Combating Anemia, Fatigue and GI Myeloma Side Effects Through Diet

Myeloma treatments, as well as the disease itself, can come with several unwanted side effects such as anemia, fatigue, and gastrointestinal issues. These frustrating side effects can often play a harsh toll on our lives, determining whether or not we want to do crucial things in our lives such as going into public, attending certain events, and going to work. 

However, not all hope is lost. Though some side effects require medication and treatment, what we eat can play a significant role in alleviating or managing side effects such as diarrhea, constipation, anemia, and fatigue. 

Learn how you can manage your side effects through what you eat by watching the video or reading the summary below: 

Gastrointestinal Side Effects

Most of the gastrointestinal side effects are caused by chemotherapy and radiation, though some of them can be caused by diet, emotional stress, or anxiety. 

Chemotherapy targets rapidly dividing cells; although that term applies to cancer cells, it unfortunately also applies to dividing cells found in our GI tract from our mouth to our anus. This causes inflammation in our gastrointestinal system which leads to common symptoms such as nausea, diarrhea and/or constipation. 

Nausea and Vomiting 

One of the top reasons for nausea and vomiting? Taking your medications at the wrong time. It's vital to pay attention to the timing of your medications. Are you taking them at the time the label directs? Are you taking them on an empty stomach? Take the medications with liquids and food when directed. If you aren't sure what the ideal timing of pill-taking should be, contact your treating physician who prescribed them to you. This will eliminate or significantly reduce nausea/vomiting caused by medication. 

Another thing to note: if you are consistently nauseous, try eating smaller meals. By eating smaller, more frequent meals, you are giving the stomach enough time to digest your food but stay consistently fed. Too big of meals might alter your GI tract's ability to absorb and digest the proper nutrients from your meals. Smaller meals could mean more energy and better nutritional absorption. 

Other Diet-Related Tips to Help with Nausea/Vomiting 

• Avoid high-fat or greasy foods (even though they can be delicious!) Fat takes a long time to digest, so if it slows our digestion down and sits in our stomach, that might add to already-existing gastro issues. 
• Eat ginger-containing foods to calm your stomach, as it's a naturally occurring antiemetic. 
• Wear an acupuncture bracelet that touches on special pressure points to reduce nausea. 

Diarrhea and Constipation

Diarrhea and constipation are common side effects within the myeloma community but are rarely discussed. It can be embarrassing to talk about these kinds of side effects with your doctor (although we highly recommend you do!) but in the meantime, here are some solutions that might be helpful to you. 

1. Write out a detailed food log. Record what you eat and how your stomach feels about an hour after you eat it. Also, include the medications that you are taking. With all of this information, it becomes clear what foods, drinks, or medications trigger your diarrhea and constipation. A dietician can also help you interpret this. Eliminate the foods/food groups that seem to be causing problems and see if your symptoms improved. 
2. Stay hydrated! If you are constipated, adding fluid to your body will increase the level of fluids in your stomach, intestines, etc. and can help move things along. If you are losing an important amount of liquid due to diarrhea, you should consider adding electrolytes to your hydration plan for the day. Try to avoid electrolytes with artificial sweeteners as this can damage GI tract cells. 
3. Consider taking natural laxatives such as prune juice or coffee. These can help with your constipation and vitamin intake. A fiber supplement can also help if natural laxatives don't seem to work. 

Remember, none of these recommendations have to be lifelong or long-term. Simply use them until those side effects pass and then you can start resuming your normal diet. 

Combating Anemia and Fatigue

Anemia is quite common in blood cancers or blood disorders. Anemia is a low red blood cell count and can be caused by cancer treatments, such as chemotherapy or radiation, as well as any cancers or disorders that affect the bone marrow. A primary symptom of anemia is fatigue. 

To combat anemia and fatigue, increase iron in your diet. Avoid taking iron-containing supplements, because it's not digested and absorbed as efficiently as food-based iron. There are actually two different kinds of food-based iron, heme iron (from red meat, poultry, and fish) and non-heme (beans, lentils, spinach, kale, apricots, etc.) Make sure that you get both of them in your diet in order to maximize iron intake. 

Include Vitamin C (strawberries, citrus fruits, etc.) when you're eating an iron-containing food to increase the absorption of said iron. Don't drink coffee or tea within 30 minutes before or after meal time as those drinks can decrease the absorption of iron. 

Another consideration is to increase B12 in your diet. The body needs B12 to make healthy red blood cells, even white blood cells and platelets, so increasing this in your diet can also help with anemia. It is found in red meat, fish and shellfish, eggs, and dairy products.

Getting Sufficient Calories and Protein 

Make sure that you are eating enough calories and protein in order to fight fatigue and other side effects. Your body is expending a lot of energy to try to recover and repair your healthy cells during cancer treatment. Eating enough calories and protein can help reduce fatigue and chronic pain. 

Protein is going to provide energy for your muscles! Although protein needs may vary, it should equal 1 gram of protein to 1 kg of weight. For example, if you weighed 75 kilograms, you should strive for 75 grams of protein per day. If you are trying to build muscle, multiply your weight in kilograms by 1.5. If you weigh 75 kilograms but are wanting to gain muscle, 112.5 grams should be ideal. Consult your dietician before determining your protein needs, however, as obesity and kidney function could vary these results. 

Easy Snack Ideas

Keep easy-to-prepare snacks on hand so you are able to fuel your body all day long.

Some ideas are:

• string cheese 
• guacamole with vegetables
• yogurt with fruits
• granola bars
• trail mix
• egg salad
• tuna salad
• smoothies
• boiled eggs
• rotisserie chicken
• protein bars
• fruit with peanut butter 
• toast with peanut butter and chia seeds 

Don't Forget Physical Activity! 

Physical activity can be a great way to help manage your side effects. Even moving your body around the house can give your mind clarity and provide your body with more energy and strength to keep fighting myeloma. Movement aids in constipation symptoms and combats fatigue. It also helps manage neuropathy, osteoporosis, and pain. 

Aim for 150 minutes of moderate exercise per week. You can move in a way that inspires you, whether it's looking up exercise videos on YouTube, talking walks outside, or gardening. 

We hope that as you apply this advice with the support of a registered dietician, you will see improvements in your side effects. Your quality of life is important and you deserve to live as normal a life as possible. You don't have to be defined by your myeloma side effects! 

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