Food and Nutrition

Strangely, I had to do quite a bit of self-educating to understand how INH affects the body. Below is some common advice listed for INH consumption, along with my opinions of WHY you should listen to it based on the INH role.  Again, this is not medical advice, simply freely available information on the internet on INH and what it does.

1.  Eliminate any potential allergens from your diet.  The most common allergens are wheat, dairy, soy, corn, and chemical preservatives.

• Background:  Allergens are often problematic by creating Histamine reactions.  Histamine is an amine naturally found in the body, and very vital to body functioning.  One of the jobs of histamine is to mediate allergens in the body. Thus, many people take "anti-histamines" for allergies due to large amounts of histamine in the body.
• The INH role: INH inhibits the metabolism of histamine. (Source) See the Histamine page for more info on this. One symptom often experienced by INH recipients is Urticaria, or hives.

2. Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.  Supplement with B-Vitamins as necessary.

• Background: B-vitamins are essential for health.  They support metabolism, energy levels, immune system and cell growth and division (including cells that discourage anemia).
• Vitamin B₁ (thiamine)
• Vitamin B₂ (riboflavin)
• Vitamin B₃ (niacin or niacinamide)
• Vitamin B₅ (pantothenic acid)
• Vitamin B₆ (pyridoxine, pyridoxal, or pyridoxamine, or pyridoxine hydrochloride) - plays a major role in making proteins, hormones, and neurotransmitters.  Good sources of B ₆ include nutritional (torula) yeast, brewer's yeast, sunflower seeds, wheat germ, soybeans, walnuts, lentils, lima beans, buckwheat flour, bananas, and avocados.(Source)
• Vitamin B₇ (biotin)
• Vitamin B₉ (folic acid)
• Vitamin B₁₂ (various cobalamins; commonly cyanocobalamin in vitamin supplements)
• The INH Role:  INH blocks the absorption of several B-vitamins.  In particular:
• Vitamin B-6 - Individuals who take isoniazid may develop nerve problems such as tingling or numbness in the arms, hands, legs, and feet. The cause is believed to be the drug's interference with the action of vitamin B ₆.^1,2  In fact, use of isoniazid is one cause of the few occasions in which vitamin B ₆ deficiency is seen in the developed world. (Source)
• Niacin - According to animal studies, isoniazid can interfere with the body's ability to produce vitamin B ₃ (niacin) by blocking tryptophan, which naturally occurs in foods. This can produce either a subtle or an all-out niacin deficiency (known as pellagra).^4,5,6  Taking niacin supplements at standard U.S. Dietary Reference Intake (formerly known as the Recommended Dietary Allowance) doses should help you get the niacin you need. (Source)
• More reading
• Folic Acid- Anecdotally, many sites mention that INH interferes with Folate (Folic Acid) absorption.

3. Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell pepper).

• Background:  Antioxidants protect your cells against free radicals.  Free radicals are molecules (examples include superoxide anion, hydroxyl radical, transition metals such as iron and copper, nitric acid, and ozone) that have one or more unpaired electrons, and so scavenge your body to give or take electrons.  As they do that, they damage cells, proteins and genetic material (DNA). It is impossible for us to avoid free radicals as they can come from outside or inside our body in the forms of sunlight, pollution, smoking, alcohol and X-rays.  Antioxidant substances include Beta-carotene, Lutein, Lycopene, Selenium, Vitamin A, Vitamin C, Vitamin E.  These substances break the scavenging chain and stabilize the molecules.  (More reading).
• INH Role: Some studies have found isoniazid to produce low level scavengers.  These include acyl, acyl peroxo, and pyridyl radicals of isoniazid.  (Source)

4. Avoid refined foods, such as white breads, pastas, and sugar.

5. Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.

6. Use healthy cooking oils, such as olive oil or vegetable oil.

7. Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.

8. Avoid coffee and other stimulants, alcohol, and tobacco.

• Coffee - No real INH interactions that I found, although it may irritate stomach.
• Tobacco - While there is no evidence that INH is itself carcinogenic (molecularly "almost" identical to nicotinic acid) - Source - smoking is in fact harmful to your health.  Just one more thing for the body to process...
• Alcohol - INH combined with alcohol increases your risk of hepatic toxicity.  Additionally, INH reduces metabolism of histamines, very often found in beer and wine.  (See my post on this for more info.)
  

9. Drink LOTS of clean, filtered Water!

•  Background: Water plays a vital role in any healing journey. The new rule of thumb for water intake is to take your body weight and divide by to for the number of ounces in water you should drink each day. Some of the functions of water in the body:
• Water serves as a lubricant
• Water forms the base for saliva
• Water forms the fluids that surround the joints.
• Water regulates the body temperature, as the cooling and heating is distributed through perspiration.
• Water helps to alleviate constipation by moving food through the intestinal tract and thereby eliminating waste- the best detox agent.
• Regulates metabolism
• (Source)

• The INH Role: INH inhibits Histamine metabolism.  Because the possibility for higher histamine levels exists during INH (and thus reactions, allergic and otherwise) one of the best anti-histamines to take is water.  Water regulates histamine levels.  The more water, the less histamine.

Supplementation:

1. Probiotics
2. Multivitamin- I'm not talking any old one-a-day, off the shelf vitamin.  I'm talking a hefty, food-based six-a-day one.  Any vitamin you take should give you maximum absorbency of the nutrients (thus the food-based suggestion), and high levels of anti-oxidants, B-vitamins, and Calcium.  Here are two suggestions:
1. Super Nutrition:  I take the Women's Blend.
2. Rainbow Light
   

• Vitamin B-6 (Pyridoxine) supplements (25-50mg) daily may help to prevent peripheral neuropathy.

• Vitamin D, calcium and folic acid levels are lowered in the body when using Isoniazid .

• Niacin may be depleted with Isoniazid7

• Vitamin E and magnesium may also be depleted with long term isoniazid use. Discuss supplementation with a multivitamin with a pharmacist.8


Herbs:

• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Aged Garlic (Allium sativum) extract, 600 - 1200 mg daily, for antibacterial and immune stimulating properties. Use garlic supplements only under the supervision of a health care provider if you take blood-thinning medications, such as warfarin (Coumadin).
• Astragalus (Astragalus membranaceus) standardized extract, 250 - 500 mg three to four times daily. A preliminary study indicates that astragalus may be helpful in treating TB.
• Rhodiola (Rhodiola rosea) standardized extract, 150 - 300mg one to three times daily, for immune support. Rhodiola is an "adaptogen" and helps the body adapt to stress.

Acupuncture:
Acupuncture can help strengthen your immune system response as well as support your lung function.

DISCLAIMER:  I am not a medical professional.  All information on this page is credited to its source; please feel free to review sources and come to your own conclusions!