Hello Nelson,

I believe the following is a very important question and if you feel unable to answer it authoritatively, then PLEASE point me towards someone who can.

The following article has just appeared on The Body, and a link to it has been included in the worldwide weekly email newsletter.

http://www.thebody.com/content/art48991.html?mtrk=10886021

Basically the message of this article is that everyone who has HIV, regardless of whether they are on ART or not, should be taking:

1. a potent multivitamin which includes selenium, and not just once a day but several times a day

2. "NAC", to increase gluthathione levels, & for the liver. (1,000 and 3,000 mg a day.)

3. Fish oils. (Two grams twice daily if on ART.)

4. Coenzyme Q10, to protect mitochondria from HIV medications. (Take 300 mg a day if you can afford the cost.)

5. green tea capsules

I take a multivitamin every day which also contains selenium and which is strong on anti-oxidants. Other than that I eat a good balanced diet.

Ought I to ensure I take all FIVE of the above listed supplements?

Many thanks.

Eddy.

That article contains someone's opinions.

This is what I can tell you:

1. a potent multivitamin which includes selenium, and not just once a day but several times a day.

My take: We know we have vitamin deficiencies but most of the data comes from pre-HAART days. We have some good evidence on selenium at 200 micrograms per day, and also on B-12 deficiencies in some patients. A good multivitamin is always a good thing but we have no data on dosages in the post-HAART era. We probably never will since it takes money to run such studies and there is no agreement on what the best tools to measure vitamin deficiencies are. So, using vitamins at high doses may have some benefit in health but we really do not know. Just remember that vitamin A, K, D, E and others are fat soluble and can accumulate in the body. Other than that, you are probably all right if you take a multivitamin once to twice a day. Make sure you are also comsuming enough calcium and vitamin D since we are getting a lot more data on bone loss in our condition.

2. "NAC", to increase gluthathione levels, & for the liver. (1,000 and 3,000 mg a day.)

We have some old data on NAC at high doses that showed some CD4 benefit, but no post-HAART data. Doses were high and hard on the gut.

3. Fish oils. (Two grams twice daily if on ART.)

We have some strong data on the triglyceride-lowering effects of fish oils, so this supplement is actually getting a lot of press. Some people may have blood clotting problems with it, so talk to your doctor if you are taking blood thinners.

4. Coenzyme Q10, to protect mitochondria from HIV medications. (Take 300 mg a day if you can afford the cost.)

I take Coenzyme Q-10 but all we have is a small pilot that saw quality of life improvements. No strong data on mitochondrial protection in HIV. I say just avoid Zerit and AZT to protect your mitochondria for now. I get energy and good appetite with it, but it is not a cheap product, so try it out and see what happens to you.

5. green tea capsules

All we have with green tea is pilot in vitro data that showed some anti HIV activity. Would it kill you to take the pills or drink the tea? NO. Will it help with energy and quality of life? Probably.

I am very open minded about supplementation but have also become more conservative post-HAART. It is unfortunate that nutrition and supplementation studies basically stopped around 1997 in HIV.

I hope this helped some.

Nelson