Vitamins and supplements

My chemo (fec-t) ended July 2022, Radiotherapy ended in August 2022 and I’m currently taking daily Tamoxifen and Herceptin 3 weekly.

My hair growth is really slow and energy levels low.  I’m changing up my diet and was taking some vitamins but have had mixed advice about vitamin E and D and Tamoxifen.

Is there any supplements I should avoid?
Is there anything that would be particularly good to take?


Hi - my oncologist has always advocated getting the majority of vitamins and minerals from food and drink form and I think this is good advice. I only supplement vit d in pill form as I am a) low and b) naturally pale as a ghost! Food has other benefits over tablets such as improved gut health etc but if in doubt your oncologist will be able to advise specific to your treatment- I am not allowed grapefruit or pomegranate for example or St John’s wort. Good luck


Hi Rudy1  

Thanks for your post. Slow hair growth and low energy levels can be difficult to cope with.  

Many people ask about vitamin and herb supplements as they want to do as much as possible to be healthy and information can be confusing. There is often the belief that vitamins and herbs are safe as they are considered natural.  However, herbal treatments don’t have to comply with the same regulations or rigorous testing that conventional medicines do. There is much we don’t know about supplements and herbal remedies.  For many products there is a lack of research to support their use, and some can interfere with conventional medicines including cancer treatments.    

You can search this American website here for information about individual herbs and vitamins including vitamins D and E.  Each has sections on existing evidence and what known interaction there is with other medications. You can also search herbal products and supplements on the European website Complementary and Alternative Medicine for cancer and on the American website Medicine Plus.   

As rubythursday has suggested, it’s best to speak to your treatment team, GP, or a pharmacist before taking any supplements.  

Hair thinning and slow regrowth can occur as a result of cancer treatments including chemotherapy, targeted therapy and hormone therapy. This can be particularly distressing as hormone treatment is usually recommend for five, sometimes 10 years. When hormone therapy finishes, hair will usually start growing back. This may take some time and for some may not fully return to the same thickness. There are no specific foods that are recommended, but a healthy well-balanced diet generally helps the condition of hair and skin. You mention that you are following a vegan diet and this information from the British Dietetic Association may be helpful.  Although there are some supplements which the manufacturers claim help strengthen hair or reduce hair loss, we are not aware that there is evidence to support this. Cancer Hair Care, are an organisation providing information and support to people who have cancer related hair loss which may be of interest to you. 

Experiencing fatigue (the feeling of tiredness or exhaustion) during and after receiving treatment for breast cancer is very common. Many people find that they start to get their energy levels back as time passes, but for some fatigue can continue for months or sometimes years. Other factors may also contribute to fatigue, such as the emotional impact of a breast cancer diagnosis, altered sleep patterns, reduced activity and poor diet.     

There are things you can try to help manage fatigue as discussed in the previous links. You may want to keep a diary to record when you feel most tired. This can help you plan activities you enjoy in the times when you have more energy. Trying to stay physically active can help. Eating a healthy balanced diet is also important. The following tips for better sleep may also be helpful. You may also be interested in the Macmillan booklet Coping with fatigue (tiredness)   

If you have not done so already, do discuss how you are feeling with your treatment team, breast care nurse or GP. It’s important they are aware of any side effects you are experiencing and how they are affecting your daily life. There are a few situations where fatigue may be due to other conditions such as anaemia, (too few red blood cells in the body) or thyroid problems so it’s important these are ruled out.   

We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in.  

We are currently evaluating this service and would appreciate your feedback. Please click here to the survey. It should take approximately 10 minutes to complete.   

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen to your concerns, talk things through and signpost you to more support and information. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001). 

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Best wishes


Breast Care Nurse   

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