74c578db9d241191b5afb1a725a wp-block-paragraph\">[130] <a href=\"https:\/\/www.nature.com\/articles\/s41522-025-00786-8\" target=\"_blank\" rel=\"noopener\">Gut microbiota shapes cancer immunotherapy responses<\/a> (Nature, 2025)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> Scientific review of the role of gut bacteria; not randomised. The research documents that microbes such as <em>Akkermansia<\/em> recode the environment around cancer cells, enhancing treatment and reducing side effects. <\/li>\n<\/ul>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c14852f7e734a0dea7960ec639e61b3b wp-block-paragraph\">[131] <a href=\"https:\/\/www.researchgate.net\/publication\/399852522_Steroid-sparing_strategies_for_managing_immune-related_adverse_events\" target=\"_blank\" rel=\"noopener\">Steroid-sparing strategies for managing immune-related adverse events<\/a> (Research Gate, 2026)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Content:<\/strong> Scientific review of adverse-event management; not randomised. Documents that targeted support relieves inflammation without weakening the immune system\u2019s ability to fight cancer, ensuring continuation of treatment. <\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Page created:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">d. 11.02.26<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-custom-menu-links-color\">\u2764<\/mark><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What you read on <\/strong><em><strong>I Have Cancer<\/strong><\/em><strong> is not a recommendation. Seek qualified guidance.<\/strong><\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignfull is-style-default has-global-padding is-layout-constrained wp-container-core-group-is-layout-b040ace0 wp-block-group-is-layout-constrained has-background\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--60);padding-right:var(--wp--preset--spacing--20);padding-bottom:var(--wp--preset--spacing--60);padding-left:var(--wp--preset--spacing--20);background-image:url(&apos;https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Maalrettet-samspil13.jpg&apos;);background-position:44% 36%;background-size:cover;\">\n<div class=\"gb-element-5eec3f18\">\n<h2 class=\"wp-block-heading has-custom-sort-tekst-color has-text-color has-link-color wp-elements-98dc27922e13d3d84668ae078b73226d\" id=\"halveringstider-links\"><span class=\"ez-toc-section\" id=\"Biological_half-lives_%E2%80%93_Links\"><\/span>Biological half-lives &#8211; Links<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"759\" height=\"754\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Kemo-og-straalestoette9.jpg\" alt=\"Kemo- og str\u00e5lest\u00f8tte symboliseret ved kig ud gennem hul i klippe mod sandstrand og klart vand og bl\u00e5 himmel.\" class=\"wp-image-29485\" style=\"object-fit:cover;width:150px;height:150px\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Kemo-og-straalestoette9.jpg 759w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Kemo-og-straalestoette9-100x100.jpg 100w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Kemo-og-straalestoette9-600x596.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Kemo-og-straalestoette9-300x298.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2026\/01\/Kemo-og-straalestoette9-150x150.jpg 150w\" sizes=\"auto, (max-width: 759px) 100vw, 759px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Methodological basis for half-lives<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">To ensure clinical credibility, the specified values have been established through a hierarchical prioritization of data across four levels \u2013 under Biological half-lives \u2013 Links (at the bottom of the page) called <strong>Level of Evidence<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-hvid-tekst-background-color has-background\"><strong>Level 1 (white):<\/strong>&nbsp;Direct evidence from human pharmacokinetic studies (measured in human blood).<\/li>\n\n\n\n<li class=\"has-custom-int-link-p-sort-1-background-color has-background\"><strong>Level 2 (green):<\/strong> Extrapolation from the most potent active ingredients in complex extracts.<\/li>\n\n\n\n<li class=\"has-custom-her-st-r-du-background-color has-background\"><strong>Level 3 (yellow):<\/strong> Pharmacological estimate based on biochemical degradation and enzymatic kinetics.<\/li>\n\n\n\n<li class=\"has-custom-orange-background-color has-background\"><strong>Level 4 (orange):<\/strong> Conservative estimate based on preclinical data (in vitro\/in vivo) with an integrated safety margin.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">By respecting these intervals, biosupport can be applied strategically during the recovery phase to optimize the overall course of treatment and minimize side effects without compromising the therapeutic index.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-int-link-p-sort-1-background-color has-background\">AHCC (active hexose correlated compound)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> Estimated &lt; 5 hours (plasma) \/ Enzymatic impact normalized within 48 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 2 (green).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> AHCC is a fermented mushroom extract rich in acetylated alpha-glucans. A human Phase 1 study (Spierings et al., 2007) documents clinical safety at high doses. However, metabolic studies (Mach et al., 2008; Mathew et al., 2017) demonstrate that AHCC functions as both a substrate and inducer of the liver enzyme CYP2D6 (Phase 1) as well as an inducer of UGT 1A3 and 1A6 (Phase 2). Since these enzymatic pathways are responsible for the metabolism of many oncological drugs (e.g., tamoxifen and letrozole), there is a risk of reduced treatment efficacy. Based on this proven enzymatic impact in human tissue, the washout period is set at 2 days to ensure metabolic normalization before treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a9219430befb89048c2a0d514e7a9598 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18202543\/\" target=\"_blank\" rel=\"noopener\">Spierings E. L. et al.: A Phase I study of the safety of AHCC in healthy volunteers<\/a> (J Nutr Sci Vitaminol, 2007) \u2013 <em>Human safety.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c4f4abd5b5786421a237af70ab327e23 wp-block-paragraph\">[B] <a href=\"https:\/\/journals.sagepub.com\/doi\/10.1177\/1534735417704948\" target=\"_blank\" rel=\"noopener\">Mathew L., Gaikwad A., Smith J. A. et al.: Evaluation of Active Hexose Correlated Compound (AHCC) in Combination With Anticancer Hormones in Orthotopic Breast Cancer Models<\/a> (Integrative Cancer Therapies, 2017) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a209ef13b1fe3467dfe855d11989a308 wp-block-paragraph\">[C] <a href=\"https:\/\/www.researchgate.net\/publication\/283035088_Evaluation_of_Active_Hexose_Correlated_Compound_Ahcc_on_Phase_Ii_Drug_Metabolism_Pathways_and_the_Implications_for_Supplement-Drug_Interactions\" target=\"_blank\" rel=\"noopener\">Coffer L. W. et al.: Evaluation of Active Hexose Correlated Compound (Ahcc) on Phase II Drug Metabolism Pathways and the Implications for Supplement-Drug Interactions<\/a> (Semantic Scholar \/ ResearchGate, 2015)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-her-st-r-du-background-color has-background\">Akkermansia (muciniphila)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 3\u20135 days (based on fecal washout). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 weeks (deviation: based on persistence in the gut and stabilization of the intestinal barrier). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 3 (yellow).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Since this involves a bacterium, measurement is not based on a traditional biological half-life in the blood, but rather on its presence in the gut. The documentation is based on a clinical study (Depommier et al., Nature Medicine, 2019), which demonstrates the metabolic impact of the bacterium. Washout studies of probiotic bacteria show that levels in the gut typically return to baseline within one week after supplementation ends. The washout period is therefore set at 1\u20132 weeks to ensure that the bacterium&#8217;s production of metabolic byproducts (postbiotics) and its influence on the intestinal barrier have ceased before the initiation of oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-185dc52e9be1f4a4857bb506a44cbd83 wp-block-paragraph\">[A] <a href=\"https:\/\/www.nature.com\/articles\/s41591-019-0495-2\" target=\"_blank\" rel=\"noopener\">Depommier et al.: Supplementation with&nbsp;<em>Akkermansia muciniphila<\/em>&nbsp;in overweight and obese human volunteers: a proof-of-concept exploratory study<\/a> (Nature Medicine, 2019)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-34c95e5fddb0ea408495470f6045abb4\">Activated charcoal<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> Not relevant (not systemically absorbed). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 1 day (deviation: based exclusively on gastrointestinal passage). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Since activated charcoal is not absorbed into the blood but remains in the gastrointestinal tract, its presence is governed exclusively by gastrointestinal transit time. According to the clinical status report (Silberman et al., 2023), the substance is most effective within 1 hour after ingestion, and its excretion follows the body&#8217;s natural passage (typically 12\u201324 hours). As there is no systemic half-life to account for, the washout period is based solely on ensuring complete passage through the gut before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9fb7a5505fb64a0b8c07c5b4f69278b8 wp-block-paragraph\">[A] <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482294\/\" target=\"_blank\" rel=\"noopener\">Activated Charcoal<\/a> (NIH, 2023)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-6e35be93e33fa77ddd3f170c7e0ca58c\">Alpha-Lipoic Acid (ALA)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 15\u201320 minutes (R-isomer) \/ up to 1 hour (racemate). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> ALA is a sulfur-containing fatty acid that functions as a potent antioxidant in both aqueous and lipid phases. Human Phase 1 studies (Z\u00e1rate et al., 2025) and randomized clinical trials (Yoon et al., 2016) unequivocally document that ALA is rapidly absorbed (tmax &lt; 1 hour) and promptly eliminated from plasma with a half-life of less than 20 minutes for the biologically active R-form. Previous assumptions of long terminal elimination (based on preclinical models) have not been reproduced in human pharmacokinetic measurements over 36 hours. Since ALA effectively regenerates other antioxidants such as vitamins C and E, the washout period is conservatively set at 2 days to ensure that the enhanced antioxidant status is normalized before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8b543a2eda12ffb86251cbd61f3aff53 wp-block-paragraph\">[A] <a href=\"https:\/\/www.frontiersin.org\/journals\/pharmacology\/articles\/10.3389\/fphar.2025.1692519\/full\" target=\"_blank\" rel=\"noopener\">Z\u00e1rate E., Bravo-Lamicq C. et al.: Pharmacokinetics and safety of a fixed-dose combination of pregabalin and thioctic acid in healthy volunteers <\/a>(Frontiers in Pharmacology, 2025) \u2013 <em>Human safety. Latest human Phase 1 data.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b2a3ec0676bb81b69b0b0f8cba23c994 wp-block-paragraph\">[B] <a href=\"https:\/\/www.tcpharm.org\/DOIx.php?id=10.12793%2Ftcp.2016.24.3.137\" target=\"_blank\" rel=\"noopener\">Yoon J., Moon S. J. et al.: Comparison of R(+)-\u03b1-lipoic acid exposure in healthy Korean male subjects<\/a> (Translational and Clinical Pharmacology, 2016) \u2013 <em>Documentation for the very short human half-life.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ddbd06189524cb79fe8b738390e2f455 wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11505271\/\" target=\"_blank\" rel=\"noopener\">Superti F. &amp; Russo R.: Alpha-Lipoic Acid: Biological Mechanisms and Health Benefits<\/a> (Antioxidants, 2024) \u2013 <em>Systematic review of mechanisms of action.<\/em><\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Amygdalin (B17)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 45\u2013120 minutes (for the substance itself), but with a risk of cyanide accumulation. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days (deviation: requires time for elimination of toxic cyanide metabolite). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> The clinical study (Moertel et al., 1982) conducted on 178 patients documents that amygdalin has no therapeutic effect on cancer but instead carries a significant risk of cyanide poisoning. The study showed that several patients had blood cyanide levels measured close to the lethal range. Since the substance is directly toxic and affects cellular oxygen uptake, the washout period is set at 2 days to ensure that cyanide levels have normalized before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-7e3ded58f7a109640a337af4147ce086 wp-block-paragraph\">[A] <a href=\"https:\/\/www.nejm.org\/doi\/pdf\/10.1056\/nejm198201283060403\" target=\"_blank\" rel=\"noopener\">A Clinical Trial of Amygdalin (Laetrile) in the Treatment of Human Cancer<\/a> (The New England Journal of Medicine, 1982)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-int-link-p-sort-1-background-color has-background\">Andrographis paniculata<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 2\u20137 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 2 (green).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Since the preparation is a complex extract, the evidence is based on extrapolation from the active driver, andrographolide. According to the systematic review (Raman et al., 2022), the plant contains active diterpene lactones (including andrographolide), which have a wide range of biological effects, including anti-inflammatory and antioxidant activity. As these constituents have low water solubility and undergo extensive metabolism in the body, the half-life varies but has been measured at approximately 6.67 hours. The washout period is set at 2 days to ensure that the plant&#8217;s influence on the cellular antioxidant balance and the liver&#8217;s enzyme systems has ceased before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-859161f04a42e8146bb7d41d81c38679 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9570691\/\" target=\"_blank\" rel=\"noopener\">Subashini Raman,&nbsp;Vikneswaran Murugaiyah et al.: Andrographis paniculata&nbsp;Dosage Forms and Advances in Nanoparticulate Delivery Systems: An Overview<\/a> (PubMed, 2022)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Apigenin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 2.5 hours (plasma) \/ 12 hours (human excretion) \/ 91.8 hours (terminal phase). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 19 days. (3 days for short-term use) <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 4 orange (preclinical data and metabolic clearance).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Apigenin is a flavonoid with complex pharmacokinetics. Systematic reviews of human data (Wang et al., 2019) report an average excretion half-life of approximately 12 hours, while the plasma half-life for free apigenin has been measured as low as 2.5 hours (DeRango-Adem et al., 2021). However, the classic kinetics study (Gradolatto et al., 2005) demonstrated a very slow elimination with a terminal half-life of 91.8 hours due to enterohepatic recirculation. Latest research (Sato et al., Nature 2024) confirms that modern nano-delivery systems significantly increase bioavailability, potentially increasing the risk of tissue accumulation. To ensure complete clearance during regular use, a safety interval of 19 days is maintained, while 3 days is considered sufficient for short-term use.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-acdf9dc525a81c3d586d4639ba97433f wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6817918\/\" target=\"_blank\" rel=\"noopener\">Wang M., Firrman J. et al.: A Review on Flavonoid Apigenin: Dietary Intake, ADME, Antimicrobial Effects, and Interactions with Human Gut Microbiota<\/a> (NIH, Biomed Res Int., 2019)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-855bc503f5c41010d32cbc9d19891a5f wp-block-paragraph\">[B] <a href=\"https:\/\/www.nature.com\/articles\/s41598-024-84063-2\" target=\"_blank\" rel=\"noopener\">Sato V. H., Sato H. et al.: Enhancement of in vitro transcellular absorption and in vivo oral bioavailability of apigenin by self-nanoemulsifying drug delivery systems<\/a> (Scientific Reports, Nature, 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a041526bb386b53f6933f9e2801b2a6e wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8167032\/\" target=\"_blank\" rel=\"noopener\">DeRango-Adem et al.: Does Oral Apigenin Have Real Potential for a Therapeutic Effect in the Context of Human Gastrointestinal and Other Cancers?