Which item is associated with increased bleeding risk and potential chemotherapy impact?

• A. Vitamin E
• B. Ginkgo biloba
• C. Grapefruit
• D. Salt

Answer: (B)

This item tests awareness of herbal supplement interactions with cancer treatment, especially how some substances can raise bleeding risk and affect chemotherapy. Ginkgo biloba has potent antiplatelet effects, meaning it can impair platelet function and increase the chance of bleeding. In a patient receiving chemotherapy, who may already have reduced platelets or on drugs that affect clotting, adding ginkgo can heighten bleeding risk. There’s also potential for ginkgo to interact with chemotherapy medications through metabolic pathways, which could alter drug levels or toxicity.

Vitamin E can also increase bleeding risk, but the standout concern tied to chemotherapy interactions is most consistently linked to ginkgo biloba. Grapefruit mainly alters drug metabolism (via CYP enzymes) rather than bleeding risk, and salt has no relevant impact in this context.