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HIV, Vitamins and Supplements

February 2013

Table of Contents


Micronutrients and HIV

Vitamins, minerals, and antioxidants are called micronutrients. Even though the body only needs small amounts, micronutrients are essential for good health. Our bodies use them in the different chemical reactions our cells go through as part of the body's normal functions. While some people get the nutrients they need through a healthy, balanced diet, many people living with HIV (HIV+) need more micronutrients to help heal cells damaged by the virus and support the immune system.

Vitamins

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Vitamins generally fall into one of two categories: (1) fat-soluble, or those that dissolve in fats, and (2) water-soluble, or those that dissolve in water.

When you take in fat-soluble vitamins (through foods or supplements), your body uses what it needs and stores the rest. Fat-soluble vitamins include vitamins A, D, E, and K. It is important not to take too much of these vitamins because they can build up in the body and cause harmful side effects. For example, too much vitamin A (betacarotene) can cause nausea, blurred vision, birth defects, and liver problems.

When you take in water-soluble vitamins, such as B vitamins and vitamin C, your body uses what it needs and filters out the extra into your urine. Side effects from water-soluble vitamins are less common, but can occur. For example, large doses of vitamin C can cause nausea, stomach cramps, and diarrhea.

Minerals

Minerals form the structures in the body (calcium in bone, iron in blood) and play a role in the normal functioning of nerves, muscles, and hormones. Several minerals, including zinc, selenium, and iron have a role in fighting HIV.

Antioxidants

The body produces molecules called free radicals as part of its normal functioning. Free radicals can damage your body's cells. Certain factors, like infection, pollution, and cigarette smoke can increase the number of free radicals in the body. Antioxidants can keep the extra free radicals from causing damage. Some vitamins, including vitamin C and vitamin E, are antioxidants. Beta-carotene (vitamin A) and selenium are also antioxidants.


Getting Enough

While micronutrients can be found in foods, most HIV+ people cannot meet all their nutrient needs through their diet. It is common for HIV+ people not to get enough micronutrients for a number of reasons: because of HIV infection itself, poor absorption of nutrients, changes in metabolism, HIV drugs, poor appetite, diarrhea, or damage to the gut.

Micronutrients that are often low in HIV+ people include vitamin A, vitamin E, selenium, zinc, and B complex vitamins (B1, Thiamine; B2, Riboflavin; B3, niacin; B6, Pyridoxine; B12, Cobolamin; and B9, folic acid). Some research shows these low vitamin levels can lead to lower CD4 cell counts, worsening of HIV, and early death. They can also cause problems like diarrhea, neuropathy, and skin conditions.

Most research shows that these low vitamin levels can have a negative effect on your immune system before you even have symptoms of HIV. Even if you have a good diet and feel fine, you may not be getting enough of certain vitamins, minerals, and antioxidants.

The Recommended Dietary Allowance (RDA) guidelines are set by the US government to let people know how much of each micronutrient they need each day to maintain good health. However, the RDA does not take into account that HIV infection increases these needs. One study showed that HIV+ people needed between 6 and 25 times the RDA of some nutrients.

Due to dieting, eating unhealthy foods, lack of time, or other pressures, half of all women in the US do not eat what they need to meet even the basic RDA requirements for folic acid, iron, zinc, calcium, magnesium, copper, vitamins A, D, E, and certain B vitamins. This puts women, especially HIV+ women, at particular risk for low levels of micronutrients. In addition, women are more likely not to get enough nutrients because of menstruation, pregnancy, and menopause.

Eating a well-balanced diet should be the basis of any plan to correct micronutrient deficiencies. Since different vitamins and minerals are found in different food groups, you should include foods from each group in your diet every day. (Read more about food groups at the USDA's "Choose My Plate" website.)

For more information, see our nutrition sheet.


Taking Supplements

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:

You may also want to consider:

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, 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 nutriets without taking too much can be tricky. Play it safe by speaking to your health care provider and an HIV-knowledgeable dietician about what supplements to take and possible side effects or interactions with your HIV drugs.




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