Navigating cancer treatment is complex enough, but when you add a history of stomach surgery to the mix, you require an extra level of coordination.

You need a practical way to ensure your oncology team sees the whole picture.

That’s where the STOMACH Framework comes in. This 9-page guide helps you notice what has changed, keep the relevant details together, and have clearer conversations with your oncology team.

Please note, this is not a diagnostic tool or a substitute for individual medical advice. Instead, the framework helps you bridge the gap between your past surgery and your current care, so you and your treating team can work together safely.

Print this out, fill in what you know, and let it guide the conversation at your next clinic visit.

Not a premium member? Get this guide and everything in the library for only $6.66 a month.

Upgrade Now

Read more

It's easy for your oncologist to say "just take some magnesium, whichever one you like."

You go to the supermarket aisle, grab whatever's cheapest or has the nicest bottle, and a few days later you're stuck near the bathroom with diarrhea.

You didn’t realize there are around a dozen different forms of magnesium. To make it worse, some brands blend a few formulations together, then slap on labels like Plus, Forte, Ultra, or Super.

Add capsules, powders, liquids, sprays, creams, delayed-release, and liposomal versions, and it's enough to make your head spin.

You're already dealing with chemo brain, fatigue, and sleepless nights. You don't need to add ‘magnesium research project’ to that list.

Isn’t magnesium just magnesium?

It’s not so simple. And also not as complex as you think.

Let’s make this easier.

Did you like the rhyme?😏

The basics

(If you’re already a magnesium expert, skip ahead)

Most magnesium supplements contain magnesium paired with another molecule - a salt or amino acid chelate. That partner changes how well you absorb it and how likely it is to send you running to the bathroom.

When you see a label like magnesium glycinate or magnesium oxide, you’re reading two names:

• The first name is magnesium

• The second name (oxide, citrate, glycinate, malate, and so on) is the partner molecule.

Here are the common types you'll see on shelves:

• Magnesium oxide

• Magnesium citrate

• Magnesium glycinate (or bisglycinate)

• Magnesium malate

• Magnesium taurate

• Magnesium L-threonate

• Magnesium orotate

• Magnesium lactate

• Magnesium aspartate

• Magnesium gluconate

• Magnesium chloride

• Magnesium sulfate

• Magnesium carbonate

• Magnesium hydroxide (milk of magnesia)

Topical sprays, oils, and creams are commonly magnesium chloride. Epsom bath salts are magnesium sulfate.

Liposomal magnesium is wrapped in a phospholipid vesicle to help absorption. Delayed-release magnesium uses a coating or matrix so it releases slowly in your small intestine. Evidence that either form improves magnesium absorption is limited.

Plus, Super, Ultra, Forte etc. are just marketing names. Read the actual ingredient list. Often you're not getting better-absorbed magnesium for your money, just a bigger dose of a poorly absorbed one that moves your bowels along faster.

Please note: This article is not recommending that you start a magnesium supplement. It explains how I assess different magnesium forms for people who are already taking magnesium in common clinical situations. It does not replace cancer-treatment guidelines, individual prescribing advice, or discussion with your healthcare team. Always ensure your treating team knows about every supplement you take.

Choosing the right magnesium

Not all magnesium behaves the same way. Some types get absorbed well and raise your blood levels. Others mostly stay in your gut and act like a laxative. Which one you need depends on what problem you’re actually trying to solve.

Here’s what premium members get below the line:

• a one-page magnesium cheat sheet you can bring with you the next time you go magnesium shopping.

• specific common scenarios encountered by people with cancer e.g low magnesium from platinum chemo/EGFR monoclonal antibodies, constipation, people with ileostomies or diarrhea, alternating constipation and diarrhea (!!!), and poor sleep, and which magnesium to choose.

• when to be careful when taking magnesium supplements and which medications it can interact with.

A premium subscription is only $6.66 a month. That also gets you full access to the Members’ Vault and Ask an Oncologist.

Upgrade Now

Read more

Dear Thrivers,

Between treatment side effects, medications, and the flood of supplement advice online, choosing a magnesium supplement can feel needlessly complicated. This cheat sheet makes the labels easier to understand.

Download and print it out. Pop it in your bag next time you’re shopping for magnesium. It’ll help you work out what the label actually means and what that particular form is likely to do for you, and to you.

Download it here:

Read more

Diarrhea doesn’t just exhaust you. It calculates the distance to every bathroom before you leave the house. It turns down dinner invitations on your behalf. It delays treatment and cuts doses.

Loperamide and a handout is a starting point, not a plan.

Some of my patients even avoid loperamide for fear of overshooting into constipation.

This article covers a few common complementary interventions for chemo-induced diarrhea. Read it alongside my earlier article on chemo diarrhea.

Some of what follows has data. Some has risk. A few have both. I’ll walk through each one, including where the caveats apply.

Glutamine

Glutamine is one of the principal fuels for the gut lining. When chemo damages that lining, supplementing with it sounds logical. And there is some evidence glutamine helps.

A double-blind RCT in colorectal cancer patients on 5-FU showed that 18g/day of glutamine improved intestinal absorption and reduced gut permeability and a meta-analysis suggested a 28-35% relative risk reduction in diarrhoea incidence in colorectal cancer. Several trials showed no benefit versus placebo.

