Supplements Protecting Against Cyclosporine Toxicity

[Falkenhayn]

While research has shown a number of supplements to protect against cyclosporine toxicity, which is a major reason why transplants fail, some studies fail to note that the supplements they endorse also interfere with cyclosporine metabolism, and might be reducing its effectiveness while they reduce its toxicity. Three I found that research indicates are helpful but which also interfere with cyclosporine metabolism are melatonin, quercetin, and curcumin. Others which are just beneficial in combating cyclosporine toxicity are cordyceps, anti-oxidant tea polyphenols, magnesium, taurine, black grape extract, vitamin E, and n-acetyl l-cysteine.

[ashok5085]

My transplant failed due to tacrolimus toxicity. It is a good topic you have raised.

[erikylii16 in reply to ashok5085]

I’m so sorry, I hope you were re-listed & are doing ok!? Prayers!

[LisaSnow]

Great information! Do you know if these compounds also work well for tacrolimus?

[Falkenhayn in reply to LisaSnow]

I have seen some published material indicating that magnesium supplementation and korean red ginseng are helpful in diminishing tacrolimus side-effects. The article summarized below also highlights the possible benefits of omega-3 oil:

Exp Clin Transplant. 2014 Dec;12(6):522-7.

Supplementation with omega-3 polyunsaturated fatty acids and experimental tacrolimus-induced nephrotoxicity.

Fernandes MB, et al.

OBJECTIVES:

Calcineurin inhibitors are effective immunosuppressive agents, but associated adverse effects such as nephrotoxicity may limit efficacy. Dietary fish oil may minimize nephrotoxicity caused by long-term use of calcineurin inhibitors. The purpose of the present study was to evaluate the effects of omega-3 fatty acids on calcineurin inhibitor nephrotoxicity in rats that had normal kidney function or chronic kidney failure.

MATERIALS AND METHODS:

Rats that had normal kidney function or chronic renal failure that was induced by mass reduction surgery were treated with tacrolimus without or with fish oil, fish oil alone, or olive oil. Kidney function and histology were evaluated after 14 days.

RESULTS:

Mean body weight loss, serum creatinine, change in serum creatinine, and rate of decrease in creatinine clearance were greater in normal rats that received than did not receive tacrolimus. Tacrolimus nephrotoxicity was greater in rats that had chronic renal failure than normal kidney function, but the mean change in serum creatinine was significantly lower in rats with chronic renal failure that were treated with tacrolimus and fish oil than tacrolimus alone. Fish oil supplementation was associated with fewer abnormal histopathologic lesions in the kidneys of tacrolimustreated rats that had normal kidney function or chronic renal failure (not signifant).

CONCLUSIONS:

Fish oil may be protective against the development of kidney dysfunction and histopathologic changes in rats treated with tacrolimus.

As always, check with your transplant team before adding anything to your daily dietary intake.

[LisaSnow in reply to Falkenhayn]

Thanks. In theory, omega 3 pufa releases anti fibrotic metabolites therefore it could protect against one aspect of associated nephrotoxicity. One needs to be cautious because the dose equivalent in human (to those fed to experimental rodent model) is likely toxic .

[Damigi28 in reply to LisaSnow]

My transplant team put me on high doses of omega 3 fish oil immediately after my transplant and no problems

[Damigi28]

Thank you for the helpful information. I will stop taking any melatonin. I had no idea.