Antiretroviral therapy has changed the face of HIV over the last decade and a half. Patient life expectancy has increased tremendously and we no longer associate many of the opportunistic infections as early-onset symptoms. Drug regimen pill burdens have also decreased for most, making adherence to protocols easier as well.
When changing protocols or adding in new therapies, however, sometimes side effects can interfere with quality of life and the likelihood that a patient will want to maintain the therapy. I have worked for almost 10 years with HIV-positive patients and have seen firsthand how natural therapies dramatically help manage side effects of medications, improve quality of life, protect the body from the chemical processing of the medications, and possibly prevent 'drug failure'. The following is a review of natural therapies for optimizing the benefits of antiretroviral drug treatment.
The immune system helps us navigate safely in our environment and avoid over- and under-reacting to foreign substances. My first suggestion to boost immune function in people living with HIV is to identify and treat underlying food and environmental sensitivities and limit immune taxing behaviors. Stress and sugar consumption have been clinically shown to depress immune function. This is exactly what we don't want to have happen in people living with HIV. Many relaxation techniques exist to help us cope with life issues and lessen the physiological response in the body; yoga, meditation, exercise, support groups, counseling and prayer can all be helpful. Local resources exist to help you find the closest and best group for you. In the meantime, for a quick "stress break," I recommend the 4/8 Time-out. It's easy to do, free and can help diffuse a stressful moment in about a minute.
- Start by closing your eyes and focusing on your breath.
- Inhale deeply through your nose for a count of four.
- Exhale fully through your mouth for a count of eight.
- Repeat until the stressful feeling passes, usually 3-4 cycles.
This technique can be modified for pain management. When inhaling, picture healing energy entering the nose; when exhaling, picture the pain and negativity releasing from the body and leaving.
Limiting sugar consumption to unrefined, natural forms and eating whole foods helps to improve immune function and promote a healthy gastrointestinal tract. Natural sugars exist in fruits and vegetables, honey (avoid unpasteurized), rice syrup and other sources. A non-caloric natural sweetener is the herb Stevia. It has a natural sweet flavor without artificial additives or calories.
Herbs and Nutrients for Immune Stimulation
Astragalus is a Chinese herb that has been used for centuries for its immuno-modulating qualities. There is mixed scientific evidence on its efficacy with HIV, but well documented studies on its ability to stimulate the immune system. Many patients use this synergistically with other immune boosters such as reishi, maitake and shitake mushrooms.
Glycerrhiza (Licorice) also has been used as a complementary immune modulator, although it should be avoided in people with hypertension. In my experience the immune modulators work much better when combined together rather than used as singular treatments. Licorice can be consumed as a tea daily and the mushrooms may be included in food preparation or taken in liquid tincture form for a more consistent higher dose.
Boxwood has been shown in research to foster immune stimulation and promotion of t-cell activation. This can be found in capsule form and taken as directed by a healthcare professional.
Echinacea has been documented to stimulate the chemicals that promote t-cell activation and antibody production. It is very effective in lessening the course of the common cold and respiratory infections when used short term. There are some conflicting studies on its use long term as well as a caution that it may briefly increase viral load. Clinically, I have no problem in its short-term use for respiratory infections -- but avoid long term use as well as use prior to viral load blood counts. During the acute onset of a cold, 2 to 4 cups of strong echinacea tea or 3 capsules 3 times daily can help limit the course of the illness.
Pau D'arco and Una de Gato (Cat's Claw) are also clinically used to stimulate immune function and may be consumed in tea form daily or liquid tincture either during acute illness or as a preventative measure.
Protecting Against Free-Radical Damage
As I sit in my New York apartment writing this article, free radical damage is occurring! This is part of the natural progression of aging, breathing and living but also can get sped up as a result of many medications and lifestyle choices. Free radicals are chemicals present in the body that increase the rate of cellular and tissue damage. Smoking, drug and alcohol use contribute to this as well as contact with environmental chemicals, pesticides and food additives.
For this reason I suggest water filtration, a diet rich in whole, unprocessed foods, and purchasing organic products whenever possible. There are naturally occurring antioxidants present in fresh fruits and vegetables, such as berries, citrus, tomato and peppers. These are best consumed fresh or frozen, as much nutrition is lost in the canning process. A healthy diet and lifestyle with inclusion of some of the following nutrients will help guard against the inevitable damage of free-radicals and may slow progression of tissue damage. Dosages depend on patient health status and existing conditions.
