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An Introduction to Dietary Supplements for People Living With HIV/AIDS

June 24, 2010

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Does Age Matter?

Whether or not you have HIV, as you grow older, you're more prone to experience certain health problems, such as bone or lipid issues. To that extent, the older you are, the more important it can become to take supplements that help prevent these aging-related health problems.

However, in a broader sense, age isn't an issue when it comes to deciding whether to take supplements. If you eat healthy all the time (a well-balanced meal three times a day, with plenty of fruits and vegetables), don't smoke or drink alcohol, exercise regularly, and if your body is able to absorb food into your bloodstream properly, then it's likely you don't have to take anything beyond your HIV meds.

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But not many HIV-positive individuals are able to maintain an ideal diet or lifestyle, and both the physical and emotional effects of HIV can hurt their ability to get all the nutrients they need without a little extra help. That's one reason why researchers are starting to see vitamin deficiencies more and more in HIV-positive individuals at any age.

As anyone who's been keeping up with the latest developments in HIV probably knows, there are a range of health issues that we traditionally associate with aging that appear to be occurring at younger ages in people with HIV. Some of these health issues, such as bone problems (which may be associated with calcium and vitamin D deficiency), can be related to a loss of nutrients. If anything, however, these findings speak to the importance of taking supplements at any age if you need them: Even if some of the health problems that result from vitamin deficiencies occur in people as they get older, the deficiencies themselves may well have been present for a long time -- and filling in those nutrient gaps now may mean fewer problems in the future.


Are There Any Risks to Taking Supplements?

Always be careful about what you put into your body. Even though supplements contain natural nutrients (or products that are derived from natural nutrients), they can still sometimes cause side effects. For instance, although some research has suggested that selenium supplements may help boost the effects of antiretrovirals, selenium is also known to cause a range of potential side effects when taken in too large a quantity -- and experts aren't entirely sure what that "too large" number is.

There are also known interactions between some supplements and certain HIV medications. St. John's wort, for instance, can potentially change the levels of HIV meds in the body, which could reduce the effectiveness of those meds. Interactions such as these make it critical that both you and your health care team know about any supplements you're taking or plan to take if you're on HIV meds.

However, even in cases where there's no known interaction, keep in mind that very little study has been done on potential interactions between supplements and HIV medications. So it's best to separate the time you take supplements and the time you take your meds by five or six hours, just to be safe.

In addition, regardless of the supplement you're considering taking, before you begin to take it, consult with your HIV physician, your nutritionist or a knowledgeable pharmacist, and be sure to research carefully. Keep in mind that with many supplements, it is possible to overdose: Taking too much of a supplement may result in uncomfortable or even potentially dangerous side effects. This makes it even more important to consult with a health care professional before you begin taking one.


What If You Can't Afford Supplements?

Just because you're strapped for cash doesn't mean you have to write off any hope of getting access to important supplements. Here are a few tips to keep in mind:

  • Though it's not terribly common, some health insurance plans will cover at least part of the cost of supplements, or may let you take part in special programs that allow you to set aside money from your pre-tax paycheck to buy supplements. Check with your health insurance company to see if that's an option for you. Note that in certain cases (if you're pregnant, for instance), it may be easier to get insurance to cover the costs of a supplement.
  • If you're eligible to take part in an AIDS Drug Assistance Program (ADAP), keep in mind that some state ADAPs cover supplements, although you may need a prescription for them and may need to buy them from specific ADAP-approved pharmacies.
  • There are almost always cheaper alternatives to buying supplements from a nearby vitamin shop or supermarket. For instance, organizations known as buyers' clubs, which include the New York Buyers' Club and the Houston Buyers Club, specifically exist to help people with HIV/AIDS and other conditions group together to get the supplements they need as inexpensively as possible.
  • As mentioned, few studies have been done on supplements in HIV-positive people. But there are studies out there -- and participating in one may be a handy way to get access to free supplements, at least while the study is ongoing. Talk to your doctor, nutritionist and local HIV/AIDS service organization about any studies they may know of, or conduct your own search: For example, ClinicalTrials.gov, an official U.S. government site, has a searchable listing of open studies involving supplements and HIV.
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Reader Comments:

