Are there any foods, drinks, or supplements that individuals on myeloma therapy should avoid?

Are there any foods, drinks, or supplements that individuals on myeloma therapy should avoid? So lots of people ask about foods and juices that they should avoid or take while having myeloma therapy. And the answer truthfully is we don't 100% know, but we do give some suggestions. So one of the suggestions we have a tendency to say is to be a little bit careful with things like strong green teas and high high doses of vitamin C. Because there was some work in the lab, not in patients, in the lab, suggesting that doesn't, it makes bortezomib therapy slightly less efficient. I know that when patients are on cholesterol lowering drugs, they're often suggested not to have grapefruit juice. And as a general rule, for most of the drugs that are there at the moment, we tend not to mind normal levels of juices. Some of the newer drugs as they're being investigated, so some of the drugs in clinical trials, people will often be advised to maybe not use certain things like that. Another favorite one is St. John's wort, and that's really because some of them interfere with the way the drug is metabolized. But usually the doctor will let you know whether you need to stay off anything or not. So for the question that you're asking is relating to drug, kind of drug-drug interactions or drug-food interactions, and there are a lot of those. And so I always encourage my patients that are on any kind of cancer treatment to consult their pharmacist because they're going to know all those details. So if there are things that are more common in the diet, like grapefruit juice or patients on supplements or vitamins or whatever it may be, and there is a huge interaction with the drug they are receiving, they definitely need to consult their pharmacist to know what to avoid or what they cannot take. And that's because foods can interact with the way the drug is metabolized. Some drugs are metabolized in the liver. Some drugs are cleared in the kidney. And so when drugs are metabolized in the liver, it can either lead to them being more active or it can lead to them becoming metabolized for clearance from the body so we don't have really high levels that are toxic. In either way, some foods can interact with the way it's metabolized in the liver and interfere with that metabolism, leading to either the drug being less effective or the drug being present in high amounts and being too toxic. So patients should definitely talk to their pharmacist about those.