<\/a> (Frontiers in Pharmacology, 2021)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a086e2dd31fa002e147bcba35904b401 wp-block-paragraph\">[D] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0090955624030757\" target=\"_blank\" rel=\"noopener\">Gradolatto et al.: PHARMACOKINETICS AND METABOLISM OF APIGENIN IN FEMALE AND MALE RATS AFTER A SINGLE ORAL ADMINISTRATION<\/a> (Science Direct, 2005)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Artemisinin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 1\u20135 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 1 day. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> A randomized controlled study ([A] Gordi, 2002) shows that artemisinin has a short half-life and exhibits time-dependent pharmacokinetics, where the substance induces its own metabolism, thereby increasing the rate of excretion over time. Another study ([B] Benakis, 1997) determines the average elimination phase to be between approximately 2.6 and 4.3 hours (distribution and elimination half-life, respectively). Since the substance is rapidly excreted from the body and does not accumulate with repeated dosing, the washout period is set at 1 day to ensure that the active ingredients are out of the system before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link: <\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4050c0d32a83969b209b05c1132c1e38 wp-block-paragraph\">[A] <a href=\"https:\/\/journals.asm.org\/doi\/10.1128\/aac.46.4.1026-1031.2002\" target=\"_blank\" rel=\"noopener\">Gordi: Artemisinin Pharmacokinetics and Efficacy in Uncomplicated-Malaria Patients Treated with Two Different Dosage Regimens<\/a> (ASM Journals, 2002)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-27ba790583b2fee8e8102458298ededb wp-block-paragraph\">[B] <a href=\"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/56\/1\/article-p17.xml\" target=\"_blank\" rel=\"noopener\">Benakis: Pharmacokinetics of Artemisinin and Artesunate after Oral Administration in Healthy Volunteers<\/a> (1997)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-her-st-r-du-background-color has-background\">Ashwagandha<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 1\u20135 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 3 (yellow).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> A comprehensive study (Modi et al., 2022) has mapped the pharmacokinetics of the central constituents (withanolides). The results show rapid absorption via the gastrointestinal tract (tmax of less than 1 hour) and fast turnover in the blood. Although the individual components have short half-lives, they exhibit the ability to cross the blood-brain barrier and affect central body functions. Due to this systemic impact and documented interactions with the hormonal system and liver metabolism, the washout period is set at 2 days to ensure metabolic normal conditions before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link: <\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-35f43b9bd89be60334d836790e00910d wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8912008\/\" target=\"_blank\" rel=\"noopener\">Modi et al.: Pharmacokinetic Study of Withanosides and Withanolides from&nbsp;<em>Withania somnifera<\/em>&nbsp;Using Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS\/MS)<\/a> (PubMed, 2022)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-1255d037b16d7c69f19d2ce68dda2f73\">Astragalus<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 2.1\u20132.7 hours (human measurements). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 1 day. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Astragalus contains saponins, with Astragaloside IV being the primary active marker. A comprehensive review (St\u0119pnik et al., 2025) summarizes the substance&#8217;s anti-inflammatory and immunomodulatory effects. A human Phase 1 study (Xu et al., 2013) documents rapid and linear elimination in humans with a half-life of 2.1\u20132.7 hours and confirms that no accumulation occurs with daily dosing. The mathematical elimination (5 x <em>t\u00bd<\/em>) is thus completed in less than 14 hours. Preclinical models have shown half-lives of up to 5.5 hours (Tan et al., 2020), but these have not been reproduced in human trials. Since Astragalus has a low oral bioavailability of approximately 2.2% (ResearchGate, 2018) and the substance is excreted rapidly, a 24-hour washout ensures full elimination of the active components and a good margin for normalization of biological processes before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1d4077a4926e2e513acf3b5fe53323ed wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23838148\/\" target=\"_blank\" rel=\"noopener\">Xu M., Yin J. et al.: Pharmacokinetics and tolerance of total astragalosides after intravenous infusion in healthy Chinese volunteers<\/a> (Phytomedicine, 2013) \u2013 <em>Primary source for human kinetics.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1aacf6f937c3c6de92831a70d8ba9281 wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1422-0067\/26\/9\/4250\" target=\"_blank\" rel=\"noopener\">Stepnik et al.: In Vivo Insights into the Role of Astragaloside IV in Preventing and Treating Civilization Diseases: A Comprehensive Review<\/a> (MDPI, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-549a9cac920c3e90530b92b069ab139f wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7507407\/\" target=\"_blank\" rel=\"noopener\">Tan Y. Q. et al.: Astragaloside IV: An Effective Drug for the Treatment of Cardiovascular Diseases<\/a> (Drug Des Devel Ther., 2020) \u2013 <em>Preclinical data and comparison.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-bc058a7c85fc89a05e92b29a552b0a68 wp-block-paragraph\">[D] <a href=\"https:\/\/www.researchgate.net\/publication\/328251852_Pharmacokinetics_Comparison_Intestinal_Absorption_and_Acute_Toxicity_Assessment_of_a_Novel_Water-Soluble_Astragaloside_IV_Derivative_Astragalosidic_Acid_LS-102\" target=\"_blank\" rel=\"noopener\">Qing, et al.: Pharmacokinetics Comparison, Intestinal Absorption and Acute Toxicity of LS-102<\/a> (Research Gate, 2018) \u2013 <em>Documentation for low oral absorption (2.2%) of AGS-IV.<\/em><\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-her-st-r-du-background-color has-background\">Baicalin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 6\u201315 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 4 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 3 (yellow).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> A clinical study (Liu et al., 2019) conducted on 16 volunteers investigated the pharmacokinetics of baicalin and its potential for interactions with medications metabolized via CYP3A and P-glycoprotein. The study shows that baicalin has an average elimination half-life of approximately 6.4 hours, but with significant individual variation. Since the substance binds strongly to plasma proteins (86\u201392%) and its active metabolite, baicalein, has the potential to inhibit important enzyme systems in the liver, the washout period is set at 4 days. This ensures that the substance is completely excreted so that it does not affect the metabolism of the oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8fed91f263ede3917a3883f11c8d7aa6 wp-block-paragraph\">[A] <a href=\"https:\/\/www.frontiersin.org\/journals\/pharmacology\/articles\/10.3389\/fphar.2019.00518\/full\" target=\"_blank\" rel=\"noopener\">Liu et al.: A Single Dose of Baicalin Has No Clinically Significant Effect on the Pharmacokinetics of Cyclosporine A in Healthy Chinese Volunteers<\/a> (Frontiers, 2019)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Berberine<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 12\u201315 hours (in the excretion phase). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Comprehensive systematic reviews ([A] Ai, 2021) and a clinical study ([B] Solnier, 2023) conducted on 10 healthy volunteers document the pharmacokinetics of berberine. Although standard berberine has a very low bioavailability (less than 1%) due to P-glycoprotein-mediated efflux, modern formulations show up to 6 times higher absorption. The terminal half-life is established at approximately 12\u201315 hours, reflecting elimination from tissue stores in the liver and kidneys, among others. Since berberine affects multiple signaling pathways (including AMPK and NF-\u03baB) and can interact with the liver&#8217;s enzyme systems, the washout period is set at 3 days to ensure complete clearance before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-6f512acc648c7ad715d72f67bbd7092a wp-block-paragraph\">[A] <a href=\"https:\/\/www.frontiersin.org\/journals\/pharmacology\/articles\/10.3389\/fphar.2021.762654\/full\" target=\"_blank\" rel=\"noopener\">Ai: Berberine: A Review of its Pharmacokinetics Properties and Therapeutic Potentials in Diverse Vascular Diseases<\/a> (Frontiers 2021)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-0301896fce4ca70c59bb2438e8694639 wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1999-4923\/15\/11\/2567\" target=\"_blank\" rel=\"noopener\">Solnier: Characterization and Pharmacokinetic Assessment of a New Berberine Formulation with Enhanced Absorption In Vitro and in Human Volunteers<\/a> (MDPI, 2023)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Boron<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> Approximately 21 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 5 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> According to a comprehensive analysis by Health Canada (2007\/2013) [A], orally ingested boron is rapidly and completely absorbed (over 90%) and passes through the body without being metabolized. It is excreted via the kidneys with a half-life of 21 hours, and most is eliminated within four days, although a very small amount may temporarily accumulate in bone tissue. Recent research ([B] Bartusik-Aebisher, 2025) indicates that boron can interact with the metabolism of steroid hormones and vitamin D, potentially extending their half-life in the body. Since boron does not accumulate in soft tissue and is excreted predictably, the washout period is set at 5 days to ensure complete clearance before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-31de6b581aedec005a1f01068ddc3e47 wp-block-paragraph\">[A] <a href=\"https:\/\/www.canada.ca\/content\/dam\/hc-sc\/migration\/hc-sc\/dhp-mps\/alt_formats\/hpfb-dgpsa\/pdf\/pubs\/boron-bore-eng.pdf\" target=\"_blank\" rel=\"noopener\">Boron as a Medicinal Ingredient in Oral Natural Health Products<\/a> (Natural Health Canada, 2007)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1d57cb69e2e980e3d0d3c86c61fb78a9 wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1424-8247\/19\/1\/81\" target=\"_blank\" rel=\"noopener\">Bartusik-Aebisher: Boron in Diet and Medicine: Mechanisms of Delivery and Detection<\/a> (MDPI, 2025)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Boswellia<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> approx. 6.8 hours (AKBA) \/ measurable in plasma up to 48 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 4 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Boswellia serrata contains active boswellic acids (BA), including AKBA, which function as potent inhibitors of inflammatory mediators (Roy et al., 2019). A human Phase 1 study (Kulkarni et al., 2021) in healthy volunteers documents an initial elimination half-life for AKBA of 6.8 hours. However, recent clinical measurements of both raw extract and formulated particles (Schmiech et al., 2024) demonstrate residual plasma concentrations up to 48 hours after ingestion, due to the substance&#8217;s lipophilic nature and slow release from tissue stores. To comply with the pharmacological standard for complete elimination (5 \\times <em>t\u00bd<\/em> in the terminal phase), the washout period is set at 4 days (96 hours). This ensures full clearance of both plasma and tissue stores as well as normalization of inflammatory signaling pathways (5-LOX) before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Links:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b34825b28e778c0f151d497919864c8b wp-block-paragraph\">[A] Kulkarni:<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34412175\/\" target=\"_blank\" rel=\"noopener\">Pharmacokinetics of solid lipid&nbsp;<em>Boswellia serrata<\/em>&nbsp;particles in healthy subjects<\/a> (PubMed, 2021) \u2013 <em>Primary source for human kinetics (AKBA).<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4c9bde02ac22f9eb40c5cf745dfdc24f wp-block-paragraph\">[B] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S094471132400521X\" target=\"_blank\" rel=\"noopener\">Schmiech et al.: Single-dose comparative pharmacokinetic\/pharmacodynamic study of a micellar formulation&nbsp;<em>versus<\/em>&nbsp;a native&nbsp;<em>Boswellia serrata<\/em>&nbsp;dry extract in healthy volunteers<\/a> (Science Direct, 2024) \u2013 <em>Documentation for terminal phase and 48-hour detection.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-23f0fdd1654618dcfbbf37b1f960a82e wp-block-paragraph\">[C] <a href=\"https:\/\/www.mdpi.com\/1422-0067\/20\/17\/4101\" target=\"_blank\" rel=\"noopener\">Roy N. K. et al.: An Update on Pharmacological Potential of Boswellic Acids against Chronic Diseases <\/a>(Int. J. Mol. Sci., 2019) \u2013 <em>Review of molecular targets and bioavailability.<\/em><\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Butyric acid<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 0.5\u201314 minutes. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 1 day. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Pharmacokinetic measurements in humans (Daniel et al., 1989) show that butyric acid is eliminated extremely rapidly from the blood. The elimination curve is divided into two phases, with an initial half-life of only 0.5 minutes followed by a phase of 13.7 minutes. Although preclinical models (Jung et al., 2021) utilize tributyrin (TB) as a &#8220;prodrug&#8221; to create a more stable release in the gut, human data confirm that the systemic presence is very short-lived. Due to this lightning-fast metabolic turnover, the washout period is set at 1 day to ensure complete elimination before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-18dee34c5feaeaf997ea411cdaf83605 wp-block-paragraph\">[A] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/0009898189902313\" target=\"_blank\" rel=\"noopener\">Daniel et al.: Pharmacokinetic study of butyric acid administered in vivo as sodium and arginine butyrate salts<\/a> (ScienceDirect, 1989)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-90520743aa8deed9ca9778d537f27e4b wp-block-paragraph\">[B] <a href=\"https:\/\/link.springer.com\/article\/10.1186\/s13036-021-00259-4\" target=\"_blank\" rel=\"noopener\">Jung et al.: An efficient system for intestinal on-site butyrate production using novel microbiome-derived esterases<\/a> (Springer Nature, 2021)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-7a5b7276c745c56f486db67174a01b86\">Cannabis (THC\/CBD)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 20 hours (THC) \/ &gt;134 hours (CBD). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 28 days (exception: based on slow release from adipose tissue and influence on CYP450). