My acupuncturist recommended this reading as background on Traditional Chinese Medicine (TCM) approaches to chemo side effects: Chemo Herb Support (PDF).

I’m not taking anything based on theory alone. The goal here is simple: identify a short list of lower-risk herbs to review with my oncologist first, rather than sending a large formula with unknown interaction risks.

MY MEDICAL CONSTRAINTS
- Chemo regimen: FOLFIRI (irinotecan + 5-FU ± leucovorin)
- Key metabolism issue: Irinotecan is processed through hepatic pathways (CES → SN-38; glucuronidation via UGT1A1)
- My weak point: I’ve had liver enzyme elevations during chemo

That means anything with liver strain potential—or anything that might affect drug metabolism (especially CYP3A4 / UGT1A1 pathways)—needs to be treated as guilty until proven safe.

THE SHORTLIST I’M CONSIDERING FOR ONCOLOGY REVIEW (SINGLE HERBS, NOT A BLEND)

Mai Men Dong (Ophiopogon root)
- Why it’s suggested (TCM rationale): Yin-nourishing; often used for chemo-related dryness, fatigue, and mucosal irritation
- Why it made the cut (relative risk): Not strongly immunostimulatory; no well-documented CYP3A4 or UGT1A1 inhibition; lower theoretical interaction risk than tonic herbs
- Primary concern to clear: Potential hepatic processing burden (data is limited; limited ≠ safe)

Bai Shao (White Peony root)
- Why it’s suggested: Blood/Yin support; traditionally used for pain, cramping, and fatigue
- Why it made the cut (relative risk): Some hepatoprotective and anti-inflammatory data exist (not a guarantee); less aggressive than ginseng-class tonics
- Primary concerns to clear: Hepatic processing and interaction potential; bleeding risk if platelets are low

Chen Pi (Aged Tangerine Peel)
- Why it’s suggested: Digestive support; used for nausea, bloating, and appetite regulation
- Why it made the cut (relative risk): Typically used at low doses; functions more like a digestive aid than a heavy tonic
- Primary concern to clear: Citrus compounds may affect CYP activity (dose-dependent)

WHAT I’M EXPLICITLY AVOIDING
- Broad “immune boosting” tonics
- Complex herbal blends without interaction screening
- Any herbs that increase liver strain while enzymes are already elevated

NEXT STEP
I’ll share this shortlist with my oncologist and consider only items that are cleared for my specific chemo regimen and lab results. If there’s no clear green light, I’ll stick with the lowest-risk supportive options: acupuncture, nutrition, hydration, sleep, and evidence-based symptom medications.