Nelson,

Here are just two short subject related questions. I am eating and supplementing just under the maximum dosages of required vitamins and minerals as seen in POZ magazine. My question is what is the maximum daily intake of protein in grams? And, I take a multi-vitamin with Vitamin A in it; but I don't supplement vitamin A, as I know it can be toxic in high doses? Is it safe to use Retin-A(Tretinoin) .025 with the amount of vitamin A in a multi- vitamin, 6,000 I.U.?

The Recommended Daily Allowance (RDA) of protein according to U.S. government standards is 0.8 gram per kilogram (2.2 pounds) of ideal body weight for the adult. This translates into 0.36 grams per pound of body weight per day. But as you probably know, the RDA requiments have been designed for healthy people. People with chronic infections like HIV may require more. However, there is very little research about this. If you are sicker, your requirements increase to support your body's production of immune cells, cytokines, lean body mass(LBM), and metabolic active tissues. The bodybuilding world usually follows a very high intake of 1 gram per pound of bodyweight per day. I think this may be too high for most of us to handle. Most people's gut can not handle more than 30-40 grams of protein per meal (higher amounts produce bloating, gas and indigestion in many). I would say that if you have a pretty good exercise program and need to gain LBM, you want 2 times the RDA for protein. Think of eating 3/4 of a gram of protein for each pound of ideal body weight. Your ideal weight is 160 pounds? You should eat 120 grams of protein a day. If you are actively wasting, 1 gram per pound per day may be needed, but it is very difficult for people in those stages of HIV to consume that kind of quantities due to nausea and lack of appetite. Whey protein supplements have become very popular for those who want to increase their protein intake. Just be aware that an ACTG study found no difference in LBM in those taking a protein supplement compared to placebo. Most protein supplement subjects' bodies compensated by decreasing total calories consumed during the day. So keep in mind that these supplements should be just that: supplements and not meal replacements. I am allergic to whey and lactose so I prefer real food to get my protein uptake requirements (lean meats, eggs, cheese, nuts, etc)

Using Retin A cream while you are taking a multivitamin with Vit A should not pose any problem. Vitamin A can cause death at levels of 1,000,000 ius in a single dose. With the highest supplement containing 7500ius per tablet, you would have to take 134 tablets in one go to kill yourself.

Some recent research on animals has shown that extremely large amounts of Vitamin A can interfere with fetal development, therefore pregnant women should not exceed 10,000ius per day.

Talk to your dietitian about your protein and vitamin requirements.