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This updated narrative review integrates mechanistic and clinical data on nutraceuticals, including amino acids, fatty acids, vitamins, minerals, and polyphenols. Consistent clinical signals include omega\u20103 fatty acids, alpha\u2010lipoic acid, vitamin D, coenzyme Q10, black seed oil, and vitamin E with levocarnitine, which primarily reduce oxidative stress to protect against cardiotoxicity. Additional preclinical and early clinical work highlights vitamin C\u2013, taurine\u2010, zingerone\u2010, and rosemary\u2010derived phenolics as candidates that target oxidative and inflammatory injury without compromising antitumor activity. Translation to care should be prevention\u2010focused, pairing baseline risk assessment with surveillance that utilizes high\u2010sensitivity troponin, natriuretic peptides, and advanced echocardiography, such as global longitudinal strain. 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