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> The pharmacokinetics of cannabis are complex due to the substances&#8217; high lipid solubility, which leads to extensive storage in the body&#8217;s adipose tissue. For THC, review studies (Huestis, 2007) document that the terminal half-life is between 20 and 30 hours, as the substance is slowly released from tissue stores into the blood. For CBD, recent pharmacokinetic modeling (Kolli et al., 2025) demonstrates that the terminal elimination half-life in humans is extremely long, exceeding 134 hours (&gt;5.5 days), meaning it can take over 70 days to reach a steady state in the body. Since both substances affect the liver&#8217;s enzyme systems (especially CYP450) and have prolonged biological activity, the washout period is conservatively set at 4 weeks (28 days) to ensure complete elimination from tissue stores before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5b6eaba937ead50fc3911f0e635261ca wp-block-paragraph\"><strong>Link: <\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4953a69aef7579c77624ae9d069a72db wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6177698\/\" target=\"_blank\" rel=\"noopener\">Lucas et al.: The pharmacokinetics and the pharmacodynamics of cannabinoids<\/a> (British Journal of Clinical Pharmacology, 2018) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-0e9fc7459058c2b3e4de0b3472beb2f4 wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2689518\/\" target=\"_blank\" rel=\"noopener\">Huestis: Human Cannabinoid Pharmacokinetics<\/a> (Chemistry &amp; Biodiversity, 2007) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-99abc7f3022413e023fe53d1bf79b521 wp-block-paragraph\">[C] <a href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/can.2023.0214\" target=\"_blank\" rel=\"noopener\">Kolli et al.: Cannabidiol Bioavailability Is Nonmonotonic with a Long Terminal Elimination Half-Life<\/a> (Cannabis and Cannabinoid Research, Mary Ann Liebert, 2025)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">CoQ10<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 33\u201357 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 12 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> CoQ10 is a fat-soluble molecule with a high molecular weight, resulting in slow and limited absorption. Systematic reviews (Bhagavan, 2006) establish an average plasma half-life of approximately 33 hours. This is supported by clinical reviews (Raizner, 2019), which confirm a half-life of over 30 hours and point out that peak concentrations are only reached 6\u20138 hours after ingestion. Other pharmacokinetic assessments (Bolt Pharmacy, 2026) indicate a range of up to 57 hours. Since CoQ10 accumulates in tissue stores and has a significant antioxidant effect, the washout period is set at 10\u201312 days to ensure that plasma levels are normalized before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1bcc04f181d03ae54da4da5043ebda09 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16551570\/\" target=\"_blank\" rel=\"noopener\">Bhagavan &amp; Chopra: Coenzyme Q10: absorption, tissue uptake, metabolism and pharmacokinetics<\/a> (Free Radical Research, 2006)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9718af79275c78553602b921efed7f46 wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6822644\/\" target=\"_blank\" rel=\"noopener\">Raizner: Coenzyme Q10<\/a> (Methodist Debakey Cardiovasc J., PubMed, 2019)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e853d639ea1a79a3e10d79e32391ce16 wp-block-paragraph\">[C] <a href=\"https:\/\/www.boltpharmacy.co.uk\/guide\/how-long-does-coq10-stay-in-your-system\" target=\"_blank\" rel=\"noopener\">Bolt Pharmacy: How Long Does CoQ10 Stay in Your System? UK Guide<\/a> (Bolt, 2026)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">DCA (dichloroacetat)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 1 hour (initial) to over 10 hours (with repeated dosing). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 14 days (exception: due to irreversible inactivation of the GSTZ1 enzyme). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> DCA exhibits completely unique and dose-dependent pharmacokinetics in humans. Initially, the substance has a short half-life of approximately 1 hour (James et al., 2016). However, DCA inactivates the enzyme (GSTZ1-1) responsible for its own metabolism in the liver. This causes the half-life to increase significantly with repeated dosing\u2014often to approximately 10 hours, but in certain cases considerably longer (Curry et al., 1991). Recent reviews (Koltai et al., 2024) point out that DCA&#8217;s ability to inhibit pyruvate dehydrogenase kinase (PDK) and alter cellular bioenergetics makes precision in dosing and washout crucial, especially since the substance can have unpredictable effects upon accumulation. Studies show that it can take from one week up to 3 months for enzyme capacity to normalize. Due to this accumulation and enzyme inhibition, the washout period is conservatively set at 14 days to ensure metabolic normalcy before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-63e7657653f6619ff8c794b03a1a8d10 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/1878534\/\" target=\"_blank\" rel=\"noopener\">Curry et al.: Disposition and pharmacodynamics of dichloroacetate (DCA) and oxalate following oral DCA doses<\/a> (Biopharm Drug Dispos, 1991)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-38da3304d488dcfe16b0cc00cdad78a0 wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5558523\/\" target=\"_blank\" rel=\"noopener\">James &amp; Stacpoole: Pharmacogenetic considerations with dichloroacetate dosing<\/a> (Pharmacogenomics, 2016)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1e056e8f28c2f8d504f7feec4b63afd5 wp-block-paragraph\">[C] <a href=\"https:\/\/www.mdpi.com\/1424-8247\/17\/6\/744\" target=\"_blank\" rel=\"noopener\">Koltai &amp; Fliegel: Dichloroacetate for Cancer Treatment: Some Facts and Many Doubts<\/a> (Pharmaceuticals, 2024)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-int-link-p-sort-1-background-color has-background\">DIM (diindolylmethane)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 4\u20138 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 2 (green).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> DIM is the primary acid-condensation product of Indole-3-carbinol (I3C). Phase 1 clinical trials (Reed et al., 2006) document that I3C cannot be measured in plasma after ingestion but is rapidly converted to DIM, which reaches its maximum concentration (<em>tmax<\/em>) after approximately 2 hours. Although most subjects have low levels after 12\u201324 hours, significant inter-individual variation has been observed, with some individuals still having measurable levels after 12 hours. Recent systematic reviews (Srikanth et al., 2025) confirm a half-life of 4\u20138 hours and point out DIM&#8217;s impact on estrogen metabolism and xenobiotic processes. Furthermore, clinical studies (Casta\u00f1on et al., 2012) show that while DIM is well tolerated with daily dosing, a stable period is required to ensure elimination. The washout period is set at 3 days to ensure complete clearance of all active metabolites before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-f6b8eb7d615887a65ddfc03bdbb89461 wp-block-paragraph\">[A] <a href=\"https:\/\/www.mdpi.com\/2223-7747\/14\/5\/827\" target=\"_blank\" rel=\"noopener\">Srikanth et al.: Unveiling the Multifaceted Pharmacological Actions of Indole-3-Carbinol and Diindolylmethane: A Comprehensive Review<\/a> (Plants, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9dd3258828ac1308a2d3e16e726e208e wp-block-paragraph\">[B] <a href=\"https:\/\/aacrjournals.org\/cebp\/article\/15\/12\/2477\/264476\/Single-Dose-and-Multiple-Dose-Administration-of\" target=\"_blank\" rel=\"noopener\">Reed et al.: Single-Dose and Multiple-Dose Administration of Indole-3-Carbinol to Women: Pharmacokinetics Based on 3,3\u2032-Diindolylmethane<\/a> (Cancer Epidemiol Biomarkers Prev, 2006)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-0b59b01576f82f3da285cdc17a5a4cc1 wp-block-paragraph\">[C] <a href=\"https:\/\/www.nature.com\/articles\/bjc2011496\" target=\"_blank\" rel=\"noopener\">Casta\u00f1on et al.: Effect of diindolylmethane supplementation on low-grade cervical cytological abnormalities<\/a> (British Journal of Cancer, 2012)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-9905b12e21f06119bd9242bbfb62b700\">EGCG (Green Tea)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 3-5 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> EGCG (Epigallocatechin-3-gallate) is rapidly absorbed from the gut, with peak plasma concentrations occurring after approximately 1.5 hours. A randomized controlled phase 1 trial (Lee et al., 2002) shows an elimination half-life of 3.4 hours, with the substance primarily found in free form in plasma, while its metabolites are excreted rapidly via the urine. Another randomized, double-blind, and placebo-controlled phase 1 trial (Ullmann, 2004) confirms that with repeated dosing over 10 days, dose-dependent saturation of excretory pathways occurs at high doses (800 mg), which can slightly prolong the half-life. Due to EGCG&#8217;s ability to inhibit specific transport proteins (OATP) and influence drug metabolism, the washout period is set at 2 days to ensure complete elimination before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-730f3fa8f22b087000abe27c9358db2b wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15580809\/\" target=\"_blank\" rel=\"noopener\">Ullmann et al.: Plasma-kinetic characteristics of purified and isolated epigallocatechin gallate (EGCG) after 10 days repeated dosing in healthy volunteers <\/a>(Int J Vitam Nutr Res, 2004)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9cdf261012fe7b21adae3a84e9451860 wp-block-paragraph\">[B] <a href=\"https:\/\/www.researchwithrutgers.com\/en\/publications\/pharmacokinetics-of-tea-catechins-after-ingestion-of-green-tea-an\/\" target=\"_blank\" rel=\"noopener\">Lee et al.: Pharmacokinetics of tea catechins after ingestion of green tea and (-)-epigallocatechin-3-gallate by humans: Formation of different metabolites and individual variability<\/a> (Cancer Epidemiol Biomarkers Prev, 2002)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-5332b3638081069d5f2e0a995f777ce6\">Genistein<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 3.8\u201310.2 hours (in the elimination phase). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 4 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Genistein is an isoflavone that is rapidly absorbed but undergoes extensive metabolism. A randomized phase 1 clinical trial (Bloedon et al., 2002) in postmenopausal women showed a terminal half-life for free genistein of 3.8 hours, while the total amount (including conjugated metabolites) had a &#8220;pseudo-half-life&#8221; of approximately 10.1 hours. Another prospective, randomized phase 1 trial (Ullmann et al., 2005) with synthetic genistein confirms terminal half-lives between 7.7 and 10.2 hours depending on the dose. Although certain mechanistic studies (Yang et al., 2012) point to the possibility of low bioavailability and recirculation, clinical data indicate that progressive accumulation does not occur with daily dosing. The washout period is set at 4 days to ensure complete elimination of both free genistein and its metabolites.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-06caf0da860ddbca45c9a43f36812e51 wp-block-paragraph\">[A] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0002916523060252\" target=\"_blank\" rel=\"noopener\">Bloedon et al.: Safety and pharmacokinetics of purified soy isoflavones: single-dose administration to postmenopausal women<\/a> (American Journal of Clinical Nutrition, 2002)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-6a590106615b3e8126bf8371ba64b4e9 wp-block-paragraph\">[B] <a href=\"https:\/\/link.springer.com\/article\/10.1007\/BF02850186\" target=\"_blank\" rel=\"noopener\">Ullmann et al.: Safety, tolerability, and pharmacokinetics of single ascending doses of synthetic genistein (Bonistein\u2122) in healthy volunteers<\/a> (Advances in Therapy, 2005)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d73522b64e10f1385d106610fa214907 wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4010305\/\" target=\"_blank\" rel=\"noopener\">Yang et al.: Bioavailability and Pharmacokinetics of Genistein: Mechanistic Studies on its ADME<\/a> (Anticancer Agents Med Chem., 2012)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-her-st-r-du-background-color has-text-color has-background has-link-color wp-elements-42e3ca7b991e61b80546398f1e5469a1\">Shark Liver Oil<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> Not precisely established (incorporated into cell membranes and transformed into plasmalogens). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 14 days (exception: based on lipid remodeling in immune cells). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 3 (yellow).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Shark liver oil is a rich source of alkylglycerols (AKG). Unlike many other preparations that merely circulate in plasma, AKG functions as building blocks incorporated into cell membranes. A phase 1 clinical trial (Paul et al., 2021) shows that shark liver oil supplementation for 3 weeks leads to a significant enrichment of plasmalogens in both plasma and white blood cells. The alkylglycerols themselves undergo extensive metabolic &#8220;remodeling&#8221; in the body. Review articles (Pugliese et al., 1998 &amp; Iannitti &amp; Palmieri, 2010) describe AKG as multifunctional with stimulating effects on macrophages and the immune system that can persist after ingestion. Since the preparation alters the lipid composition of immune cells over a prolonged period, and precise data for terminal elimination are lacking, the washout period is conservatively set at 14 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b805ad1e29ff9d2d13344da1290e1d83 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9553838\/\" target=\"_blank\" rel=\"noopener\">Pugliese et al.: Some biological actions of alkylglycerols from shark liver oil <\/a>(J Altern Complement Med, 1998)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e791fe6f40649dae6afdb6e0229d53f2 wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1660-3397\/8\/8\/2267\" target=\"_blank\" rel=\"noopener\">Iannitti &amp; Palmieri: An Update on the Therapeutic Role of Alkylglycerols<\/a> (Marine Drugs, 2010)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8c6132eb2868952db0e3feef8459baea wp-block-paragraph\">[C] <a href=\"https:\/\/med-life.ca\/literature\/2021\/7\/19\/shark-liver-oil-supplementation-enriches-endogenous-plasmalogens-and-reduces-markers-of-dyslipidaemia-and-inflammation\" target=\"_blank\" rel=\"noopener\">Paul et al.: Shark liver oil supplementation enriches endogenous plasmalogens and reduces markers of dyslipidaemia and inflammation<\/a> (Med-Life Discoveries, 2021)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-a73e723e6a7ede08e245e6e05da2f7d2\">Honokiol<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 2.5\u20135 hours (in the elimination phase). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Honokiol is a polyphenol from the magnolia tree that exhibits a biphasic kinetic profile. Review articles (Arora et al., 2012) describe an initial rapid distribution in the body followed by a slower elimination phase. A randomized phase 1 clinical trial (Sarrica et al., 2018) indicates an average half-life in this phase of approximately 2.33 hours in humans. Although honokiol is generally considered safe, preclinical studies (Kim et al., 2018) show that the substance can inhibit important liver enzymes (especially CYP1A and CYP2C). Since this enzyme interaction can alter the metabolism of other drugs, the washout period is set at 3 days to ensure that normal liver function is restored.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-981665fc0718b8fecc8bc22c3e2e5bec wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3663139\/\" target=\"_blank\" rel=\"noopener\">Arora et al.: Honokiol: a novel natural agent for cancer prevention and therapy<\/a> (Current Molecular Medicine, 2012)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e6f3304d4e822de55c564aca2da3aac3 wp-block-paragraph\">[B] <a href=\"https:\/\/www.thieme-connect.com\/products\/ejournals\/pdf\/10.1055\/a-0642-1966.pdf\" target=\"_blank\" rel=\"noopener\">Sarrica et al.: Safety and Toxicology of Magnolol and Honokiol<\/a> (Planta Medica, 2018)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-47c366ff827ad7f3d1cd40633bafa2de wp-block-paragraph\">[C] <a href=\"https:\/\/pdfs.semanticscholar.org\/f59f\/2ae636ea54c91abb8127885930b223a44682.pdf\" target=\"_blank\" rel=\"noopener\">Kim et al.: Modulation of Rat Hepatic CYP1A and 2C Activity by<br>Honokiol and Magnolol: Differential Effects on<br>Phenacetin and Diclofenac Pharmacokinetics In Vivo<\/a> (Molecules, 2018)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-7f2f897aced184480040b43d756cbc0d\">I3C (Indol-3-carbinol)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> Less than 1 hour (extremely rapid conversion). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 3 days (exception: follows the elimination of the active metabolite DIM). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> I3C is an unstable molecule that is immediately converted into condensation products in stomach acid. A phase 1 clinical trial (Reed et al., 2006) documents that I3C itself is not detectable in plasma after oral ingestion, as it functions as a &#8220;pro-drug&#8221; primarily for DIM. A follow-up phase 1 clinical trial (Reed et al., 2008) examined the absorption of the active metabolite directly and demonstrated a safe profile at doses up to 200 mg. A systematic review (Srikanth et al., 2025) confirms that the pharmacological effect in humans is primarily mediated via these metabolites. Since I3C is converted instantaneously but leaves behind active substances with longer elimination times, the washout period is set at 3 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-2953b33c7acdb0f575ae631b752ebaba wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11902694\/\" target=\"_blank\" rel=\"noopener\">Srikanth et al.: Unveiling the Multifaceted Pharmacological Actions of Indole-3-Carbinol and Diindolylmethane: A Comprehensive Review<\/a> (PubMed, Plants, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9dd3258828ac1308a2d3e16e726e208e wp-block-paragraph\">[B] <a href=\"https:\/\/aacrjournals.org\/cebp\/article\/15\/12\/2477\/264476\/Single-Dose-and-Multiple-Dose-Administration-of\" target=\"_blank\" rel=\"noopener\">Reed et al.: Single-Dose and Multiple-Dose Administration of Indole-3-Carbinol to Women: Pharmacokinetics Based on 3,3\u2032-Diindolylmethane<\/a> (Cancer Epidemiol Biomarkers Prev, 2006)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-7963fbaa224e962060c9abb6b1ecda21 wp-block-paragraph\">[C] <a href=\"https:\/\/www.researchgate.net\/publication\/23307387_Single-Dose_Pharmacokinetics_and_Tolerability_of_Absorption-Enhanced_33&#039;-Diindolylmethane_in_Healthy_Subjects\" target=\"_blank\" rel=\"noopener\">Reed et al.: Single-dose pharmacokinetics and tolerability of absorption-enhanced 3,3&#8242;-diindolylmethane in healthy subjects<\/a> (Research Gate, Cancer Epidemiol Biomarkers Prev, 2008)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-4010fe24aa2861edd92035471879ebe3\">Ginger<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 0.6\u20132.4 hours (in the elimination phase). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Ginger contains several active components, including gingerols and 6-shogaol. A phase 1 clinical trial (Zick et al., 2008) documents that these substances are absorbed rapidly but are primarily found as conjugated metabolites in plasma with a half-life of less than 2 hours. Another clinical trial (Zhang et al., 2022) confirms that the half-life for both the free substances and their metabolites remains stable between 0.6 and 2.4 hours, even with long-term use. A review article (Biomedicine &amp; Pharmacotherapy, 2023) defines 10-gingerol as a central phenolic compound with significant anti-inflammatory properties and describes its role in managing complex physiological responses. Since the substances are metabolized and excreted rapidly without accumulation, the washout period is set at 2 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b6c22ce9913d610f337738b57fb6cae3 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC2676573\/\" target=\"_blank\" rel=\"noopener\">Zick et al.: Pharmacokinetics of 6-, 8-, 10-Gingerols and 6-Shogaol and Conjugate Metabolites in Healthy Human Subjects <\/a>(Cancer Epidemiol Biomarkers Prev, 2009)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4d95f7bdadd2e65687c00f5b015cdb35 wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9654594\/\" target=\"_blank\" rel=\"noopener\">Zhang et al.: Pharmacokinetics of Gingerols, Shogaols, and Their Metabolites in Asthma Patients<\/a> (J Agric Food Chem, 2023)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c5b91ba06eaa6a6ac17ec93a44dda01f wp-block-paragraph\">[C] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38025831\/\" target=\"_blank\" rel=\"noopener\">ScienceDirect: 10-Gingerol &#8211; an overview<\/a> (Biomedicine &amp; Pharmacotherapy, 2023)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-7cc853f73ec302312e935ba6b5403577\">L-Carnitin \/ ALC<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 25.7\u201360.3 hours (plasma) \/ 38\u2013119 hours (total body turnover). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 13 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> L-Carnitine and its acetylated form, ALC, are strictly regulated in the body through diet, endogenous production, and efficient renal reabsorption. A clinical trial (Cao et al., 2009) shows that L-carnitine has a longer half-life in plasma (60.3 hours) than ALC (35.9 hours) after oral ingestion. A comprehensive review article (Rebouche, 2004) points out that the total body turnover time is up to 119 hours, as the substance is stored in tissues such as muscle, and that ALC is partially hydrolyzed during absorption. Data from Wikipedia\/DrugBank (2024) confirm that ALC in the blood is rapidly broken down by plasma esterases into carnitine, which then transports fatty acids into the mitochondria for energy production. Due to the slow tissue turnover and the significance for mitochondrial metabolism, the washout period is set at 13 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c7ddb288725ceeafb6691fd430bd8119 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19178874\/\" target=\"_blank\" rel=\"noopener\">Cao et al.: Comparison of pharmacokinetics of L-carnitine, acetyl-L-carnitine and propionyl-L-carnitine after single oral administration of L-carnitine in healthy volunteers<\/a> (PubMed, 2009)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ebee6891e7668ea22801d08a77995618 wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15591001\/\" target=\"_blank\" rel=\"noopener\">Rebouche: Kinetics, pharmacokinetics, and regulation of L-carnitine and acetyl-L-carnitine metabolism<\/a> (Ann N Y Acad Sci, 2004)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b321b98189bf43e92b4503468cfb9e0a wp-block-paragraph\">[C] <a href=\"https:\/\/en.wikipedia.org\/wiki\/Acetylcarnitine\" target=\"_blank\" rel=\"noopener\">Wikipedia: Acetylcarnitine &#8211; Clinical data and Biochemical production<\/a> (2024)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">LDN (Low Dose Naltrexone)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 4 hours (naltrexone) \/ 13 hours (6-beta-naltrexol). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Naltrexone is a well-documented drug that is rapidly absorbed upon oral ingestion (Tmax 1 hour). A clinical review (Toljan et al., 2018) describes naltrexone as an opioid antagonist that, in low doses (phase 1 trial), triggers a temporary receptor blockade. According to official pharmacokinetic data in DrugBank (2024), naltrexone has a plasma half-life of 4 hours but is converted in the liver to the primary active metabolite, 6-beta-naltrexol, which has a significantly longer half-life of approximately 13 hours. The clinical profile from Renew Health (2026) supports that although the substance and its metabolite are eliminated from plasma after approximately 72 hours, the secondary biological effect of increased endorphin production lasts for up to 24 hours after each dose. Since LDN interacts with the body&#8217;s opioid system and can block the effect of pain medication, the washout period is set at 3 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d285a0f1b08cc5ec811bc7cd7dfd5039 wp-block-paragraph\">[A]<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6313374\/\" target=\"_blank\" rel=\"noopener\"> Toljan et al.: Low-Dose Naltrexone (LDN)\u2014Review of Therapeutic Utilization<\/a> (Medical Sciences, 2018)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-f6eabc4293700e5d24952361abcbe380 wp-block-paragraph\">[B] <a href=\"https:\/\/go.drugbank.com\/drugs\/DB00704\" target=\"_blank\" rel=\"noopener\">DrugBank: Naltrexone &#8211; Identification, Pharmacokinetics and Mechanism of Action<\/a> (2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-64b7d75fc379d4504a616d030ebced0c wp-block-paragraph\">[C] <a href=\"https:\/\/renewhealth.com\/how-long-does-low-dose-naltrexone-stay-in-your-system-understanding-its-effects-benefits-and-duration-in-the-body\/\" target=\"_blank\" rel=\"noopener\">Renew Health: How Long Does Low Dose Naltrexone Stay in Your System<\/a> (2026)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-4411a6bb608bd30e29d3ddafda2c1a0f\">L-Glutamine<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 1\u20132 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> L-Glutamine is the most abundant amino acid in the body and serves as a central energy source for intestinal and immune cells, among others. A population pharmacokinetic analysis (Sadaf et al., 2024) shows that the substance has very rapid absorption and elimination with a Tmax of approximately 1.2 hours, and no accumulation is observed with repeated dosing. Official data from DrugBank\/FDA (2024) confirm that the terminal elimination half-life is approximately 1 hour, while technical overviews (Protocol for Life Balance, 2018) report an average half-life of 110 minutes in human trials (phase 1). Since glutamine is metabolized extremely rapidly through the body&#8217;s natural metabolic pathways and excreted efficiently, the washout period is set at 2 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-2f90dfa62f627178abcbcbb212dbd09f wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10954986\/\" target=\"_blank\" rel=\"noopener\">Sadaf et al.: A Population Pharmacokinetic Analysis of&nbsp;l-Glutamine Exposure in Patients with Sickle Cell Disease: Evaluation of Dose and Food Effects<\/a> (Clin Pharmacokinet, 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-92f8a7a994bc4a9d6acef6686925bdd6 wp-block-paragraph\">[B] <a href=\"https:\/\/go.drugbank.com\/drugs\/DB00130\" target=\"_blank\" rel=\"noopener\">DrugBank: L-Glutamine &#8211; Identification, Pharmacology and Pharmacokinetics<\/a> (2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e1120ff3a7ca08a9ac2b94daa866466c wp-block-paragraph\">[C] <a href=\"https:\/\/www.protocolforlife.com\/wp-content\/uploads\/2018\/10\/P0221-L-Glutamine-Powder.pdf\" target=\"_blank\" rel=\"noopener\">Protocol for Life Balance: L-Glutamine Pure Powder &#8211; Technical Summary and Naturokinetics <\/a>(2018)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-c6268897887a1703f7d494bbcfa333d4\">Liposomal Curcumin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 6\u201342 minutes (plasma) \/ up to 2 hours (tissue). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Curcumin is characterized by extremely low water solubility and rapid metabolism. The liposomal formulation is developed as a delivery system that protects the molecule and significantly increases bioavailability compared to standard curcumin extract (Prasad et al., 2014). However, a clinical pharmacokinetic phase 1 trial (Bolger et al., 2017) of the liposomal form (Lipocurc\u2122) shows that the substance is still rapidly eliminated from the bloodstream with a plasma half-life of between 24 and 42 minutes in humans following infusion. Although the substance is effectively distributed to tissues such as the liver and lungs, it is rapidly converted by reductases into the metabolite tetrahydrocurcumin (THC) and undergoes phase II conjugation into glucuronide and sulfate forms (Li et al., 2024). Since the active curcuminoids are rapidly metabolized and excreted, the washout period is set at 2 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-2af27983482a9d4f2d920e939fa39379 wp-block-paragraph\">[A] <a href=\"https:\/\/ar.iiarjournals.org\/content\/37\/7\/3483\" target=\"_blank\" rel=\"noopener\">Bolger et al.: Distribution and Metabolism of Lipocurc\u2122 (Liposomal Curcumin) in Dog and Human Blood Cells: Species Selectivity and Pharmacokinetic Relevance<\/a> (Anticancer Research, 2017)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-228026b970ef65679665819682e7e13c wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1999-4923\/16\/11\/1459\" target=\"_blank\" rel=\"noopener\">Li et al.: Comparative Pharmacokinetic Assessment of Curcumin in Rats Following Intratracheal Instillation Versus Oral Administration: Concurrent Detection of Curcumin and Its Conjugates in Plasma by LC-MS\/MS<\/a> (Pharmaceutics, 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ada0223cb4149de98630cf0f065700ec wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3918523\/\" target=\"_blank\" rel=\"noopener\">Prasad et al.: Recent Developments in Delivery, Bioavailability, Absorption and Metabolism of Curcumin:&nbsp;the Golden Pigment from Golden Spice<\/a> (Cancer Research and Treatment, 2014)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-orange-background-color has-text-color has-background has-link-color wp-elements-d2a94d75e85aec922e1ebece8f64e58d\">Luteolin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 5\u20139 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 4 (orange).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Luteolin is a natural flavonoid with antioxidant and anti-inflammatory properties being investigated for its ability to modulate signaling pathways in cancer cells (Wang et al., 2024). Human studies show that the substance is absorbed rapidly, with peak concentrations occurring after 1\u20132 hours, but it has low bioavailability of the free aglycone at approximately 17.5% due to extensive metabolism in the gut and liver (Lv et al., 2025). As specific human curve data for elimination are lacking, data from pharmacokinetic animal models (phase 1) (Sarawek et al., 2008) are utilized, showing a half-life for free luteolin of 8.94 hours and approximately 5\u20137 hours for the conjugated metabolites. Based on the moderate metabolic rate and documented metabolism, the washout period is set at 2 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3a5126dcdbc908aaae1368d26c9564e5 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11346905\/\" target=\"_blank\" rel=\"noopener\">Wang et al.: Progress, pharmacokinetics and future perspectives of luteolin modulating signaling pathways to exert anticancer effects: A review<\/a> (Medicine (Baltimore), 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b83f719e8a142db51aed283c90e0b6fb wp-block-paragraph\">[B] <a href=\"https:\/\/www.frontiersin.org\/journals\/pharmacology\/articles\/10.3389\/fphar.2025.1535555\/full\" target=\"_blank\" rel=\"noopener\">Lv et al.: Luteolin: exploring its therapeutic potential and molecular mechanisms in pulmonary diseases<\/a> (Frontiers in Pharmacology, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4380aaec81ca06a6529f133f7424980a wp-block-paragraph\">[C] <a href=\"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1934578X0800301218\" target=\"_blank\" rel=\"noopener\">Sarawek et al.: Pharmacokinetics of Luteolin and Metabolites in Rats<\/a> (Natural Product Communications, 2008)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-d4235f7b9176b3c559e325d1fa461f82\">Lysine<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 15\u201316 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 4 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> L-Lysine is an essential amino acid crucial for protein synthesis and collagen formation, as detailed in a comprehensive review article (Hole\u010dek, 2025), which describes the latest insights into the substance&#8217;s physiological significance in humans. Clinical pharmacokinetic phase 1 studies (Capparelli, 2007) have demonstrated an average plasma elimination half-life of 15.72 \u00b1 3.76 hours. Lysine is actively transported into cells, resulting in tissue concentrations significantly higher than those in plasma. The assessment of the amino acid&#8217;s safety profile and metabolic adaptation relies on toxicokinetic review studies (Bier, 2003), which define the framework for safe intake. Since lysine has a relatively long half-life and influences immune and growth processes via lysine-arginine antagonism, the washout period is set at 4 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1c387a8819594d15bb1773b83881c9bd wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12469518\/\" target=\"_blank\" rel=\"noopener\">Hole\u010dek: Lysine: Sources, Metabolism, Physiological Importance, and Use as a Supplement<\/a> (International Journal of Molecular Sciences, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-993fc84b621e15e42acdb5449b8d02bd wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3462098\/\" target=\"_blank\" rel=\"noopener\">Capparelli: Pharmacologic, Pharmacodynamic, and Pharmacokinetic Considerations with Intravenous Ibuprofen Lysine<\/a> (The Journal of Pediatric Pharmacology and Therapeutics, 2007)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d4a11c117796b3ae15cd710e08b3ff4c wp-block-paragraph\">[C] <a href=\"https:\/\/jn.nutrition.org\/article\/S0022-3166(22)15989-4\/fulltext\" target=\"_blank\" rel=\"noopener\">Bier: Amino Acid Pharmacokinetics and Safety Assessment<\/a> (The Journal of Nutrition, 2003)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-3380601b3177cc85bc81ce1fd6d89820\">Magnesium<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 5.2 hours (plasma) \/ approx. 40 days (biological\/tissue). