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

By Warren Tong

June 24, 2010

Table of Contents

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Introduction

Staying healthy when you're HIV positive is about so much more than taking antiretrovirals. Yes, HIV medications are the most important part of the equation for most people. However, they're not the whole story: For instance, ensuring that your body maintains optimal levels of key nutrients can be critical in maintaining your health.

Much of the time, people with HIV can maintain good nutrient levels simply through a balanced diet, regular exercise and a healthy overall approach to the way they take care of their body. But it's not always easy to do this -- and sometimes, no matter how hard you try, it's still not enough to ensure that you get all the nutrients you need. When this happens, taking supplements can help fill the gaps.

This article will answer a few common questions about vitamins and supplements for people with HIV/AIDS, and provide quick introductions to some of the more popular supplements that HIV-positive people take.

Please note that this article is not meant to be a comprehensive review of everything a person with HIV needs to know about supplements. It's just the beginning of the conversation, and we hope you'll add your own thoughts in the comments section to help that conversation along.


Why Bother With Supplements?

Vitamins and supplements.

Vitamins and supplements.

The word "nutrients" refers to a group of chemicals that aid in all of the body's natural functions, whether it's cognition, digestion or immunity. Nutrients include vitamins, minerals and amino acids.

You get most of your nutrients by eating food. But if you're living with HIV, food might not always be enough, since the virus can impair your immune system or force it to work in overdrive. This is when supplements can come in handy. Supplements are substances you can take to make up for not getting enough nutrients through your everyday life. Although supplements are usually taken in pill, capsule or tablet form, they can also potentially be in powder or liquid form, and sometimes are required to be injected.

Supplements can control or improve many aspects of your health, including:

Many supplements also have antioxidant qualities, which relieve a condition called "oxidative stress." Oxidative stress occurs in our bodies because every metabolic process produces chemicals that can damage healthy cells. Although oxidative stress happens naturally through illness, aging and other triggers, that stress can perpetuate the activity of HIV within the body. Antioxidants are the shields that protect the body from some of this oxidative stress.

That being said, bear in mind that supplements cannot replace HIV medications. There is no substitute for antiretrovirals when it comes to keeping HIV at bay. There are definitely side effects and other downsides to taking HIV medications, but overall, the long-term side effects of untreated HIV are far more dangerous. And no supplement has yet been found that, conclusively, reliably fights HIV itself -- although there are several supplements that people over the years have claimed can do so.


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:


What Nutrients Should You Take Supplements For?

It's tough to determine which supplements, if any, are "the best" for HIV-positive people to take. One major reason is that individuals can have different deficiencies in certain vitamins, minerals and other nutrients.

The ideal scenario is to have your doctor run blood tests to measure your levels of each of the nutrients listed below. If any deficiencies are found, talk with your doctor or nutritionist about what they mean and whether supplementing is the best way to get your levels back up into a healthy range.

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Another reason it's hard to identify "the best" dietary supplements to take is that there's limited research and no guidelines when it comes to supplementation among people with HIV. The recommended daily allowance (RDA) of dietary nutrients in the U.S. was established many years ago -- and it was based on a population of HIV-negative men in relatively good health. If anything, as an HIV-positive person, you arguably need more than the RDA of some nutrients, since your immune system tends to be under more stress.

One of the most frequently asked questions that people living with HIV have is, "Will a supplement on top of my HIV meds give me an improved immune recovery or immune function?" The bottom line is that health care professionals don't know for sure. But what is known is that some supplements are a very good idea for your health overall.

To find out about some of the specific supplements that should be on your shopping list, we spoke with HIV and nutrition expert (and longtime HIV survivor) Nelson Vergel. He regularly answers questions in our "Ask the Experts" forum on nutrition and exercise, and he recently conducted a survey on complementary therapy use by HIV-positive people that included a breakdown of the most popular supplements and the reasons people took them. With his help, we've put together an alphabetical list of some of the nutrients that are especially worth watching -- and the supplements that may be most worth taking -- if you're a person living with HIV. As we mentioned earlier, this isn't meant to be a comprehensive list of all the nutrients and supplements you should know about if you're HIV positive. Think of it as the beginning of a conversation that you should continue with your doctor or nutritionist, as well as additional research on TheBody.com and elsewhere. Please offer your own thoughts and experiences in the comments section at the bottom of this article!

(One quick note on forms of supplements: Most supplements are available not only as pills (i.e., tablets or capsules that you swallow), but also in liquid or gel formulations that can be injected or applied via nasal spray. Injections and nasal sprays tend to be much more potent than pills, so they might be used in cases of a severe nutrient deficiency. Generally speaking, supplements in pill form are readily available without a prescription, but injections and nasal sprays require prescriptions or must be administered under the supervision of a health care professional.)

Alpha-Lipoic Acid

Calcium and Vitamin D

Carnitine

Coenzyme Q10 (CoQ10)

Vitamin B12

Zinc


Multivitamins: The All-in-One Solution

A daily, complete multivitamin pill can serve as a good source for many of the nutrients listed above, as well as a number of others. There are also indications that multivitamins help delay the progression of HIV disease, as found in a long-term, randomized trial that was conducted in Tanzania, Africa.

However, figuring out which multivitamin to use can be a dizzying experience. There are a large number of different multivitamin pills sold by different companies, all of which contain different dosages of a wide range of nutrients. You may be best off speaking with your doctor or nutritionist to first learn more about what nutrient deficiencies you may have; then you can compare multivitamins to see which is likely to fill your needs best. Visit our "multivitamins and HIV" index page to learn more.

Additional reporting for this article was provided by Myles Helfand.




This article was provided by TheBody.com. You can find this article online by typing this address into your Web browser:
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General Disclaimer: TheBody.com is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through TheBody.com should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.