Dr. Holodniy, I was disgnosed with giardiasis in mid January and was put on a 3times a day-7 day treatment on Flagyl. IT seemed to work immediately. Five days later the symptoms returned with force. My doctor put me on a 14 day treatment of Flagyl of the 3 a day and hjalf-way through the major pains have subsided but I still have gas and cramping that makes me wonder if it is working. I have heard about several natural cures but I want to make sure they are safe to try. My t-cells are in the low 700s and I am undeatectable thanks to Reyataz,Truvada and the Norvir. I am worry that if I can't get rid of this I will have asorbsion issues which will make my HIV treatment difficult. Here are the natural solutions that were recommended. I know there is no way to know if they really work but I am willing to try as long as they are safe to use while on these meds. wormwood Grapefruit seed extract Goldenseal Clove Quassia

Any information would be very welcomed. Thank you

I can't speak to the natural solutions you list. My only concern there would be what drug interactions they might create with your HIV meds, particularly with ritonavir. There are several approaches to treating refractory or recurrent giardiasis. Either treat longer with flagyl (metronidizole), use alternative medications like nitazoxanide, or treat with a combination of agents. Also important to emphasize that the possible source has been eliminated or that reexposure has not occurred, which might be contributing to ongoing infection.