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Magnesium is a vital cation and an essential cofactor for over 300 enzymatic reactions, including energy production via ATP metabolism and DNA synthesis. A comprehensive review article (Gr\u00f6ber, 2019) highlights how the substance shares transport and metabolic pathways with numerous drugs, creating a risk for interactions. Clinical pharmacokinetic phase 1 studies (Okusanya et al., 2015) of magnesium sulfate have established a plasma half-life of approximately 5.2 hours, which contrasts with the total biological half-life of approximately 42 days reported in DrugBank (2018). This marked difference is due to the fact that over 50% of the body&#8217;s magnesium is deposited in bone tissue, which acts as a slow exchange reservoir. Since magnesium in the bloodstream is excreted exclusively via the kidneys in proportion to serum concentration, the washout period is set at 2 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d3ec4a46e93311055ff2059453ac56be wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6539869\/\" target=\"_blank\" rel=\"noopener\">Gr\u00f6ber et al.: Magnesium and Drugs<\/a> (PubMed, International Journal of Molecular Sciences, 2019)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3f07ad864edde4c7f935affabbc0bf76 wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4737322\/\" target=\"_blank\" rel=\"noopener\">Okusanya et al.: Clinical pharmacokinetic properties of magnesium sulphate in women with pre\u2010eclampsia and eclampsia<\/a> (BJOG, 2015)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8098c10baf2375c09e96b15812fc8e8c wp-block-paragraph\">[C] <a href=\"https:\/\/go.drugbank.com\/drugs\/DB14513\" target=\"_blank\" rel=\"noopener\">DrugBank: Magnesium &#8211; Summary, Mechanism of Action and Pharmacokinetics<\/a> (2018)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-6948894e5fd922ecc84b4e1edef8f765\">Milk Thistle (Silymarin\/ Silybin)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 1\u20133 hours (free) \/ 3\u20138 hours (conjugated). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Milk thistle contains the silymarin complex, in which silybin is the primary active component with antioxidant and anti-inflammatory properties. Clinical pharmacokinetic phase 1 studies (Wen, Dumond et al., 2008) show that silymarin-flavonolignans are absorbed rapidly but are also eliminated promptly. After absorption, the substance undergoes extensive phase II metabolism (glucuronidation and sulfation), resulting in the majority being found in conjugated form with a half-life of up to 8 hours. Xie et al. (2019) further document that silybin undergoes enterohepatic recirculation (reabsorption from the gut), which extends the substance&#8217;s presence in the organism. Efflux transporters such as MRP2 contribute to limiting systemic availability. Since silybin and its metabolites are excreted via bile and kidneys but are recirculated in the process, the washout period is set at 2 days to ensure complete clearance.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ae1ca1c67cced8ff7864a5ebda39436d wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17913795\/\" target=\"_blank\" rel=\"noopener\">Wen Z., Dumond J et al.: Pharmacokinetics and metabolic profile of free, conjugated, and total silymarin flavonolignans in human plasma after oral administration of milk thistle extract<\/a> (NIH, Drug Metabolism and Disposition, 2008)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a24f257e7fcd461dcc776ef1ef47efdb wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1420-3049\/24\/20\/3693\" target=\"_blank\" rel=\"noopener\">Xie et al.: Metabolism, Transport and Drug\u2013Drug Interactions of Silymarin<\/a> (Molecules, 2019)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-762f9900789281fda4666c86202593ba\">Melatonin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 40\u201360 minutes. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 1 day. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Melatonin is an endogenous hormone that regulates the body&#8217;s circadian rhythm via interaction with MT1 and MT2 receptors in the brain. In a clinical cohort crossover phase 1 study (Andersen et al., 2016), the pharmacokinetics of both oral and intravenous melatonin were investigated in healthy volunteers. The study demonstrated that melatonin undergoes extremely extensive &#8220;first-pass&#8221; metabolism in the liver, resulting in a very low oral bioavailability averaging 2.5% to 3%. The elimination half-life was measured at 54 minutes after oral ingestion and 39 minutes after intravenous infusion, respectively. The primary metabolic pathway is through the liver&#8217;s CYP1A2 enzymes, where the hormone is converted to 6-hydroxymelatonin, which is subsequently conjugated and excreted in the urine (Savage et al., 2024). While standard formulations have a short duration of action, prolonged-release formulations (e.g., Circadin) have an extended half-life of 3.5 to 4 hours (Wikipedia, 2024). Due to the rapid metabolic turnover, the washout period is set at 1 day.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8585fd0f9c6921a0bb7fdfae9e9692fd wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4759723\/\" target=\"_blank\" rel=\"noopener\">Andersen et al.: Pharmacokinetics of oral and intravenous melatonin in healthy volunteers<\/a> (BMC Pharmacology and Toxicology, 2016)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e25e7ad02f031d5904bc3220b6416116 wp-block-paragraph\">[B] <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534823\/\" target=\"_blank\" rel=\"noopener\">Savage et al.: Melatonin &#8211; StatPearls<\/a> (NCBI Bookshelf, 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-39d6a3153d7c699984bbfe7382af0878 wp-block-paragraph\">[C] <a href=\"https:\/\/en.wikipedia.org\/wiki\/Melatonin_as_a_medication_and_supplement\" target=\"_blank\" rel=\"noopener\">Wikipedia: Melatonin as a medication and supplement &#8211; Pharmacokinetics<\/a><\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-0b76f98b2389bba718c06139b201fe71\">Metformin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 1.5\u20136.2 hours (plasma) \/ approx. 17.6\u201323.4 hours (erythrocytes). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 5 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Metformin is a biguanide that lowers blood sugar by inhibiting hepatic glucose production and improving insulin sensitivity. A comprehensive review of metabolic pathways (Gong et al., 2012) states that metformin does not undergo hepatic metabolism at all but is excreted 100% unchanged via the kidneys. The oral bioavailability is approximately 40\u201360%, and absorption is dependent on specific transporters such as OCT1 and OCT2. Clinical pharmacokinetic phase 1 studies (Xie et al., 2015) explain the significant difference in half-lives by the fact that metformin distributes into erythrocytes (red blood cells). While elimination from plasma occurs rapidly (half-life approx. 6.2 hours), the repartitioning from blood cells back into plasma is very slow (half-life approx. 32\u201339 hours), resulting in a terminal half-life in whole blood of up to 23.4 hours. Since the substance is exclusively excreted renally and persists in the blood cells, the washout period is set at 5 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-45db72c2ae7a7e3034c8ad43d16428e6 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3651676\/\" target=\"_blank\" rel=\"noopener\">Gong et al.: Metformin pathways: pharmacokinetics and pharmacodynamics<\/a> (Pharmacogenetics and Genomics \/ PMC, 2013)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-cd55eb00e8063863154e5dd96dd0b387 wp-block-paragraph\">[B] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0022356524190787\" target=\"_blank\" rel=\"noopener\">Xie et al.: Metformin&#8217;s Intrinsic Blood-to-Plasma Partition Ratio (B\/P) <\/a>(Journal of Pharmacology and Experimental Therapeutics, 2015)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-12ffcac48b08c3846487e6a7891f6142\">Lactic acid bacteria (Probiotic)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> N\/A &#8211; excreted continuously during passage (Transit time: approx. 24\u201348 hours \/ Persistence: 3\u20136 days). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days (based on normal intestinal transit). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Note:<\/strong> In cases of risk for severe neutropenia or specific immunotherapy, 6 days is recommended to ensure complete fecal washout. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Lactic acid bacteria are living microorganisms whose effects depend on their ability to survive passage through the gastrointestinal tract. A clinical pilot phase 1 study (Tremblay et al., 2023) investigated the correlation between total whole gut transit time (WGTT) and bacterial persistence. The study documents that the bacteria are detected in the stool 1\u20132 days after ingestion and that most strains are washed out 3\u20136 days after discontinuation. Transit time varies individually, but the study confirms that the bacteria do not colonize the gut permanently but are excreted continuously. A review article (Bezkorovainy, 2001) supports this, estimating that only 20\u201340% of the ingested bacteria survive the passage to the colon. Since the bacteria do not accumulate systemically and are washed out rapidly in accordance with intestinal transit, the washout period is set at 2 days. For patients with severely compromised immune systems (neutropenia) or those undergoing treatment with checkpoint inhibitors, the period is extended to 6 days to eliminate any metabolic or immunological interaction.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-7b3b64ed2f97876875782bfcbea87569 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10083121\/\" target=\"_blank\" rel=\"noopener\">Tremblay et al.: Total Transit Time and Probiotic Persistence in Healthy Adults<\/a> (PubMed, Journal of Neurogastroenterology and Motility, 2023)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-568acb33237ba42a34f2c2c555c6bea3 wp-block-paragraph\">[B] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0002916523065048\" target=\"_blank\" rel=\"noopener\">Bezkorovainy: Probiotics: determinants of survival and growth in the gut<\/a> (The American Journal of Clinical Nutrition, 2001)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-140f08f50546fd05fd581de0f17d9dcb\">NAC (N-acetylcysteine)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 2.0\u20136.3 hours (plasma) \/ approx. 15\u201319 hours (terminal\/tissue). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 4 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> N-acetylcysteine (NAC) is a thiol-containing compound that serves as a central precursor for the synthesis of glutathione (GSH), the body&#8217;s primary intracellular antioxidant. A comprehensive review article (dos Santos Ten\u00f3rio et al., 2021) describes how NAC exerts its effects by both restoring cellular redox balance and inhibiting inflammation through the suppression of NF-\u03baB and reduction of cytokines such as IL-6 and TNF-\u03b1. Clinical pharmacokinetic phase 1 studies (Olsson et al., 1988) have demonstrated low oral bioavailability of free NAC (approx. 4\u20139%) due to extensive first-pass metabolism, where the substance is rapidly deacetylated to cysteine. A more recent phase 1 study (Papi et al., 2020) has established that while the plasma half-life is short (approx. 2 hours), the terminal half-life for total NAC is significantly longer (approx. 15\u201319 hours), reflecting protein binding and the formation of disulfides. Since NAC is primarily excreted renally and metabolized into natural amino acids, the washout period is set at 4 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-6a279e9893c666c031604870f36408a6 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7854405\/\" target=\"_blank\" rel=\"noopener\">Pharmacokinetics and Safety of Single and Multiple Doses of Oral N-Acetylcysteine in Healthy Chinese and Caucasian Volunteers: An Open-Label, Phase I Clinical Study<\/a> (Adv Ther, 2020)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-0087af190f4923bede70622954d3900b wp-block-paragraph\">[B] <a href=\"https:\/\/europepmc.org\/article\/med\/3360052\" target=\"_blank\" rel=\"noopener\">Olsson et al.: Pharmacokinetics and bioavailability of reduced and total N-acetylcysteine<\/a> (Eur J Clin Pharmacol, 1988)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c151351fb1d239df2c9b1bd470b7fe02 wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8234027\/\" target=\"_blank\" rel=\"noopener\">dos Santos Ten\u00f3rio et al.: N-Acetylcysteine (NAC): Impacts on Human Health<\/a> (PubMed, Antioxidants, 2021)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-9c458febe8dcf50c12eafff7fc0d7b95\">Niacin (B3)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life:<\/strong> 20\u201345 minutes (niacin) \/ approx. 4.3 hours (the metabolite nicotinamide). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout:<\/strong> 2 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of Evidence:<\/strong> 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation:<\/strong> Niacin (nicotinic acid) is an essential B-vitamin used in gram doses as a lipid-regulating agent through conversion to the coenzyme NAD. A pharmacokinetic phase 1 study (Menon et al., 2007) of extended-release (ER) niacin shows that niacin undergoes rapid and extensive metabolism via two primary pathways: conjugation with glycine to nicotinuric acid (NUA) and the formation of nicotinamide (NAM). While niacin itself has a very short plasma half-life of under one hour, the metabolite nicotinamide persists significantly longer (half-life approx. 4.3 hours). Clinical investigations of patients with impaired renal function (Reiche et al., 2011) indicate that although certain metabolites like NUA accumulate in dialysis patients, no dose adjustment is required as niacin kinetics themselves remain stable. FDA documentation confirms that approximately 60\u201370% of a dose is excreted renally within 96 hours, primarily as metabolites, and that only about 3% is excreted as unchanged niacin. Since both the active substance and its primary metabolites have a rapid turnover and do not accumulate systemically to a significant degree in healthy individuals, the washout period is set at 2 days.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-40803d8b0ccc90ce99bbcde039036983 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17725178\/\" target=\"_blank\" rel=\"noopener\">Menon et al.: Plasma and urine pharmacokinetics of niacin and its metabolites from an extended-release niacin formulation<\/a> (PubMed, Int J Clin Pharmacol Ther, 2007)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-416430d89479bea9c715a0d0bdeac0d0 wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20562093\/\" target=\"_blank\" rel=\"noopener\">Reiche et al.: Pharmacokinetics of extended-release nicotinic acid in patients with chronic kidney disease<\/a> (Nephrology Dialysis Transplantation, 2011)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-acc3b91dbc7195fb54616062a5145972 wp-block-paragraph\">[C] <a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2012\/021249s029lbl.pdf\" target=\"_blank\" rel=\"noopener\">FDA: Advicor (niacin extended-release\/lovastatin) &#8211; Clinical Pharmacology<\/a> (AccessData FDA)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-her-st-r-du-background-color has-text-color has-background has-link-color wp-elements-6ee1eeb7f9716f700d414877a95fb4a6\">Nigella Sativa (Black Cumin)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: Not detectable in human serum (due to immediate protein binding and instability). However, note reaction during chemotherapy. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 4 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 3 (yellow).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Nigella Sativa contains thymoquinone (TQ). A comprehensive review of clinical trials up to March 2025 (Gouda et al., 2025) shows potential, but also limitations due to low bioavailability. A human trial (Tekba\u015f et al., 2023) has confirmed that TQ is not measurable in the blood after oral ingestion due to immediate protein binding (&gt;99%). Although human data for elimination are limited, a study in rats (Ahmad et al., 2025) demonstrates that TQ is a potent inhibitor of CYP3A4, which increased the exposure of oncological medicine (Dasatinib) by over 200%. Due to this strong enzymatic impact seen in animal models, and the uncertainty of transferring this to humans, a precautionary washout of 4 days (96 hours) is established to ensure full enzymatic normalization before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5b6eaba937ead50fc3911f0e635261ca wp-block-paragraph\"><strong>Link: <\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-22fc3eaa275f8cb7f059ca44059df268 wp-block-paragraph\">[A] <a href=\"https:\/\/www.medsci.org\/v22p3939.pdf\" target=\"_blank\" rel=\"noopener\">Ahmad A. et al.: Drug Interaction of Dasatinib with Thymoquinone: A<br>Pharmacokinetic Study in Rats<\/a> (Int. J. Med. Sci., 2025) \u2013 <em>Documentation for 200% increase in drug concentration in rats<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-732e6cfc41159eeb2a03cfbc3a271add wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1422-0067\/24\/22\/16431\" target=\"_blank\" rel=\"noopener\">Tekba\u015f A. et al.: Gas Chromatography\u2013Mass Spectrometry Detection of Thymoquinone in Oil and Serum for Clinical Pharmacokinetic Studies<\/a> (MDPI, Int. J. Mol. Sci., 2023) \u2013 <em>Human source proving rapid binding and elimination from serum.