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Improving HAART Naturally

Holistic Approaches to Strengthen Your Immune System & Enhance Your Treatment Regimen

Summer 1999

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

Much of the focus on herbal or supplemental medicines has dealt either with alternatives to anti-retroviral therapy or minimizing the side effects from synthetic medications. Lost in this discussion is the role alternative therapies can play in enhancing an individual's response to highly active antiretroviral therapy (HAART). Since natural medicine is based on the principle of treating the whole person and simply not the disease or condition, it is always difficult to discuss recommendations without an actual person seeking help. Still, when dealing with people on HAART, some general suggestions can be made.

Gut Function

For anyone on HAART, the first issue to address is the gut. Is it working well? With all the talk about compliance, medication schedules, and treatment success or failure, many practitioners overlook the health of the digestive tract. Common symptoms of gut distress are nausea, gas, bloating, diarrhea, constipation, or heartburn. If any of these are familiar to you, you run the risk of poorly absorbing your drugs.

If the drugs aren't digested well, they won't make it into the bloodstream and tissues where they need to work on HIV. The result might be failure of treatment for no other reason than a compromised gastrointestinal tract.

Food Allergies. Since food sensitivities and allergies frequently occur in people with HIV and AIDS, it can be extremely prudent to avoid foods that are suspected of causing problems. The two most common foods to consider avoiding are dairy and wheat. The ideal way to test for such food reactions is to eliminate the food from the diet completely for 2 weeks, and then reintroduce one food at a time for 3 days and observe the symptoms.

Allergic food reactions are often of two types. Type One hypersensitivity reaction occurs within minutes of ingesting the food, but Type Four reaction may take as long as 72 hours for symptoms to appear. Reintroducing the food for 3 days and watching for reactions is the safest and most reliable method to make sure a Type Four reaction will not develop.

Be wary of laboratory tests for food allergies and sensitivities, since most of the inexpensive tests are not reliable or accurate. Many people aren't even aware that their symptoms are a result of food reactions, since modern commercials tell us that our symptoms can be easily cured through over-the-counter pills. Typical symptoms of food reactions can be the same as those listed above (diarrhea, constipation, gas, bloating, heartburn, nausea), or they can occur throughout the body, such as on the skin (rashes, eczema, psoriasis, acne), muscles and joints (arthritis, joints stiffness, muscle aches, and pain), respiratory tract (sinusitis, postnasal drip, recurrent sinus infections or cough), and general systemic symptoms (fevers of unknown origin, headaches, fatigue).

After identifying possible food reactions, the next consideration is healing the gut. The most effective way to promote gut health is eating a diet full of whole, non-processed foods. This means whole grains, fruits, and vegetables.

Whole grains such as rice have multiple benefits for the gut. Not only does rice provide fiber, which keeps the colon healthy and functioning properly, which in turn affects cholesterol levels, rice solids help bind toxins in the gut. An old and proven remedy for chronic diarrhea is congee, rice gruel made from cooking 1 cup of white rice in 6 cups of water on medium heat for 30 minutes. Eaten daily as done throughout Asia, congee protects the gut and keeps it working well. Although not as specific in their healing benefits, cooked whole grains such as millet, quinoa, barley, amaranth, and buckwheat provide necessary soluble fibers that aide in general health.

Animal products (chicken, red meat, and eggs) should be consumed in moderation. First of all, such food sources can elevate triglyceride and cholesterol levels, definitely something to avoid for people suffering with lipodystrophies. When animal products are consumed, they should be from animals that are free range and raised without hormones and antibiotics. Even for people who are not reacting to dairy, safer choices for the immune system are milk and cheeses from antibiotic-free and hormone-free cows, In particular, food products from hormone-injected animals may interfere with the natural balance of testosterone and other hormones.

L. Glutamine. Another simple way of healing the gut is through supplements. Deficiencies in the amino acid L-glutamine may cause inadequate antioxidant status in the body, and wasting and loss of both intestinal and immune function. L-glutamine is the primary fuel for lymphocytes and macrophages and the lining of the gastrointestinal tract. L-glutamine is available in most health food stores, and supplementing with it can help regenerate the damaged cells of the gut -- which maybe all that is necessary to improve digestion and absorption of food, and hence HAART. For acute infections, a dose of 30 to 40 grams per day of L-glutamine powder spread out over five doses of 6 to 8 grams each for 7 days may be helpful. Such a large dose is not necessary for everyone, and is definitely not indicated for those with advanced liver and kidney diseases. A more conservative amount of 2 to 4 grams per day can be safely consumed in capsule form.

