What supplements can be bad for HIV positive people?

Question

Nelson, I know you know a lot about supplements. I have watched several of your youtube videos. My question related to supplements we should avoid. I am taking Isentress plus Truvada. Thanks

Answer

Great question.

These are supplements that we should be careful with (I am including the medication that may be affected):

1- St John's Wort. An herbal product that is used for improving mood. It can increase blood levels of antiretrovirals and potentially increase side effects.

2- Grapefruit and its extracts. It can decrease blood levels of antiretrovirals which can lead to resistance.

3- Calcium/aluminum/magnesium antiacid supplements. Never take them at the same time you take Reyataz or integrase inhibitors since it can affect absorption of those drugs. Take it at least 2 hours before or 6 hours after these medications. Food may minimize interactions if integrase inhibitors are taken with any of these supplements but I would not risk it.

4- Iron. It can be toxic if taken at higher doses (for anemia). Like item 3 above, take it 2 hours before or 6 hours after reyataz and integrase inhibitors. Food may minimize interactions if integrase inhibitors are taken with any of these supplements but I would not risk it.

5- Vitamin A and K. They can be toxic if taken in higher doses since they may accumulate in the liver.

6- Creatine (used for muscle building). It can increase blood levels of creatinine that, although not clinically relevant, may freak out your doctor since he/she may think your kidneys are being affected by Viread.

Supplements that have some encouraging data in HIV:

1- Vitamin D- May decrease parathyroid hormone levels increased by Viread. High parathyroid hormone makes calcium leach out of your bones which can eventually lead to decreased bone density. I strongly believe everyone on Viread should take this supplement.

2- Fish oils (Omega 3)- Good for lowering triglycerides.

3- A simple multivitamin with B vitamins and selenium. Shown to increase survival in HIV+ people not on meds. A study is being done in Canada to see if it has the same effect on people on meds.

4- Whey protein (for muscle building)- Shown to increase CD4 cells in an ACTG study. Be careful if lactose intolerant.

I hope this simplified list helps you and others make the right choices!

In health,

Nelson Vergel