<\/em><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-addff80cb0215a7d0a6710bf59d00fba wp-block-paragraph\">[C] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2950199725001417\" target=\"_blank\" rel=\"noopener\">Gouda Y. A. et al.: Thymoquinone and therapeutic potentials: Updated evidences from clinical trials<\/a> (Pharmacological Research, 2025) \u2013 <em>Compilation of clinical evidence up to March 2025.<\/em><\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-aeef207ae351e9a5110e6f805cfe286d\">Omega-3 (EPA\/DHA)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 37\u201379 hours (EPA) \/ approx. 46 hours (DHA). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 21 days (deviation: incorporation into platelet membranes requires full replacement of cells). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Omega-3 fatty acids (EPA and DHA) are well-investigated through direct evidence from human studies. A randomized phase 1 trial (Braeckman et al., 2013) conducted on healthy volunteers has measured the terminal half-lives for EPA to an average of 79 hours with regular intake. Another phase 1 trial (Lapointe et al., 2019) confirms the kinetic profile of the fatty acids and demonstrates that they achieve steady-state after 7\u201310 days of treatment. FDA documentation (FDA, 2014) and data from DrugBank (DrugBank, 2024) state that DHA has a half-life of approx. 46 hours. Although the mathematical elimination from plasma is faster, the washout period is conservatively set at 21 days because the fatty acids are physically incorporated into the phospholipids of the cell membranes and affect platelet function long after they are out of the blood. This ensures complete clearance from both plasma and tissue stores before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-af44461763a79a051f53278bb555341d wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4467252\/\" target=\"_blank\" rel=\"noopener\">Braeckman et al.: Pharmacokinetics of Eicosapentaenoic Acid in Plasma and Red Blood Cells After Multiple Oral Dosing With Icosapent Ethyl in Healthy Subjects<\/a> (Clin Pharmacol Drug Dev., 2013)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5193f4b9bc2cd2031e991767dc44bdb8 wp-block-paragraph\">[B] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0149291819304990\" target=\"_blank\" rel=\"noopener\">Lapointe et al.: Evaluation of OM3-PL\/FFA Pharmacokinetics After Single and Multiple Oral Doses in Healthy Volunteers<\/a> (Clinical Therapeutics, 2019)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-938f180f6b25bc14304d38c8c67e9a46 wp-block-paragraph\">[C] <a href=\"https:\/\/go.drugbank.com\/drugs\/DB13961\" target=\"_blank\" rel=\"noopener\">DrugBank: Fish Oil &#8211; Identification, Pharmacology and Pharmacokinetics<\/a> (DrugBank Online, 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e34186acf5fb171a92a4b2e725cd424a wp-block-paragraph\">[D] <a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2014\/205060Orig1s000ClinPharmR.pdf\" target=\"_blank\" rel=\"noopener\">FDA: Epanova (omega-3-carboxylic acids) &#8211; Clinical Pharmacology and Biopharmaceutics Review<\/a> (AccessData FDA, 2013)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-orange-background-color has-text-color has-background has-link-color wp-elements-76960497c1d0297b3176db06e4438108\">Pao Pereira<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 12\u201324 hours (based on preclinical models). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 5 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 4 (orange).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: The preparation is extracted from the bark of Geissospermum vellosii and contains beta-carboline alkaloids. A preclinical study ([A] Bemis et al., 2009) conducted on mice demonstrates tumor-inhibiting effects, and another preclinical study ([B] Yu &amp; Chen, 2014) shows that the extract potentiates the effect of carboplatin. As only preclinical data and no human measurements for elimination exist, an increased safety margin is used (Level 4). The half-life is estimated at 12\u201324 hours based on metabolic indicators in animal models. The washout period of 5 days serves as a deliberate &#8220;over-insurance&#8221; to eliminate the risk of interaction with oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-68f2ed6840f53f368c338e68c1325b52 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19476740\/\" target=\"_blank\" rel=\"noopener\">Bemis et al.: beta-carboline alkaloid-enriched extract from the amazonian rain forest tree pao pereira suppresses prostate cancer cells<\/a> (PubMed, 2009)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-c63ddd02a871b25a0ed12ac858cf3b50 wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24033267\/\" target=\"_blank\" rel=\"noopener\">Yu &amp; Chen: The plant extract of Pao pereira potentiates carboplatin effects against ovarian cancer<\/a> (PubMed, 2014)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-c60b7e5802a81d41cb3eaad115442a57\">Papaya leaf extract<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 24\u201348 hours (based on preclinical excretion rate). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 10 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Papaya leaf extract (Carica papaya) has been clinically investigated for its ability to increase platelet counts. A randomized, placebo-controlled pilot study ([C] Sathyapalan et al., 2020) conducted on adult patients with dengue fever and severe thrombocytopenia documents that the extract is safe, well-tolerated, and effective in accelerating the recovery of platelet counts. The study further indicates potential immunomodulatory and antiviral activity through influence on cytokine levels (e.g., IL-6 and TNF\u03b1). Since clinical data in humans confirm safety and biological effect, but pharmacokinetic animal studies ([A] ResearchGate, 2025) demonstrate a very slow elimination phase, where only 4.73% of the substance was excreted after 48 hours, the preparation is placed at Level 1 for clinical evidence, while the washout period is kept conservative. The washout period is set at 10 days to ensure complete elimination of the active metabolites before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5bc6a1e660d4f1c48ffd5e4b2def05a4 wp-block-paragraph\">[A] <a href=\"https:\/\/www.researchgate.net\/publication\/329379258_Pharmacokinetic_aspect_of_Carica_papaya_leaf_extract_after_oral_administration\" target=\"_blank\" rel=\"noopener\">Nugrahaningsih Wh et al.: Pharmacokinetic aspect of Carica papaya leaf extract after oral administration<\/a> (ResearchGate, 2025) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4150e7d44652fd319a965988c25e6b0a wp-block-paragraph\">[B] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9203216\/\" target=\"_blank\" rel=\"noopener\">Sharma et al.: Carica papaya L. Leaves: Deciphering Its Antioxidant Bioactives, Biological Activities, Innovative Products, and Safety Aspects<\/a> (PMC, 2022)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-dfd011455eda6bb1b014001845352e55 wp-block-paragraph\">[C] <a href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0228699\" target=\"_blank\" rel=\"noopener\">Dipu T. Sathyapalan et al.: Papaya ved trombocytop\u00e6ni: Efficacy &amp; safety of&nbsp;<em>Carica papaya<\/em>&nbsp;leaf extract (CPLE) in severe thrombocytopenia (\u226430,000\/\u03bcl) in adult dengue \u2013 Results of a pilot study<\/a> (Plus One, 2020)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-hvid-tekst-background-color has-background\">Pau D\u2019Arco<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 24\u201348 hours (based on clinical toxicity data). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 10 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Pau D\u2019Arco (Tabebuia impetiginosa) contains the active naphthoquinones lapachol and beta-lapachone. The preparation has been the subject of extensive clinical investigations, including trials under the auspices of the National Cancer Institute (NCI) in the 1970s ([A] de Almeida, 2009). Although lapachol exhibited antitumor activity in human clinical phase 1 trials, further development was halted due to toxicity at therapeutic doses. A review of the biological mechanisms ([B] Castellanos et al., 2009) confirms that the substance interferes with the vitamin K cycle, which affects coagulation. Recent evaluations of human and animal studies ([C] Almeida, 2013) demonstrate that lapachol has the ability to reduce tumor pain and induce remission, but also emphasize the complex metabolic interactions. Since the clinical trials in humans document both efficacy and significant systemic impact (Level 1), the half-life is estimated at 24\u201348 hours. The washout period is conservatively set at 10 days to ensure that the impact on coagulation factors and DNA enzymes has ceased before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ef1914888ae28fdc57054991e4539d3b wp-block-paragraph\">[A] <a href=\"https:\/\/benthamopenarchives.com\/abstract.php?ArticleCode=TONPJ-2-42\" target=\"_blank\" rel=\"noopener\">de Almeida: Preclinical and Clinical Studies of Lapachol and Beta-Lapachone<\/a> (The Open Natural Products Journal, 2009) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8d0ac15058f1e8c0f100fae623bffe16 wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18992801\/\" target=\"_blank\" rel=\"noopener\">Castellanos et al.: Red Lapacho (Tabebuia impetiginosa)&#8211;a global ethnopharmacological commodity?<\/a> (PubMed, 2009) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5020ee8dac10ad157555decf94bc662b wp-block-paragraph\">[C] <a href=\"https:\/\/www.researchgate.net\/publication\/268378689_Lapachol_and_its_derivatives_as_potential_drugs_for_cancer_treatment\" target=\"_blank\" rel=\"noopener\">Almeida: Lapachol and its derivatives as potential drugs for cancer treatment <\/a>(ResearchGate, 2013)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-d60950ff345a07bca7a33d097d6eada1\">Quercetin<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: Approx. 11 hours (terminal elimination phase). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Quercetin is a well-investigated flavonoid with extensive human data. A randomized crossover study ([A] Graefe et al., 2001) of 12 healthy volunteers documents that the terminal elimination half-life is approximately 11 hours, regardless of whether the substance is ingested as isolated glycosides or via a plant matrix (e.g., onion or buckwheat). The study further demonstrates that free quercetin cannot be measured in plasma, as it is rapidly converted into glucuronides. Recent randomized clinical trials ([C] Joseph et al., 2022) confirm the rapid biotransformation and show that modern delivery systems can significantly increase bioavailability, but without fundamentally changing the metabolic clearance. A systematic review ([B] Fren\u021b et al., 2024) emphasizes the many biological effects, including the influence on inflammatory signaling pathways. Since elimination is primarily hepatic and the half-life is clinically verified in humans, the washout period is set at 3 days to ensure complete elimination before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9104ec9ef6b2cbe17552b5d38017f3de wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11361045\/\" target=\"_blank\" rel=\"noopener\">Graefe et al.: Pharmacokinetics and bioavailability of quercetin glycosides in humans<\/a> (PubMed, 2001)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-e9740de53cda8d62f6a35a5a5443b803 wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/1422-0067\/25\/22\/12091\" target=\"_blank\" rel=\"noopener\">Fren\u021b et al.: A Systematic Review: Quercetin\u2014Secondary Metabolite of the Flavonol Class<\/a> (MDPI, 2024)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8ebe9e96177e7620359f6da09f60e186 wp-block-paragraph\">[C] <a href=\"https:\/\/pubs.acs.org\/doi\/10.1021\/acsomega.2c05929\" target=\"_blank\" rel=\"noopener\">Joseph et al.: Enhanced Bioavailability and Pharmacokinetics of a Natural Self-Emulsifying Reversible Hybrid-Hydrogel System of Quercetin<\/a> (ACS Omega, 2022)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-56a805aab3363950b54c960d462b7e15\">Resveratrol<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 2\u20135 hours (at single dose) \/ up to 9.7 hours (at sustained intake). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Resveratrol has been extensively clinically investigated in humans. Systematic reviews and clinical phase 1 trials ([A] Patel et al., 2011; [B] Mu\u00f1oz et al., 2015) show that the substance is absorbed effectively (approx. 70%), but has a low bioavailability of around 1% due to rapid and extensive metabolism in the liver (cytochrome P450) and the gut microbiota. At a single dose, the half-life is short (approx. 2\u20135 hours), but with daily administration over 21 days, an accumulation effect is observed where the half-life increases to 9.7 hours ([B] Mu\u00f1oz et al., 2015). Recent pharmacokinetic evaluations from 2025 ([C] Wang et al., 2025) confirm that modern formulations can significantly increase the absorption rate and bioavailability, but that the overall elimination pathways remain rapid. As the substance in high doses (over 2.5 g) can cause gastrointestinal side effects and affects growth factors such as IGF-1, the washout period is set at 3 days to ensure complete clearance of both the parent compound and the dominant sulfate and glucuronide metabolites before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8c66d2f0645e11b31ff2d1fd4c398261 wp-block-paragraph\">[A] <a href=\"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/full\/10.1111\/j.1749-6632.2010.05853.x#b10\" target=\"_blank\" rel=\"noopener\">Patel et al.: Clinical trials of resveratrol<\/a> (Annals of the New York Academy of Sciences, 2011) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5061966d57c6534598f6795fb9d09223 wp-block-paragraph\">[B] <a href=\"https:\/\/www.longdom.org\/open-access\/pharmacological-properties-of-resveratrol-a-preclinical-and-clinical-review-12536.html\" target=\"_blank\" rel=\"noopener\">Mu\u00f1oz et al.: Pharmacological Properties of Resveratrol. A Pre-Clinical and Clinical Review<\/a> (Biochemistry &amp; Pharmacology, 2015) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b341c3c4f166be87ddd41dacef5a51e7 wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12238501\/\" target=\"_blank\" rel=\"noopener\">Wang et al.: Pharmacokinetic evaluation of two oral Resveratrol formulations in a randomized, open-label, crossover study<\/a> (Scientific Reports\/Nature, 2025)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-d28a0578806782b2d6c913a245e621fd\">Rhodiola rosea<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 4\u20136 hours (for the active main component salidroside). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Rhodiola rosea is clinically verified through a phase III randomized, double-blind, and placebo-controlled trial ([A] Olsson et al., 2009) of the standardized extract SHR-5, which demonstrated a significant effect on stress-related fatigue and a reduction in the cortisol response. A comprehensive review article ([D] Bertollo et al., 2026) emphasizes the plant&#8217;s therapeutic potential in psychiatric care through modulation of neurotransmitters and the HPA axis, but simultaneously warns of the risk of herb-drug interactions. Pharmacokinetic overviews ([B] Fan et al., 2020) and clinical reviews indicate that the terminal half-life for the active component salidroside is approx. 4\u20136 hours in humans. Since the preparation has a direct biological impact on the body&#8217;s stress hormones (cortisol) and neuroinflammatory signaling pathways, the washout period is set at 3 days to ensure complete clearance and stabilization of the hormonal systems before oncological treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-cd3afabcf9f73e535c8be46bdbf11d78 wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19016404\/\" target=\"_blank\" rel=\"noopener\">Olsson et al.: A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue<\/a> (PubMed, 2009) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3570c1ecee8252b8569819ed60a9701e wp-block-paragraph\">[B] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S075333222030651X\" target=\"_blank\" rel=\"noopener\">Fan et al.: Salidroside as a potential neuroprotective agent: a review of pharmacokinetics and safety<\/a> (ScienceDirect, 2020) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-38e1a547e4b52a143c5e5c9061a81669 wp-block-paragraph\">[C] <a href=\"https:\/\/www.mdpi.com\/2076-3425\/16\/2\/223\" target=\"_blank\" rel=\"noopener\">Bertollo et al.: Medicinal Plants for Major Depressive Disorder<\/a> (MDPI \/ Brain Sciences, 2026)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-3b11a4d497739079d6ff4d0730d61ff9\">Mushrooms (medicinal)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 0.5\u20131 hour (triterpenes)\/ up to 24 hours (for beta-glucan interaction). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 5 days (deviation: based on immunological interaction from beta-glucans). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Medicinal mushrooms such as <em>Ganoderma lucidum<\/em> (Reishi) are clinically well-documented through several randomized controlled trials (RCTs) and meta-analyses ([A] Lucius, 2025; [B] Jin et al., 2016). A study ([A] Lucius, 2025) demonstrates that the active triterpenes (ganoderic acids) are absorbed and eliminated very rapidly with a terminal half-life of only 0.66 hours. The beta-glucans have a low direct bioavailability (0.5\u20135%) but exert their primary immunomodulatory effect through sustained interaction with the gut microbiota and immune cells ([C] Kirdeeva et al., 2026). Clinical evidence shows that Reishi improves quality of life and immune status (CD3, CD4, NK cells) in cancer patients without negatively affecting liver or kidney function ([A], [B]). Since the mushrooms contain complex polysaccharides that can interact with the immune system over a longer period, the washout period is set at 5 days to ensure that the immunological and enzymatic impact (CYP450) is normalized before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-0e88c03e7b5b9a02178394ae50103e40 wp-block-paragraph\">[A] <a href=\"https:\/\/journals.sagepub.com\/doi\/10.1089\/ict.2024.56835.luc\" target=\"_blank\" rel=\"noopener\">Lucius: Clinical Evidence for the Use of Ganoderma lucidum Medicinal Mushroom<\/a> (Sage Journals, Integrative and Complementary Therapies, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d404ba52ceedb2aef71370f804ddedd5 wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27045603\/\" target=\"_blank\" rel=\"noopener\">Jin et al.: Ganoderma lucidum (Reishi mushroom) for cancer treatment <\/a>(Cochrane Database, 2016)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-56f95247ab32d446c4957231a3e5ee74 wp-block-paragraph\">[C] Kirdeeva et al.: <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12897983\/\" target=\"_blank\" rel=\"noopener\">The Inclusion of Dietary and Medicinal Mushrooms into Translational Oncology: Pros and Cons at the Molecular Level<\/a> (MDPI \/ IJMS, 2026)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-e3ea43aeb5147f94b6ec4ea7a13c56f2\">Sulforaphane<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 2\u20133 hours. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days (72 hours) (deviation: based on persistence of active nitrile metabolites). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Sulforaphane is clinically verified in humans through randomized clinical trials ([A] Egner et al., 2011; [B] Bouranis et al., 2023). Human pharmacokinetics establish a terminal half-life of 2\u20133 hours for free sulforaphane. Recent human data ([B]), however, show that the metabolite sulforaphane-nitrile has a significantly slower excretion profile and can be traced in the body for up to 72 hours after ingestion. Since this sustained presence of metabolites affects the liver&#8217;s detoxification enzymes (phase 2 enzymes), which are critical for the metabolism of oncological medicine ([C] Yagishita et al., 2019), the washout period is set at 3 days to ensure complete elimination and normalization of enzyme activity before treatment.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-119d94c0ef332fd1c767a380c172eca7 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3076202\/\" target=\"_blank\" rel=\"noopener\">Egner et al.: Bioavailability of sulforaphane from two broccoli sprout beverages: Results of a short term, cross-over clinical trial in Qidong, China<\/a> (Cancer Prevention Research, 2011) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-07f8ac963a9ef6a5208e935889657dd6 wp-block-paragraph\">[B] <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mnfr.202300286\" target=\"_blank\" rel=\"noopener\">Bouranis et al.: Sulforaphane and Sulforaphane-Nitrile Metabolism in Humans Following Broccoli Sprout Consumption: Inter-individual Variation, Association with Gut Microbiome Composition, and Differential Bioactivity<\/a> (Molecular Nutrition &amp; Food Research, 2023) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-04cc77b999070e57185afee3dbb90d6c wp-block-paragraph\">[C] <a href=\"https:\/\/www.mdpi.com\/1420-3049\/24\/19\/3593\" target=\"_blank\" rel=\"noopener\">Yagishita et al.: Broccoli or Sulforaphane: Is It the Source or Dose That Matters?<\/a> (MDPI \/ Molecules, 2019)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-6f395180231a115c54798b071aafdd6a\">TUDCA (tauroursodeoxycholsyre)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 3.5\u20135.8 days. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 4 weeks (28 days). (Deviation to ensure complete clearance from the enterohepatic circulation). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: TUDCA is a hydrophilic bile acid that is clinically verified through randomized crossover studies ([A] Invernizzi et al., 1999) and recent pharmacokinetic phase I trials ([B] Pena et al., 2026). TUDCA exhibits higher bioavailability and less conversion to toxic metabolites than regular UDCA. Since bile acids are part of a closed circuit between the gut and the liver (enterohepatic recirculation), systemic elimination is slow. The latest clinical measurements ([B]) establish the terminal half-life at up to 5.8 days. As TUDCA affects bile secretion, cholesterol metabolism, and possesses chaperone activity in the cells, the washout period is set at 4 weeks to ensure complete elimination before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4a49e15f93b985ea7a08ab76d3a13e10 wp-block-paragraph\">[A] <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep.510290220\" target=\"_blank\" rel=\"noopener\">Invernizzi et al.: Differences in the Metabolism and Disposition of Ursodeoxycholic Acid and of its Taurine-Conjugated Species<\/a> (Hepatology, 1999)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-6af161ec10999c5f0482541bfaf3da9a wp-block-paragraph\">[B] <a href=\"https:\/\/www.scirp.org\/journal\/paperinformation?paperid=148989\" target=\"_blank\" rel=\"noopener\">Pena et al.: Pharmacokinetic Evaluation of Ursodeoxycholic Acid, Unconjugated and Conjugated, within Two Oral Formulations in Healthy Male Subjects<\/a> (Journal of Biosciences and Medicines, 2026)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5aff940f21f90a9047cd4a1eee556b7b wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6952947\/\" target=\"_blank\" rel=\"noopener\">Kusaczuk: Tauroursodeoxycholate\u2014Bile Acid with Chaperoning Activity: Molecular and Cellular Effects and Therapeutic Perspectives<\/a> (MDPI \/ Cells, 2019)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-46de6ece37629bfe0cfdfa76d2923233\">Vitamin A (retinyl-palmitat\/retinol)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 13.5 hours (plasma) \/ 128 days (biological in liver stores). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days (72 hours). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Note:<\/strong> Although plasma levels normalize quickly, liver stores persist for up to 4 months. In case of suspected hypervitaminosis A (overdose), the oncologist should be consulted regarding specific interactions. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Pharmacokinetic studies ([A] Davis et al., 2000) document a plasma half-life of approx. 13.5 hours, which means that the circulating amount of Vitamin A is eliminated after approx. 3 days. This is the primary washout period to avoid acute interactions in the blood during oncological treatment. It should be noted, however, that Vitamin A is stored in the liver&#8217;s stellate cells with an extremely long biological half-life of 128 days ([C] Furr et al., 1989). Although the patient can start treatment after 3 days of cessation of supplementation, liver stores will remain saturated for up to 4 months, which requires attention in case of suspected hypervitaminosis A or when using drugs with high liver metabolism.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d188581b013db95980585b6ed6372d4a wp-block-paragraph\">[A] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11052924\/\" target=\"_blank\" rel=\"noopener\">Davis et al.: Pharmacokinetics of retinyl palmitate and retinol after intramuscular retinyl palmitate administration in severe malaria <\/a>(Clin Sci, 2000) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-6bd4f1b5cee670d29b26d87ecc07258a wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8895053\/\" target=\"_blank\" rel=\"noopener\">Reinersdorff et al.: Plasma kinetics of vitamin A in humans after a single oral dose of [8,9,19-13C]retinyl palmitate<\/a> (PubMed, J Lipid Res, 1996) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b2eb33cf5fde8dea15704c957098e171 wp-block-paragraph\">[C] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2648799\/\" target=\"_blank\" rel=\"noopener\">Furr et al.: Vitamin A concentrations in liver determined by isotope dilution assay with tetradeuterated vitamin A<\/a> (PubMed, Am J Clin Nutr, 1989)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-4616c0d1e53bad28ac869cf7d6c2dcda\">Vitamin B complex<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 1\u20132 hours (for B1, B2, B3, B5, B7, B9)\/ 15\u201325 days (for B6). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days for the complex generally\/ 4 weeks (28 days) for B6. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: The Vitamin B complex consists of eight water-soluble vitamins that are primarily excreted rapidly via the kidneys. For most of these, including thiamine (B1) and riboflavin (B2), the renal clearance is so rapid that toxicity and accumulation are rarely a problem ([D] FAO, 2001). The plasma half-life for these is very short, and they are washed out after 3 days ([C] Ali et al., 2022). Vitamin B6 (pyridoxine), however, differs significantly by having a terminal elimination phase of up to 25 days. An expert consensus ([B] Schellack et al., 2025) states that complete clearance of B6 requires 20\u201340 days, which is supported by clinical findings of persistently elevated levels after cessation ([A] Lindschinger et al., 2019). Since an excess of B6 is associated with a risk of peripheral neuropathy, the washout period for preparations containing B6 must always be 4 weeks before oncological treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Link:<\/strong><\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4c71aa7c175b071c5fb888e56cf42488 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6930747\/\" target=\"_blank\" rel=\"noopener\">Lindschinger et al.: A Randomized Pilot Trial to Evaluate the Bioavailability of Natural versus Synthetic Vitamin B Complexes<\/a> (PubMed, Oxid Med Cell Longev, 2019)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-1621152363a0e6dc11bbb05893c4c82a wp-block-paragraph\">[B] <a href=\"https:\/\/www.dovepress.com\/expert-consensus-on-vitamin-b6-therapeutic-use-for-patients-guidance-o-peer-reviewed-fulltext-article-DHPS\" target=\"_blank\" rel=\"noopener\">Schellack et al.: Expert Consensus on Vitamin B6 Therapeutic Use: Guidance on Safe Dosage and Clinical Management<\/a> (Drug Healthc Patient Saf, 2025)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4eddfcc09e956b8a5589449e4eb73f31 wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9573099\/\" target=\"_blank\" rel=\"noopener\">Ali et al.: Dietary Vitamin B Complex: Orchestration in Human Nutrition throughout Life<\/a> (Nutrients, 2022)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3f0836fed97102ba3d24dd0d2a821089 wp-block-paragraph\">[D] <a href=\"https:\/\/www.fao.org\/4\/y2809e\/y2809e09.htm\" target=\"_blank\" rel=\"noopener\">FAO: Chapter 3. Thiamin, riboflavin, niacin, vitamin B6, pantothenic acid and biotin<\/a> (Human Vitamin and Mineral Requirements, 2001)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-51286e552c7e1a55fd11e2cb968f2379\">Vitamin D3 (Cholecalciferol)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 12\u201324 hours (initial distribution phase from blood to tissue)\/ 15\u201325 days (terminal elimination). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days (72 hours). Note: 72-hour clearance time for the free, circulating amount in the blood to avoid acute interactions, although the body&#8217;s total stores are emptied much more slowly. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Vitamin D3 is extremely fat-soluble and exhibits a significant storage effect. While the circulating form in the blood (25(OH)D) has a half-life of approx. 2\u20133 weeks, recent research ([B] U\u00e7ar et al., 2025) documents that the Vitamin D3 molecule itself is actively absorbed and retained in the body&#8217;s fat cells (adipocytes). From there, it is only slowly released into the bloodstream. Clinical trials ([A] Charoenngam et al., 2021) confirm that this is particularly pronounced in patients with a higher BMI, where Vitamin D is rapidly drawn out of circulation and deposited. The 3-day washout period is targeted at removing the acute amount in plasma before oncological treatment, while the systemic stores in adipose tissue will persist for months after cessation ([C] Fassio et al., 2020).<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-4abdab1a60cc129c9d74e8fda45a4f06 wp-block-paragraph\">[A] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0002916522004415\" target=\"_blank\" rel=\"noopener\">Charoenngam et al.: A pilot-randomized, double-blind crossover trial to evaluate the pharmacokinetics of orally administered 25-hydroxyvitamin D<sub>3<\/sub>&nbsp;and vitamin D<sub>3<\/sub>&nbsp;in healthy adults with differing BMI and in adults with intestinal malabsorption<\/a> (Am J Clin Nutr, 2021) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-ce8407d844c39caa06e021c190c2a98c wp-block-paragraph\">[B] <a href=\"https:\/\/www.mdpi.com\/2072-6643\/17\/13\/2107\" target=\"_blank\" rel=\"noopener\">U\u00e7ar et al.: Vitamin D3, 25-Hydroxyvitamin D3, and 1,25-Dihydroxyvitamin D3 Uptake in Cultured Human Mature Adipocytes<\/a> (Nutrients, 2025) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b98ff529736ee8eaff8809b6d07e335d wp-block-paragraph\">[C] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7352201\/\" target=\"_blank\" rel=\"noopener\">Fassio et al.: Pharmacokinetics of Oral Cholecalciferol in Healthy Subjects with Vitamin D Deficiency: A Randomized Open-Label Study<\/a> (Nutrients, 2020)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-1e6e121a89356dc73b58e349f9951de4\">Vitamin E (alpha-tocopherol)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 20 hours (plasma)\/ &gt;2 years (biological in adipose tissue). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 4 days (96 hours). Note: 72-96 hours ensures elimination of excess circulating tocopherol and normalization of liver output. Deposition in adipose tissue persists for years. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Vitamin E exhibits complex pharmacokinetics governed by rapid hepatic uptake and re-excretion. Clinical isotope-labeling studies ([A] Violet et al., 2020) show that 85% of a dose is cleared from plasma within 20 minutes, after which it is redistributed via lipoproteins from the liver, peaking after 3\u20134 hours. This process is inhibited in hepatosteatosis (fatty liver), where the vitamin is sequestered in liver fat. While the plasma half-life is approx. 20 hours ([D] Zaffarin et al., 2020), Vitamin E is extremely persistent in adipose tissue, where it takes up to 2 years to reach new steady-state levels after cessation ([B] Handelman et al., 1994). Since high doses (&gt;300 mg) interact with oncological drugs such as tamoxifen and anticoagulants ([C] Podszun et al., 2014), the washout is set at 4 days to ensure the elimination of excess circulating levels.