Comment by: Judy (Egypt) Thu., Mar. 1, 2012 at 8:24 pm EST
What about astragalus? I read a book by Dr. Andrew Weil and he recommended this for people with chronic immune conditions like HIV. This and maitake mushrooms,calcium,garlic and some others this article addresses.
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Comment by: MsCharlie (south africa) Thu., Jul. 28, 2011 at 8:06 am EDT
Over the weekend I found out I was positive, Im 27yrs old, my CD4 is 1004. Wat supplements can you suggest. I havent told anyone except my boyfriend, dont think Im going to tell anyone. Im all alone please advise.
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Replies to this comment:
Comment by: basilia (png) Sat., Sep. 7, 2013 at 1:43 am EDT
how did you became positive please can you explain


Comment by: Social Worker (India) Fri., Jun. 3, 2011 at 4:29 pm EDT

1) Good diet
2) Exercise
3) Enough sleep
4) Stay away from drugs
5) No to unprotected sex

Increase your CD4...
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Replies to this comment:
Comment by: Mosley (Dietitian) (south africa) Tue., Aug. 16, 2011 at 8:00 am EDT
you are very right social worker


Comment by: Anonymous (Detroit, Mi) Tue., Jan. 4, 2011 at 2:54 pm EST
I drink green tea every day,take a multi vitamin with 200mg selenium and do yoga. This regimin took my cd4 from 400's to 600.
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Comment by: Jay (houston Tx) Sun., Jan. 2, 2011 at 5:58 pm EST
coconut oil is very good 2 tbls a day
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Comment by: Christos (athens) Tue., Dec. 28, 2010 at 10:51 am EST
hi from athens Greece.... for 2 years I had undetectable virus load but my immune system had stabilized around 230 cd4. Before one month my doctor told me that my immune system dropped at 180 cd4...
I had to do something so I started to take daily (zinc,drinking a lot of fresh orange juice, selenium,Omega3 ,A,D,Q10,L-carnitine,tetosterone) and I went back after 3 weeks to count my cd4....it went up at 350 from 180 ....I was at 230cd4 for more than 3 years with undetectable virus load....I m taking norvir/intelence/presista /truvada ...I dont which of all helped me to increase immunes cells but I will keep going with this combination...Good luck to all of us...but supplements are helping a lot...
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Comment by: EUCABETH (Kenya) Tue., Sep. 21, 2010 at 2:17 am EDT
As far as i know supplments should be recommended to hiv patient in situations that patient has recorded a high instance of a particular nutrient diffiency thats attributed by the related factors or generally inadequacy of the intake of that nitrient in terms of dietary intake,maybe to correct the diffiency.
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Comment by: Stephanie (East London) Fri., Sep. 3, 2010 at 9:19 am EDT
All types of supplements and pills of all sorts are invented to help maintain the patients health and also to help them with the prevention of lacking certain nutrients. I am a nutritionist and in my profession, if you have the money to buy supplements as such then the patient should buy it indeed. But in a poverty stricken situation, clearly we discourage the unnecessary spending on these pills which will then promote and provide sufficient disposable capital to the patient to spend on nutritious foods instead of pills. There is advantages and disadvantages to using supplements with any sickness, however ignorant people shouldn't slander against such supplements.
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Replies to this comment:
Comment by: Mosley (dietitian) (limpopo) Tue., Aug. 16, 2011 at 8:03 am EDT
it is not very necesary to take supplements if you can take adequate diet orally even if you have money you dont have to but them