Herbs and Nutrients to Protect Against Free-Radical Damage
Alpha Lipoic Acid targets liver protection and is helpful for patients on hepatotoxic medications such as antiretrovirals, antifungals and typically any long-term medication protocols. No known contraindications exist.
Beta-carotene is helpful for optimal eye health and the water soluble form of Vitamin A is found in most multivitamins.
Coenzyme Q-10, the major antioxidant in cardiac tissue, also has protective effects on brain tissue. Studies indicate high dosage can be used safely and effectively. Certain cholesterol lowering drugs have also been shown to deplete coenzyme Q-10. Patients on cholesterol lowering drugs should consider adding at least 200mg of CoQ-10 daily.
N-Acetyl Cysteine (N-AC) is protective to Liver tissue and aids in breaking down excessive mucus.
Green Tea and White Tea may be consumed as tea or in extract form daily.
Vitamin C may be consumed to bowel tolerance. This is anywhere from 1 to 6 grams daily. (Bowel tolerance means up to the amount that causes gastrointestinal upset.)
Selenium, Vitamin E and Zinc can be included in a good daily multivitamin for their antioxidant properties.
Healthy Gastrointestinal Tract
The gastrointestinal tract is responsible for absorption of water, nutrients, vitamins and minerals and even produces some nutrients with the aid of friendly bacteria. Gas, bloating, indigestion, changes in bowel habits, nausea and vomiting are all symptoms of imbalance and can be used to guide treatment.
Fiber aids in regulating lipid levels, removes toxins and provides bulk for healthy bowel habits. Soluble and insoluble fiber sources such as oat bran, apple pectin, flax and whole grains should be included. Bloating after taking a fiber supplement can sometimes indicate a sensitivity to that source. This occasionally occurs with psyllium, in which case changing to a different form may be indicated. It is essential to include adequate water intake when taking fiber supplements.
Fish Oil and Essential Fatty Acids provide the necessary building blocks for cell membranes. They also have anti-inflammatory properties and aid in regulating lipid levels. These oils are more sensitive to going rancid and should be refrigerated. 1 to 2 tablespoons may be included daily.
Ginger is helpful in tea or herb form for controlling nausea and vomiting.
Glutamine is an amino acid that aids in maintaining a healthy gastrointestinal lining and helps to repair gastrointestinal damage. It can also be helpful in managing diarrhea. 1 to 2 grams of powdered glutamine may be mixed in smoothies or water. Milk Thistle is restorative to the liver, and aids in liver cell regeneration. Milk thistle can be consumed in capsule form or purchased as seeds and ground in a coffee grinder. When used this way, 2-3 tablespoons daily can be sprinkled on salads, in soups and in smoothies.
Probiotics (Acidophilus, Bifidus, lactobacillus spirogenes) help to maintain balance of good and dangerous bacteria and compete for the food the dangerous bacteria need to grow and cause us problems. Lactobacillus acidophilus and bifidus may be found in yogurt with active culture or in supplements and can be consumed freely without known side effects. It should be refrigerated to maximize shelf life. Patients on antibiotic therapy, diagnosed with thrush, diarrhea or constipation should consider taking probiotics 2 capsules 3 times daily with meals. For thrush a capsule can also be opened in some water and used daily as a mouth rinse.
As with any treatment protocol, check with a licensed specialist prior to beginning a supplement regimen. Hopefully you have found this information a useful starting point in finding a protocol that is best for you at this time in your life. Each person is individual and therefore, what works for one person may not always be indicated for someone else. Lastly, be patient with this process -- lifestyle changes take time and discipline to become permanent fixtures in our day-to-day routine.
JoAnn Yanez, N.D. is a Doctor of Naturopathic Medicine, Arizona Licensed Physician and graduate of the Southwest College of Naturopathic Medicine. She maintains a consulting practice in New York, working with HIV and chronic disease. Dr. Yanez can be seen lecturing on these topics across the country and may be reached at www.DrYanez.com for further information and consultations.