Hello,

I'm curious about your opinions on mushroom derived beta glucans, I have read a couple of Japanese studies using maitake and shitake derived supplements and have been taking these since January: http://www.newchapter.com/mushrooms/lifeshield-immunity

I know you are skeptical of supplements other than a basic multi and fish oil(both of which I also take) but I found this interesting: http://nccam.nih.gov/grants/CAMNP/priorities?nav=gsa#Betaglucans

I've been on Stribild since March, my levels were CD4 439 and VL 25,000 before starting and after 4 weeks my levels were CD4 717 and VL 28.

I haven't had any side effects or drug interactions, metabolic panel results and urinalysis all good too, so with such a quick supression of VL and rise in CD4 I'm wondering if the beta glucans might have had some beneficial/adjuvant effect. I know this is a tricky conclusion to come to, I'm just looking for some informed speculation.

Do you think it could have been the Stribild alone? I was wondering if you recommend continuing the supplements and if taking them in pill or liquid form(haven't tried but also curious) is preferable.

Thanks!

Hello and thanks for posting.

I remain skeptical and wary of claims of effectiveness and safety about supplements- including those of the Japanese mushroom preparations. It's not that I'm not interested in the possibilities, but more concerned about the untested safety or lack of proof of effectiveness. Personally, I wouldn't continue on with supplements (liquid or pill) without such known safety profiles, especially when you're taking a medication with the known potential for drug-drug interactions (ie., cobicistat).

The NCCAM page that you cite lists a lot of candidates that are of interest, but the page notes that these are research areas, and not saying that the supplements are good to take.

As for your labs, Stribild (or any integrase inhibitor regimen for that matter) is well known to produce rapid and dramatic decreases in viral load in the first weeks of treatment. Indeed, your decline isn't surprising to me at all.

The CD4 count increase is larger that I would have expected; I'd wonder if this reflects some discrepancy in your absolute and percent CD4 measurements. Do your CD4 percentages also show a ~doubling in the same time? I'd wouldn't expect so, but if this is seen, then one could take stock in the dramatic improvement in immune health.

Hope that helps, BY