Comment by: ralph (tn) Sun., Aug. 29, 2010 at 9:52 am EDT
Your Dr. Should Question you well on your Overall Well-Being and have Him/Her Suggest the Right Sups for You,Ig not "ASK" .But I Know these Sups won't work for Everyone,we're all different taking different meds on different Hiv Levels. I'm a 2 year old Vet of HIV and I'm still learning the ropes. Think/Consult your Dr. Before you Act on these Sups.You may save yourself some or Alot of unnessary Grief.Thank You
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Comment by: (Des Moines, WA) Mon., Aug. 23, 2010 at 11:56 pm EDT
you people shut up because if this information does not benefit you then leave it behind nobody is forcing you to do it! what doesnt people you may help somebody else.
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Comment by: marie (michigan) Thu., Aug. 12, 2010 at 3:47 pm EDT
supplements do not help but make bacteria grow.
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Comment by: Mathew (Niger) Mon., Aug. 2, 2010 at 5:40 pm EDT
We should always back our atricle with real proof and not by mere writing. People wit hiv should not be led to spend their money unecessary. God is watching. The sickness may be any of us. Thank u
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Comment by: s.l (jamaica) Tue., Jul. 13, 2010 at 4:30 pm EDT
dietery supplements are not relevant the important thing is to keep a good diet ..stay away from sugar fructose corn syrup [hfcs]..eat fresh fruits and vegetables an use oilve oil to cook ..eat natural no sodas or things like that
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Comment by: Myles Helfand (TheBody.com) Fri., Jul. 9, 2010 at 1:14 pm EDT
@George: Actually, there's a whole section on calcium and vitamin D on page 3 of this article. :) It's also worth noting that the most compelling info we have on bone density issues for HIV-positive women is among *postmenopausal* women, where studies have shown a higher risk of not just low BMD, but actual bone fractures.

All that said, though, I just want to take a moment to remind y'all of a point made a couple of times within the article itself: This is by no means meant to be a comprehensive list of supplements to take, or of specific vitamin deficiencies you need to watch out for, if you're living with HIV. We've got lots of other articles on our site that provide additional information; this one is meant to help get you started on some of the important issues. Your comments help add a lot to the discussion! (Well, those that aren't from trolls trying to sell their products. :) )
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Comment by: George (Palm springs) Thu., Jul. 8, 2010 at 1:44 pm EDT
This is really superficially done. There have been loads of findings about vitamin d3 deficiency in people with HIV. Why isn't that here? Plus loads of stuff about calcium because of bone density issues in people with HIV (particularly in women). This little guide is not for HIV positive people.
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Comment by: James (Atlanta) Tue., Jul. 6, 2010 at 4:16 pm EDT
Supplements are great! I became resistant to Atripla a couple of years back and after doing research discovered the benefits of selenium and alpha lipoic acid. I took these two supplments faithfully. I recently went back to my doc. I have no mutations and I currently take Atripla again.
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Replies to this comment:
Comment by: Joe (Florida) Tue., May. 10, 2011 at 11:07 pm EDT
James, what benefits have you gotten from these supplements as far as your CD4 count and anything else that you think would be beneficial for a guy?


Comment by: Drew (Sydney , AUS) Mon., Jul. 5, 2010 at 7:07 am EDT
This is all about MONEY... There is no Science to back up Vitamins/Supplements

I urge everyone to think twice in regards to using these pills.

Capitalism never cares about the HIV Communities health only profit margins $$$$$$

