Before, During and After Starting Drug Treatment: The Body's Basic Elements of Health

When most people discuss HIV treatment, they're talking about antiretroviral drugs and all the issues related to their use. However, before we move on to a discussion of HAART, it is very important to know that there are things other than medicines that all PHAs should include in their disease management plan for the best possible results. All of these things should be part of a lifelong plan for living with HIV, whether you are currently on drug therapy or not.

Good Nutrition

First, address the nutrient problems of this disease. There is substantial research showing that multiple nutrient deficiencies begin early in HIV disease -- even when CD4+ counts are still high -- and that these deficiencies can both speed disease progression and cause many symptoms. Since virtually every known nutrient contributes to some aspect of the immune response, doing everything necessary to maintain optimal levels of nutrients is crucial for managing this disease.

So what does that mean in practical terms? First, eat what's good for you. This means consuming a balanced diet with a variety of foods. This includes:

• good levels of protein;

• good levels of mostly unrefined complex carbohydrates (brown rice instead of white; whole grain breads, crackers, cookies and pasta instead of those made with nutrient-poor white flour);

• lots of fresh fruits and vegetables;

• moderate amounts of only the good kinds of fats (use only natural fats and mostly the monounsaturated fats like olive oil; avoid the partially hydrogenated oils -- also referred to as "trans" fats -- widely found in margarines, shortenings and many baked goods, fried foods and snack foods; read the labels!);

• lots of healthful liquids (water, juices, herbal teas and the like; not chemical and sugar-loaded junk drinks); and

• always make sure the food you eat and the water you drink is safe!

Second, take appropriate nutrient supplements to help ensure that you will always have in your body optimal nutrient levels for slowing disease progression, improving long-term survival, and reducing or eliminating many drug side effects and other symptoms such as fatigue, skin problems, diarrhea, neuropathy, digestive problems, wasting, memory or other mental problems, and others. Start with a high-potency multivitamin/mineral formula that provides not only optimal levels of the basic micronutrients (like vitamin A, B vitamins, vitamin D, minerals and trace minerals), but also especially potent levels of all the antioxidants (such as vitamin E, vitamin C, alpha-lipoic acid, N-acetyl-cysteine, selenium, carotenoids, coenzyme Q10, etc.) that are so crucial for immune system support and body protection.

NOTE: For a complete discussion of nutrient approaches to drug side effects, see CATIE's Practical Guide to HIV Drug Side Effects. For much more complete information on the nutrient aspects of HIV disease, see CATIE's Practical Guide to Nutrition, both available at www.catie.ca. Also check out CATIE's Supplement Sheets at www.catie.ca/supple-e.nsf or by calling 1.800.263.1638 [if you're in Canada].

Hormone Replacement

For all HIV positive people -- men and women -- it is very important to monitor hormone levels and, when deficiencies are found, to do appropriate hormone replacement therapy. Too-low levels of testosterone are common, and appropriate replacement using the through-the-skin approaches (patches for men, and creams or gels for men or women) that will best achieve normal levels will have many benefits, including maintenance of muscle mass and organ tissue (crucial for long-term survival), as well as restoration of normal sex drive. For women, testing and appropriate replacement of female hormones may also improve overall health and to prevent worsening of PMS, perimenopausal or menopausal symptoms. You should note that there are side effects from using these hormones so, as with all medications, discuss the pros and cons with your doctor.

Exercise

Appropriate moderate exercise that combines aerobics (walking, rowing, swimming, running, skating, and all the other heart-pumping exercises) and weight training (the muscle-building exercises like weight lifting that create plenty of the lean tissue you need for survival) is terribly important for all PHAs. It can contribute to both the physical maintenance of the body and to mental well-being. Yoga is another such form of exercise.

For more information on exercise, see Built To Survive, a comprehensive guide to surviving and thriving with HIV by building well-being, improving lean body mass and increasing your overall health. It covers lifestyle changes, hormonal therapies and nutrition and dietary supplements, and includes a simple guide to productive exercising. It is available at www.medibolics.com.

Program the Mind Toward Healing

The power of the mind to boost the body toward healing is amazing. And the power of hope is one of the best tools you can have for long-term survival. Studies have shown speedier disease progression in those with negative attitudes toward the disease and in those with higher levels of stress. Anything that helps lower stress and create feelings of hope and a positive outlook -- including yoga, meditation, positive thinking, affirmations, massage, support groups and absolutely anything else that helps you thrive -- can be a powerful tool to add to your healing repertoire.

NOTE: For more information on this aspect of HIV disease, see CATIE's Practical Guide to Complementary Therapies, available at www.catie.ca.