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improve immnune system and gain weight
May 31, 2002

I am poz going on 3 years, taking sustiva and trizivir. I want to know what I should be eating or if I should be taking any supplements to help improve the immune system and gain a little weight. Thanks.

Response from Ms. Fields-Gardner

Start at the starting point: eat a healthy and well-balanced diet. I know that sounds as "unmagical" as can be, but a lot of people seem to miss that as a starting point ("I took my supplements with my coffee this morning, so I am okay...").

Weight is generally considered a calorie issue. The exception is when there are hormonal or cytokine changes that seem to get in the way. Still, adequate amounts of calories will be essential to weight gain and maintenance.

Now that you have done that, you can look to the modulating effects of nutrients. While many have been pretty weak and particularly disappointing in the forms we typically use, there are some that are worth exploring. Start with the modulation of inflammatory response by fish oils... preferably in fish! While treatment of inflammation that has already caused damage is disappointing, there is a potential for prevention of long-term damage in HIV infection (though this is very difficult to prove).

There are a number of other recommendations that have been made to improve blood levels of glutathione, for instance. And while there is not enough good information to make it an "across the board" recommendation at this time, there is potential for some benefit in the use of alpha-lipoic acid, glutamine, N-acetyl cysteine, and others. Recommendations for L-acetyl carnitine could hold some promise, even though the study that suggested effectiveness against neuropathy required intravenous delivery.

But here you get into some quicksand areas and these and other recommendations should be made on an individual basis. So, off you go to your HIV-savvy dietitian to talk more about it.


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