Be warned !!!
Reply to this comment


Comment by: Debbie (Florida) Mon., Jul. 5, 2010 at 1:51 am EDT
My Best friend is HIV positive and I have tried finding so many products to help him find some relief. I was told about a product from a lady named Candace halls that has changed his life, he feels a lot more energized and a lot stronger. So if you are willing to try something that might help you go to. Ardysslife.com/candacehalls
and look for LeVive or you can get a power pack email candace at candace_charity@hotmail.com
I hope this will help someone the way it's helped my best friend.
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Comment by: Leslie (Manitoba, Canada) Sun., Jul. 4, 2010 at 10:01 am EDT
With all these drugs that are used to deal with HIV, I think Milk Thistle would be an invaluable addition. I read from several sources that it aids the Liver and since this organ processes everything that goes through the body. it should be included.
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Comment by: L. C. (Chicago, IL) Fri., Jul. 2, 2010 at 10:56 am EDT
I attended a complementary and alternative medicine (CAM) and HIV presentation a few years ago. The presenter (an MD)mentioned that astragalus (a Chinese herb) has been shown to stimulate the immune system, protect it from chemotherapy/RT, increase CD4 count. It has also been used to treat hep C. He said the recommended dose is 1,000-1,500 mg daily.
Has anyone out there heard more on the subject?
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Comment by: Rick (North Carolina) Fri., Jul. 2, 2010 at 6:00 am EDT
D.J. Thanks for the very useful supplement information.
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Comment by: Gary (Wichita) Thu., Jul. 1, 2010 at 11:47 pm EDT
EGCG, the main component of green tea, has been shown to be very effective in increasing the immune response, thereby lowering the viral load and increasing CD+4. EGCG also seems to lessen many of the side effect of taking antiretrovirals. Drink lots of green tea or take lots of powerful green tea extracts. Cell Pro 7 is a good one. Go to www.pubmed.gov and search for HIV EGCG and see all of the research.
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Comment by: Mark (London) Thu., Jul. 1, 2010 at 4:51 pm EDT
I wouldn't touch most of those supplements with a 10ft bargepole, even if you paid me, unless I had a diagnosed medical need to be taking them and had discussed that need with a dietician.

Like Karen, I take a daily cheap pharmaceutical grade multivitamin and mineral tablet; but beyond that, this long-term survivor gets by just fine on a sensible and uncomplicated varied diet.

If you are going to supplement, don't go for unsupervised megadosing or any of the ludicrously expensive patent formulations that are so unscrupulously marketed to part the HIV-positive with their money - all you will get if expensive urine and the possibility of a needless toxic overdose or an unexpected adverse interaction.

Keep it simple, keep it sensible, get professional advice and be honest with your doctor about what, and how much, you are taking.
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Comment by: Karen Geronymo RDLD/N (Miami Beach, Florida) Tue., Jun. 29, 2010 at 3:19 pm EDT
Though I don't generally recommend a large variety of vitamin and mineral supplements for the average stable person living with HIV as many supplements are frequently not well studied for benefits/disavdvantages/interactions with medications, their content and production location is often unregulated by the FDA, and they can be costly for those on a limited budget. I do, however recommend a Pharmaceutical grade or USP (United States Pharmacopia) designated multivitamin and antioxident supplement IN ADDITION TO a healthy and varied diet. Whenever possible, a person with HIV should meet with a Registered Dietitian at least one time to help assess their needs and provided education as necessary.
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Comment by: D.J. (Wilton Manors, FL) Sat., May. 22, 2010 at 1:46 pm EDT
I think we missed some important supplements in this article. Niacin (Extended Release)- to reduce Cholesterol and Triglycerides, Potassium - purely for the vasodilation properties and taken 2 - 1 to Calcium as Calcium is a vasoconstrictor, CLA - to help move and balance fat deposits (buffalo hump and visceral fat), Fish Oil - to help with Cholesterol and Triglycerides as well, Selenium and Vitamin A as Beta Carotene - in combination stave off Thrush and actually reversed the Leukoplakia I had developed. Since taking Selenium and Beta Carotene I have not has a single sore throat or incident of Thrush...things that plagued for for over 2 years.

I think Evening Primrose Oil is also a recommendation as it has helped me with Insulin Resistance. I have stopped taking EPR 3 times and all three times my doctor has mentioned that my blood sugar has risen. She now recommends all of her patients take Evening Primrose Oil.
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