It is important to get as many of the vitamins and minerals you need from food as possible. This is because nutrients found in food are better for your body than nutrients found in supplements. While supplements do not replace a well-balanced diet, they can help you get the additional micronutrients you need. Supplements include vitamins, minerals, herbs, and other related products used to boost the nutritional content of your diet. Supplements are available in pill, capsule, tablet, powder, or liquid form.
Speak to your health care provider and see a registered dietician for a nutritional evaluation. They can help you determine what combination of diet changes and supplementation you need.
Here are some basic recommendations:
- Take a multivitamin/multimineral supplement (without extra iron) every day
- Multivitamins should be taken with food and a full glass of water to help absorption and prevent stomach upset
- Consider a B complex vitamin and an antioxidant supplement in addition to your multivitamin. If you are vegetarian, consider getting your vitamin B12 level checked; if it is low, it is important to ask your provider for the correct amount of B12 to take.
- Because women are at higher risk for bone disease, make sure you are getting 1,000 milligrams of calcium (1,200 milligrams if you are over 50) from foods or supplements each day. Women who are menopausal do not have the estrogen levels to support new bone growth. If you are menopausal, it is important for you to take calcium supplements for the rest of your life.
- Humans make vitamin D by being outdoors and exposing our skin to the sun. Many people are low in vitamin D, which is important for absorbing and using calcium. It is important to have your vitamin D level checked and to ask your provider for the correct amount of vitamin D to take if your level is low. The RDA for vitamin D is 600 units (or 15 micrograms) per day.
- Iron may be too low in women, especially during their menstrual periods. This can lead to anemia. However, it is not recommended that people living with HIV take extra iron without their health care provider's advice.
- Because studies have shown that St. John's Wort (Hypericum perforatum) affects the levels of protease inhibitors and non-nucleoside reverse transcriptase inhibitors in the blood, the US Food and Drug Administration (FDA) recommends that those taking any HIV drugs not take St. John's Wort. St. John's Wort is an herb commonly used as an anti-depressant.
- If you are planning to get pregnant, speak to your health care provider about prescription pregnancy vitamins that contain folic acid. Folic acid needs to be taken before becoming pregnant, since the first six to eight weeks of pregnancy is the most important time for folic acid to protect the developing baby's nervous system.
You may also want to consider:
- Alpha-lipoic acid: for its antioxidant properties and diabetic neuropathy. Suggested dose: 20-50 mg per day for general antioxidant properties, 200-300 mg per day for diabetic neuropathy. Reportedly tolerated well up to 600 mg per day.
- Carnitine (also called acetyl-L-carnitine): to support proper metabolism. It may also help with neuropathy. Suggested dose: 500 mg to 3000 mg (3 g) per day.
- Coenzyme Q10: acts as an antioxidant and supports immune function. Suggested dose: 30-200 mg per day.
- Cysteine (also called N-acetyl-L-cysteine, or NAC): the body converts cysteine to glutathione, a powerful antioxidant. Suggested dose of NAC: 500 mg per day to start; people living with HIV may take up to 4,000 mg per day, with your health care provider's supervision.
- Probiotic supplement: these contain "healthy bacteria" like acidophilus to support digestion and immune health. Having healthy bacteria in your gut helps your body absorb more nutrients and make the most of what you eat. A suggested dose of Lactobacillus acidophilus (L. acidophilus), one of the most common probiotics, is one to two billion colony-forming units (CFUs). The dose depends on the health condition being treated. Those using probiotics may take as many as 15 billion CFUs per day for intestinal health with their health care provider's supervision.
Because of the potential for side effects and interactions with medications, supplements should be taken only under the supervision of a knowledgeable health care provider.
Deciding which supplements to take can be difficult and confusing because there are so many different kinds on the market. Try not to make your selections based on price, fancy or expensive packaging, or product promises. Instead, read the label to see what is really inside.
Micronutrients are essential to your body's healthy functioning. However, making sure you get enough nutrients without taking too much can be tricky. You can play it safe by speaking to your health care provider or an HIV-knowledgeable dietician about what supplements to take and possible side effects or interactions with your HIV drugs.