Vitamins. Of course, everyone should be taking a good multivitamin and mineral supplement daily to assure nutritional needs are being met. Repeated studies show that HIV-positive individuals frequently have nutritional deficiencies. Antiretroviral treatments place more stress on the body and thus consume many nutrients in the process of clearing the drugs from the body. For this reason alone, supplementation with a multivitamin is necessary.

Milk Thistle. Also known as silymarin, this supplement prevents liver cell destruction, enhances liver function, inhibits free radical damage in the liver, and promotes protein synthesis of new liver cells. Several studies have shown that milk thistle can prevent destruction of liver cells from toxic chemicals. With HAART, this is an important complement.

How to Increase Your CD4 Count

Once the gut is working better, and HIV medicines are being more effectively absorbed, the next step is raising CD4 counts. If virologic success is measured as an "undetectable" viral load, immunologic success is measured in increasing CD4 counts. For those on successful HAART, natural therapies might offer alternatives to immune-based therapies like interleukin-2 (IL-2).

Beta carotene. Several studies have shown that taking 180 mg (300,000 IU) a day of beta carotene can raise CD4 counts. Although the degree to which CD4 counts may be increased is not as significant as seen with HAART, many times beta carotene has been recommended to patients not choosing to begin HAART.

However, some practitioners caution against using beta carotene in such high doses when not on antiretrovirals since there is the possibility of increasing hosts for the virus. However, for people who are on successful HAART, use of beta carotene might be warranted. Although no studies to date have shown exactly how CD4 cells increase and where are they coming from, if HAART drugs are working and there are no side effects, increasing CD4 cells when the viral load is undetectable is an attractive option.

Beta carotene has many other benefits for the immune system beyond its effect on CD4 cells. It heals mucus membranes (such as the lining of the gut) and skin. Furthermore, it is a potent antioxidant. But be careful -- not all beta carotene is the same. Look only for natural forms of beta carotene. Synthetic forms contain a different molecular configuration that does not confer the same benefits. Finally, anyone taking high doses of beta carotene should be sure to take a multivitamin to ensure they are getting adequate vitamin E (400 to 800 IU per day), since high doses of beta carotene can inhibit the absorption of vitamin E.

Hyperthermia. Another therapy to consider with successful HAART is hyperthermia. This is a process of raising a person's core body temperature by sitting them in a tank of hot water, much like a hot tub or Jacuzzi. This should not be done without supervision, and clinics that offer hyperthermia treatments constantly monitor the patient's blood pressure, pulse, and temperature while keeping them hydrated and their head cool and wet. Studies of hyperthermia have shown that raising core body temperature can stimulate immune cell proliferation and thus cause an increase in CD4 cells.

However, as seen with the beta carotene studies, these levels decrease approximately 4 to 8 weeks after discontinuation of the treatments. A safer, home version of this treatment is simply to take a 5-minute warm bath, wrap up in sweat pants and sweat shirt, and cover up with blankets. Following this procedure weekly or every other week stimulates the body's immune response, initiating the production of the cells that fight infection. Moreover, such a home treatment is extremely useful for anyone who feels they are coming down with a cold or flu. Remember, fevers are not necessarily a bad thing. A fever is the body's way of fighting bacterially and virally infected cells. Fevers for brief periods are not something we wish to stop because they are a sign of a healthy system. Concern is warranted only when fevers are chronic.

These are just a few ways to enhance HAART effectiveness. Many natural therapies can stimulate immune response and are a wonderful addition to successful HAART.

Before exploring those options, remember the basics:

  • Make sure the gut is working well. If not, find a skilled practitioner to work with.

  • Avoid food allergies and sensitivities.

  • Take a good multivitamin and mineral supplement daily.

  • Consider supplementation with L-glutamine and beta carotene.

  • Consider modified home hyperthermia treatments on an on-going basis to stimulate body's immune system.

Brad S. Lichtenstein, ND is a naturopathic physician in private practice in Seattle, WA. He is adjunct faculty at Bastyr University and a supervisor at the HIV clinic at the Natural Health Clinic. He can be reached at(206) 285-4625 or email at

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

This article was provided by Seattle Treatment Education Project. It is a part of the publication STEP Perspective.
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