Table 2.

Specific cytostatic-micronutrient interactions

Cytostatic drug	Micronutrient [Ref.]	Mechanism	Possible consequences
Cisplatin	magnesium [52, 25]	renal Mg excretion ↑, intestinal Mg absorption ↓	hypomagnesemia, hypokalemia, metabolic disturbances (e.g. lipid anomalies)
	carnitine [53]	renal carnitine excretion ↑	hypocarnitinemia, risk of fatigue and lipid anomalies ↑
Pemetrexed	folie acid [54,55]	folie acid antagonist	diarrhea, mucositis, thrombocytopenia, neutropenia, homocysteinemia
5-Fluorouracil	thiamine [56]	inhibited phosphorylation of thiamine	risk of nerve disorders, heart failure, lactic acidosis, Wernicke's encephalopathy
Ifosfamide	carnitine [57]	renal carnitine excretion ↑	risk for carnitine deficiency after several CT cycles, risk of fatigue and lipid anomalies ↑

Mg = Magnesium; CT = chemotherapy.