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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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help to balance liver enzymes on mega-HAART
May 12, 2000

I was stable for 2+ years on Viracept & Combivir with a VL 1500-2000 and CD4 750-ish and managed loose stools with metamucil (THANKS FOR THE TIP!) it worked best if I took it even when I didn't need it - i.e. even on the normal days

anyway, I switched to norvir fortovase zerit videx hydroxyurea & viramune and eliminated the VL within 6 weeks of switching. Hooray! unfortunately, my liver enzymes started creeping up about 8 weeks into it and I was getting nausea, sometimes choking back vomit. this got progressively worse, and I quit all the meds all at once when the liver enzymes got about 5x upper limit of normal. Somewhere between 3 & 6 weeks off meds my liver function returned to normal, but the VL hit 60k. I asked my doctor if I could go back on it if we added milk thistle and other herbs for the liver, but he said there was no evidence that milk thistle or any other herbs would help PI-induced liver disorder. Is PI so much different than tylenol? Milk thistle has been proven to help alcoholic rats survive tylenol overdose even though I'm not a rat doesn't that suggest something?

Is there any evidence that it Doesn't help? What combination of herbs would help most? foods to avoid (or eat more)? I'm not against changing the antiviral combination either, but I don't want to use them all up too fast either.

Hey, I want to keep my liver healthy even more than my doctor does (I'm saving it for heavy drinking in my old age)

Right now I'm not on any drugs or supplements but in addition to milk thistle I've read about glutathione. Should I get my glutathione level tested and take NAC if its low as prophylaxis for liver trouble before going back on meds?

Response from Dr. Henry

There is anecdotal evidence that glutathione and N-acetyl cysteine may be helpful. Check out the book Healing HIV by Jon Kaiser -- it has a good section on vitamin and supplement therapies for liver health. Norvir is especially hard on the liver (have you been checked for hepatitis B and C and A and vaccinated for A/B if you haven't had them?). Keith Henry, M.D.

Coenzyme Q10
Is St John's Wort safe for HIV+ woman??

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