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How People Living With HIV Use Herbal Therapies

Part of A Practical Guide to Herbal Therapies for People Living With HIV


HIV-positive people use herbs for a few key purposes:

Immune System Therapies

Many people with HIV take herbs to support the immune system and to help it repair the damage caused by the virus. This is one of the most important uses for herbs but it's also an area in which it may be difficult to find enough information to make informed choices. We know that the immune system works as a result of incredibly complicated interactions between immune cells and the proteins they use to communicate with each other. It's often difficult to predict how drugs or herbs that target one part of the immune system will impact on another part. Science has learned a lot about the immune system during the last 15 years, and much of this research has been driven by research into HIV infection, but much more needs to be learned. So far, neither pharmaceutical companies nor herbal practitioners have focused on treatments that take full advantage of our knowledge of the immune system. Most of the interest in herbal immune treatments lies with herbs that were formerly used for cancer treatment.

HIV hides inside the cells of our bodies, as do many of the micro-organisms that cause AIDS-related infections. Infected cells appear abnormal to the immune system, so the immune system fights these infections by destroying abnormal cells. Since cancer cells are also abnormal cells, the immune system uses a similar approach to destroy cancer cells. The destruction of abnormal cells is directed by a portion of the immune system called the cell-mediated immune system.

The cell-mediated immune system includes specialized immune cells, such as CD4+ cells, CD8+ cells and natural killer cells that work together with the immune proteins interleukin-2 (IL-2), interferon gamma (IFN-gamma), tumour necrosis factor alpha (TNF-alpha) and many other proteins. Herbal therapies that may be useful for HIV-positive people usually enhance cell-mediated immunity.

Although we say that AIDS is an immune deficiency syndrome, parts of the immune system of an HIV-positive person work very hard and may already be overstimulated by the demands of HIV infection. Some immune stimulants (or immune boosters) may actually worsen the health of HIV-positive people by stimulating the wrong parts of the immune system or by increasing the burden on the system. Immune therapies are often taken in cycles (a few days or weeks on followed by a few days or weeks off) to prevent the system from adapting to the treatment in such a way that the treatment's effects are weakened. This point is important to consider when choosing herbal therapies for immune support.

Some herbs used as immune therapies include ashwagandha, Astragalus, Atractylodes, cat's claw, ginseng, greater celandine, shatvari and shiitake as well as maitake mushrooms.

Antimicrobial Therapies

An antimicrobial is a chemical substance that kills micro-organisms such as bacteria, viruses, fungi and protozoa. These micro-organisms cause the infections common in people with AIDS. Plants have antimicrobial properties that protect against infection. These properties are usually effective against a broad range of possible infections, since plants have no formal immune systems that identify and react to specific infections.

The antimicrobial properties in plants are also useful in fighting infections in humans but are generally considered milder and less targeted than drugs or the actions of our immune systems.

People living with HIV typically use antimicrobial herbs to prevent AIDS-related infections or to treat relatively mild infections. Such herbs may also be used to enhance the effects of antimicrobial drugs. Antiviral herbs are a subcategory of antimicrobial herbs, and some of the herbs used by people with HIV primarily to treat the virus may also help prevent other infections.

Herbs used as antimicrobials include garlic, goldenseal, neem, propolis, Sanguinaria and tea tree.

Anti-HIV Therapies

There is reason to believe that some herbs may attack HIV directly. Studies have identified herbs that kill viruses other than HIV in a test tube, and records based on traditional knowledge identify herbs used to fight viral infections.

A few small clinical trials have been done on antiretroviral herbs, but no herbal treatment has been shown to be as effective as antiretroviral drugs in stopping the replication of HIV.

When investigating antiviral treatments, it's important to note how the treatments have been tested. Although a test-tube study tells us that a treatment can stop the replication of a virus, it doesn't tell us whether this herb can be absorbed into the body at effective levels. Nor does it tell us whether the herb can stop replication inside the body.