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-0963b253eefc62430773bef7d4b6d63a wp-block-paragraph\">[A] <a href=\"https:\/\/df6sxcketz7bb.cloudfront.net\/manuscripts\/133000\/133309\/cache\/133309.2-20200327123830-covered-e0fd13ba177f913fd3156f593ead4cfd.pdf\" target=\"_blank\" rel=\"noopener\">Violet et al.: Vitamin E sequestration by liver fat in humans<\/a> (JCI Insight, 2020) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-306cd8ac09e8f62be478e81d4687ed0a wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8172086\/\" target=\"_blank\" rel=\"noopener\">Human adipose alpha-tocopherol and gamma-tocopherol kinetics during and after 1 y of alpha-tocopherol supplementation<\/a> (Am J Clin Nutr, 1994) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-26bcf17a8ab4777b24cc08549fe9e149 wp-block-paragraph\">[C] <a href=\"https:\/\/www.cambridge.org\/core\/journals\/nutrition-research-reviews\/article\/vitamin-edrug-interactions-molecular-basis-and-clinical-relevance\/F5DDFEAA7E81CCF1604728962397AD0B\" target=\"_blank\" rel=\"noopener\">Podszun et al.: Vitamin E\u2013drug interactions: molecular basis and clinical relevance<\/a> (Nutr Res Rev, 2014) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8c8e3a90342f86cb249a7717c221c0f4 wp-block-paragraph\">[D] <a href=\"https:\/\/www.dovepress.com\/pharmacology-and-pharmacokinetics-of-vitamin-e-nanoformulations-to-enh-peer-reviewed-fulltext-article-IJN\" target=\"_blank\" rel=\"noopener\">Zaffarin et al.: Pharmacology and Pharmacokinetics of Vitamin E: Nanoformulations<\/a> (Int J Nanomedicine, 2020)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-7937f5eed72093c9483bd98b3d3bc5d1\">Vitamin K2 (menaquinone)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 72 hours for MK-7 &#8211; (1 hour for MK-4) <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 2 weeks (14 days) for MK-7 &#8211; (Approx. 1 day for MK-4) <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Vitamin K2 primarily exists as the homologs MK-4 and MK-7, which exhibit fundamentally different pharmacokinetics. MK-4 has a very short half-life of approx. 1 hour and rarely reaches measurable levels in the blood at nutritional doses ([A] Sato et al., 2012). Conversely, MK-7 has a long half-life of approx. 72 hours ([C] CRN, 2025), which leads to accumulation with daily intake and sustained circulation in the blood for several days after cessation ([B] Du et al., 2023). Since Vitamin K2 directly counteracts the effects of certain types of medicine and affects the coagulation cascade, the washout period for MK-7 is set at 14 days to ensure complete elimination (5 x <em>t\u00bd<\/em>), while MK-4 is washed out after 24 hours.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When a patient mentions they are taking &#8220;Vitamin K2,&#8221; it can be assumed with high probability that it is MK-7. Therefore, the long washout of 14 days is the most relevant safety precaution in this context.<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-3d4f7fe6047e7f8c53c804786f7be7e3 wp-block-paragraph\">[A] <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3502319\/\" target=\"_blank\" rel=\"noopener\">Sato et al.: Comparison of menaquinone-4 and menaquinone-7 bioavailability in healthy women<\/a> (Nutr J, 2012) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-8ed1748c1845e498dc378d9aa6fab413 wp-block-paragraph\">[B] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37132123\/\" target=\"_blank\" rel=\"noopener\">Du et al.: The study of bioavailability and endogenous circadian rhythm of menaquinone-7, a form of vitamin K<sub>2,<\/sub>&nbsp;in healthy subjects<\/a> (Br J Nutr, 2023) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-5b48fa29668f053dcc71b7eae6013f7d wp-block-paragraph\">[C] <a href=\"https:\/\/crnusa.org\/sites\/default\/files\/pdfs\/09.2-CRNVMS4-VITAMINK2_MK7_FINAL-EHedits.pdf\" target=\"_blank\" rel=\"noopener\">Council for Responsible Nutrition: Vitamin K2 &#8211; Menaquinone-7<\/a> (Vitamin and Mineral Safety, 4th Ed., 2025)<\/p>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-dec53620ace72d862ca45278becb9644 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading has-custom-sort-tekst-color has-custom-hvid-tekst-background-color has-text-color has-background has-link-color wp-elements-6ec6ffda20d04dd5dd367109f550574b\">Zink<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Half-life<\/strong>: 5 hours (plasma)\/ &gt;300 days (biological in tissue). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Washout<\/strong>: 3 days (72 hours). Note: 72 hours ensures complete clearance of the free plasma concentration and interrupts the enterohepatic recirculation before oncological treatment. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Level of evidence<\/strong>: 1 (white).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation<\/strong>: Zinc exhibits a distinct biphasic kinetics. The circulating amount in plasma has a half-life of approx. 5 hours ([C] Ranasinghe et al., 2018), and the zinc concentration typically peaks 5\u20136 hours after ingestion ([A] Salhab et al., 1999). A special characteristic of zinc is the enterohepatic recirculation, where zinc is excreted via the bile and reabsorbed in the intestine, which can lead to secondary peaks in the plasma level up to 24 hours after cessation. Since free-circulating zinc can act as an effective chelator and potentially interact with chemotherapeutics such as cisplatin, the washout period is set at 3 days to ensure stable plasma levels. It is noted that the body&#8217;s total stores in muscles and bones have a biological half-life of over a year, but these pools do not participate in the acute interaction risk ([B] Study 2).<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-9b002a2f59f3ba2326ea9a203da6c634 wp-block-paragraph\"><strong>Link:<\/strong> <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d8bd46f9fed16de2e1e7c5a551bffbee wp-block-paragraph\">[A] <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0378517398003688\" target=\"_blank\" rel=\"noopener\">Salhab et al.: The bioequivalence study of Folifer-Z: sustained-release iron and zinc<\/a> (Int J Pharm, 1999) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a79f9db79141a1f45b258b3078159497 wp-block-paragraph\">[B] <a href=\"https:\/\/www.researchgate.net\/publication\/259271190_Zinc_pharmacokinetic_parameters_in_the_determination_of_body_zinc_status_in_children\" target=\"_blank\" rel=\"noopener\">Vale, Leite et al.: Zinc pharmacokinetic parameters in the determination of zinc status<\/a> (ResearchGate\/Journal of Trace Elements, 2025) <\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-a78cda18c75b7c66f861a95f1de6dc20 wp-block-paragraph\">[C] <a href=\"https:\/\/medcraveonline.com\/JDMDC\/JDMDC-05-00131.pdf\" target=\"_blank\" rel=\"noopener\">Ranasinghe et al.: Pharmacokinetics of zinc in pre-diabetes: a pilot study<\/a> (J Diabetes Metab Disord Control, 2018)<\/p>\n\n\n\n<p class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-b9a75eb7f4fb5452cb973597dce58903 wp-block-paragraph\"><a href=\"#menu\">(menu)<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Site created:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">March 06, 2026<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-custom-menu-links-color\">\u2764<\/mark><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><strong><em>This is not a recommendation. Seek competent guidance.<\/em><\/strong><\/strong><\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignfull clinical-experience has-contrast-background-color has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-a4776045 wp-block-group-is-layout-constrained\" style=\"min-height:400px;margin-top:0;margin-bottom:0;padding-top:0;padding-bottom:0;background-image:url(&apos;https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/03\/Logo-til-brevpapir.jpg&apos;);background-size:cover;background-attachment:fixed;\">\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"gb-element-f7396b13 author-box-border\">\n<h2 class=\"wp-block-heading has-text-align-center\" id=\"author\"><span class=\"ez-toc-section\" id=\"About_the_Author_Professional_Background\"><\/span>About the Author &amp; Professional Background<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-794e3cfa wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1022\" src=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-1024x1022.jpg\" alt=\"Portr\u00e6tfoto af Hanne til forsiden.\" class=\"wp-image-20118\" srcset=\"https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-1024x1022.jpg 1024w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-300x300.jpg 300w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-100x100.jpg 100w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-600x599.jpg 600w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-150x150.jpg 150w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a-768x767.jpg 768w, https:\/\/jegharkraeft.dk\/wp-content\/uploads\/2025\/09\/Hanne-Kjaer-Uhlig-til-forsiden-a.jpg 1300w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-bottom is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"wp-block-paragraph\">This article has been prepared and validated by the undersigned, <a href=\"https:\/\/jegharkraeft.dk\/en\/about-cantact-thanks-mail\/\">Hanne Kj\u00e6r Uhlig<\/a>. I am a registered nurse (1975, with clinical experience until 2013) and hold an M.Arch. (1983, specializing in industrial design), and I taught at DTU (Technical University of Denmark) for a number of years.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Following the loss of my mother to cancer in 2000 and my own cancer diagnosis in 2024, I founded this non-profit information site &#8220;<em>Jeg har Kr\u00e6ft<\/em>&#8221; (I Have Cancer).<\/p>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The goal is to use my analytical and academic approach to bring clarity, safety, and scientific evidence to the field of integrative, complementary, and alternative cancer treatment. At the same time, my healthcare experience is utilized to make the articles patient-centered and relevant.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Article characteristics:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Clinical and personal background:<\/strong> Created from a combination of decades of experience as a nurse and personal experiences as both a patient and a relative.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Scientific methodology:<\/strong> The content is based on systematic research of medical databases and clinical trials. The articles are consistently supported by source references under Links.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Independent non-profit project:<\/strong> Operations are funded through voluntary donations and memberships through the Support Association Jeg har Kr\u00e6ft. The site is completely independent of commercial manufacturer interests and works solely to improve the quality of life for cancer patients.<\/li>\n\n\n\n<li><strong>The board of directors of the support association consists of:<\/strong>\n<ul class=\"wp-block-list\">\n<li class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-6162a8dcb9471d3a828f1725f647680f\">Chairman: <strong><a href=\"https:\/\/ingentingellermindre.com\/about-hanne-uhlig\/\" target=\"_blank\" rel=\"noopener\">Hanne Kj\u00e6r Uhlig<\/a>, nurse and cand.arch.<\/strong><\/li>\n\n\n\n<li class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-74584b4df5ece3a7272f01ab1cbed1b6\">Treasurer: <strong><a href=\"https:\/\/stoett-ret.dk\/jens-ottosen-stoett\" target=\"_blank\" rel=\"noopener\">Jens Ottosen-St\u00f8tt<\/a>, jurist<\/strong><\/li>\n\n\n\n<li class=\"has-custom-sort-tekst-color has-text-color has-link-color wp-elements-d427f0ce05890f46b243d5480143712e\">Member: <strong><a href=\"https:\/\/tku.dk\/\" target=\"_blank\" rel=\"noopener\">Thomas Kj\u00e6r Uhlig<\/a>, doctor, specialist in ophthalmology<\/strong><\/li>\n\n\n\n<li>Member: <strong>Martin Kj\u00e6r Uhlig, cand.merc.aud.<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Community:<\/strong> Join the Facebook group: Jeg har Kr\u00e6ft &#8211; Hvad kan jeg g\u00f8re? Danish Language only.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-nowrap is-layout-flex wp-container-core-buttons-is-layout-848fd1e1 wp-block-buttons-is-layout-flex\" style=\"border-style:none;border-width:0px;border-radius:0px;margin-top:0;margin-bottom:0\">\n<div class=\"wp-block-button is-style-outline is-style-outline--4\"><a class=\"wp-block-button__link has-custom-hvid-tekst-color has-custom-bl-baggrund-background-color has-text-color has-background has-link-color has-border-color has-custom-bl-baggrund-border-color wp-element-button\" href=\"https:\/\/www.facebook.com\/groups\/1276867696609057\" target=\"_blank\" rel=\"noopener\">get member of the fb-group<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"has-custom-menu-links-color has-text-color has-link-color wp-elements-485790e51077e9636b3d4b79d3c87ead wp-block-paragraph\"><a href=\"#menu\">(to menu)<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-custom-menu-links-color\">\u2764<\/mark><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>What you read on Jeg har Kr\u00e6ft is not a recommendation. Seek professional guidance.<\/em><\/strong><\/p>\n<\/div>\n<\/div>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_84 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Indhold<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Treatments\" >Treatments<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Support_during_Immunotherapy\" >Support during Immunotherapy<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#What_is_support_during_immunotherapy\" >What is support during immunotherapy<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Mechanisms_of_immune_support\" >Mechanisms of immune support<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#How_to_use_the_article\" >How to use the article<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Risk_assessment\" >Risk assessment<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Clinical_decision_support_and_pharmacokinetics\" >Clinical decision support and pharmacokinetics<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Example_of_Interpretation_%E2%80%93_Artemisinin\" >Example of Interpretation &#8211; Artemisinin<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Biochemical_Overview_%E2%80%93_Table\" >Biochemical Overview &#8211; Table<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#These_conditions_are_reviewed\" >These conditions are reviewed<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Collaboration_offer_for_oncologists_and_healthcare_professionals\" >Collaboration offer for oncologists and healthcare professionals<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Practical_suggestions_for_support_during_immunotherapy\" >Practical suggestions for support during immunotherapy<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Microbiome_enhancers\" >Microbiome enhancers<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Organ_protection_against_immune_inflammation\" >Organ protection against immune inflammation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Mitochondrial_support_energy_for_T_cells\" >Mitochondrial support (energy for T cells)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Skin_and_mucous_membranes\" >Skin and mucous membranes<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Immune-related_side_effects\" >Immune-related side effects<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Conclusion\" >Conclusion<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#Biological_half-lives_%E2%80%93_Links\" >Biological half-lives &#8211; Links<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/jegharkraeft.dk\/en\/support-during-immunotherapy\/#About_the_Author_Professional_Background\" >About the Author &amp; Professional Background<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Treatments Integrative Oncology Support during Immunotherapy \u2191 Previous \u2193 Next Contents: Summary of Support during Immunotherapy The microbiome as the engine: Managing side effects: Selective protection: Synergy through balance: What is support during immunotherapy Immunotherapy has revolutionised oncology by not attacking the cancer directly, but by releasing the \u201cbrake\u201d on the body\u2019s own immune system. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":30812,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[374,387],"tags":[],"class_list":["post-30810","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-treatments","category-treatment-decisions"],"modified_by":"Hanne Kj\u00e6r Uhlig","wpml_current_locale":"en_US","wpml_translations":[],"_links":{"self":[{"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/posts\/30810","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/comments?post=30810"}],"version-history":[{"count":8,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/posts\/30810\/revisions"}],"predecessor-version":[{"id":39943,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/posts\/30810\/revisions\/39943"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/media\/30812"}],"wp:attachment":[{"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/media?parent=30810"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/categories?post=30810"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jegharkraeft.dk\/en\/wp-json\/wp\/v2\/tags?post=30810"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}