But here is the problem. Glutamine is also fuel for many cancers. Tumors use it to grow and to manage oxidative stress. Giving it to protect your gut may, in some contexts, also support the tumour.

This is the trade-off that generic supplement advice doesn’t mention. Short-term symptom relief is one outcome. Long-term oncological impact is another.

Yes, short‑course oral glutamine for mucositis or diarrhoea has not been shown to worsen oncologic outcomes in trials. But the studies are small and not designed to exclude long-term harm.

That uncertainty is why I generally avoid glutamine in my own practice.

Probiotics

Probiotics have the most consistent evidence of anything on this list.

A few systematic reviews

Read more

Some days, ‘eat well’ is just too much to think about so here’s a simpler plan.

This anti-inflammatory checklist is for the days when your energy is low, your appetite is off, or decision-making feels heavy. It focuses on small, doable choices that can support your body during and after treatment without requiring planning or perfection.

Inside, you’ll find gentle, flexible options to reduce inflammation, maintain nourishment, and respect where you are today. Use it as a guide, not a rulebook.

Read more

Chemo blunts your body’s natural melatonin production, shifts your circadian rhythm, triggers hormonal changes, and often comes packaged with steroids that send wake-up signals to your brain at 2 a.m. Read Why Chemo Wrecks Your Sleep if you haven’t.

That means there is no single sleep supplement that works for everyone. The right choice depends on why you’re not sleeping. And remember, CBT-I and reducing steroid dose (if you’re on it) has the strongest evidence for long-term sleep improvement. Supplements work best as a support layer, not a substitute.

For a stepwise lifestyle and supplement plan to manage chemo-related insomnia, go here.

* Always discuss supplements with your oncologist before starting them. Many natural products interact with chemo, meaning they can make drugs more toxic or less effective.

Supplements that may improve insomnia

This is not an exhaustive list, merely the common ones that I consider for my patients.

Magnesium Glycinate / Bisglycinate

What it is

Magnesium is an essential mineral involved in over 300 biochemical reactions in the body, including regulation of the nervous system, muscle relaxation, and modulation of GABA receptor function.

Many people are mildly magnesium-deficient, and this is worsened by chemotherapy-related poor appetite, nausea, vomiting, and diarrhoea.

Who is this supplement for?

Magnesium suits people with multiple sleep problems - difficulty falling asleep, night-time waking, restlessness, and anxiety.

It’s particularly valuable for those on platinum-based chemotherapy (such as cisplatin or carboplatin), which directly depletes magnesium, and for anyone whose sleep is disturbed by muscle cramps or body tension. Magnesium is also a gentle, well-tolerated first choice for older or more frail patients.

Dose and timing

• 200–250 mg elemental magnesium taken 1–2 hours before bed, with a small amount of food if your stomach is sensitive

• Don’t exceed 350 mg elemental magnesium from supplements per day without medical supervision

Safety notes

Generally well tolerated. The glycinate/bisglycinate forms have far less of the laxative effect associated with magnesium oxide or citrate.

Avoid or reduce dose significantly in kidney impairment. The kidneys excrete magnesium, and reduced kidney function can cause dangerous magnesium accumulation.

Melatonin

What it is

Melatonin is a hormone your brain naturally produces after dark to signal that it’s time to sleep. Chemo, steroids, and bright light exposure at night can all suppress this natural output, leaving your body without the chemical ‘lights out’ signal it needs.

Who is this supplement for?

Melatonin is most useful for people whose

Read more

Chemotherapy‑related insomnia is common but very treatable, and working through it in deliberate steps is far more effective than trying to “fix” everything in one night. Below is a progressive plan you can implement over weeks, layering changes gradually rather than all at once.

Read more

Sleep problems are among the most common and most distressing side effects of cancer treatment. Many patients live with overwhelming daytime fatigue paired with an inability to fall asleep, stay asleep, or waking too early. Insomnia can begin before treatment, intensify during chemo, and persist for years after it ends.

This 3-part guide does not offer a pill to suppress the problem. It treats insomnia as a signal that the body’s internal terrain is dysregulated and walks you through how to identify and correct the root causes across interconnected systems.

First, we establish a framework for identifying causes of your insomnia, reset your circadian clock and address hormone imbalances. The second part covers autonomic nervous system regulation, mind-body therapies, diet, and exercise. Finally, we take a deep dive into insomnia-fighting supplements and herbs that you can use during cancer treatment.

If you haven’t already, read Why Chemotherapy Wrecks Your Sleep and Two Things Your Oncologist Can Do Right Now To Help You Sleep. This guide is a continuation from those discussions.

The three-factor framework

Sleep medicine uses a three-part lens to understand insomnia:

Read more

The DUTCH test can tell you a lot but a DUTCH report without clinical context is like receiving a map in a foreign language. All the information is right there in front of you, and yet none of it makes sense.

That’s exactly why I wrote this guide. I walk you through the report and translate what it means for your daily life with practical lifestyle, diet, and supplement strategies that may actually move the needle for your hormones. You’ll come away understanding the different estrogens, how your body processes them, and why that matters. I also take a close look at I3C and DIM. These two supplements are widely recommended but you need to be careful before reaching for them.

This isn’t a wellness blog post. It’s a clinical education resource built for the patient sitting at the kitchen table with a 12-page report and no idea where to start.

If you’ve ever held a DUTCH report and felt lost, this one was written for you.

Read more