Simply put, many of the natural processes of our body - like breathing - produce chemical by-products called oxygen free radicals. Although these free radicals are a natural part of our body's metabolism, if left unchecked, they can damage our cells in much the same way that rust damages a car. Antioxidants, which our bodies produce, prevent this damage. Also, antioxidant vitamins, like vitamins C and E, are present in many of the foods we eat.

Studies have shown that people with HIV produce high levels of free radicals, and that their bodies have lower levels of antioxidants. To counteract this problem, many people living with HIV take antioxidant supplements. Examples of strong antioxidants are the nutritional supplements N-acetyl-cysteine and CoEnzyme Q10, and antioxidants are discussed in more detail in CATIE's Practical Guide to Nutrition. Some of the antioxidant herbs covered in this guide are ginger, ginkgo, milk thistle and turmeric.

HIV-Related Conditions

Some people living with HIV use herbs to help treat or prevent conditions related to the virus. Besides those antibiotics previously mentioned, examples of such herbs include the following:

  • Ginkgo to prevent HIV-related dementia.

  • St. John's wort for mild to moderate depression.

  • Greater celandine for Kaposi's sarcoma.

  • Marijuana for wasting.

  • Aloe vera for skin problems.

  • Lemon balm for insomnia and herpes simplex.

Drug Side Effects

Some people use herbs to cope with the side effects of the drugs they take to combat HIV infection. When we talk about drug side effects, we often think of ones that are direct and short-term, like nausea, diarrhea and headaches. Some herbs are used to treat these conditions, like ginger or marijuana for nausea, and peppermint or psyllium husks for diarrhea. Peppermint oil may also be used for headaches by applying a small amount to the temples.

High levels of cholesterol and triglycerides are becoming more common in people living with HIV. This problem seems to be associated with the use of antiretroviral drugs. Having high levels of cholesterol and triglycerides in the blood may increase a person's risk of heart attack or stroke. In response, some people living with HIV are exploring herbal remedies, including garlic, ginger, ginseng and guggul.

The use of herbal therapies to manage drug side effects is very complicated because of the potential for herb-drug interactions. These interactions can increase side effects, weaken the effectiveness of treatment and/or cause drug resistance leading to limited treatment options. The use of herbal therapies for managing drug side effects will not be discussed in depth in this guide. CATIE's Practical Guide to Managing HIV Drug Side Effects discusses this topic in more detail.

If you are considering taking herbal therapies along with prescription or non-prescription medications, including antiretroviral drugs, please read the section in this guide called Herb-Drug Interactions.

General Well-Being

People living with HIV face many challenges. As a result, they may experience increased levels of stress, and this stress may be detrimental to the immune system. HIV-positive people may experience fatigue due to this stress. Fatigue may also be the side effect of an anti-HIV drug or a symptom of HIV infection. Two groups of herbs are often used to deal with stress and fatigue.

Adaptogens are herbs that normalize the body's function and help it cope better with illness and stress. They seem to work on a variety of conditions. How they work is not clearly understood and will vary with the different herbs. They may affect the parts of the brain that govern our hormones. Adaptogens have been observed to help people cope better with non-specific problems like stress and fatigue but they may have more specific effects, as well. For example, Panax ginseng has been shown to help regulate (by increasing or decreasing) insulin levels in diabetes. Adaptogens may also assist in regulating the immune system. Tonic herbs are invigorating substances that promote vigour, physical tone and a sense of well-being. They might give an HIV-positive person more stamina. They are often used by traditional practitioners to help people cope with the burdens of aging. Although tonic herbs may help a person cope with fatigue, they are rarely used in times of crisis.

Ashwagandha, ginseng and shatvari are herbs often used for general well-being. Plant-based materials are similarly used in aromatherapy and treatments involving flower essences. These therapies are discussed in CATIE's Practical Guide to Complementary Therapies.

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This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.