Questions and Answers with NAM n Edwin J Bernard, editor ATU
Micronutrients are anything your body needs to function that isn’t carbohydrate, fat or protein. Micronutrients include vitamins, minerals and other compounds. They do not include herbal supplements.
There is no simple yes or no answer. Few studies have come to definite conclusions.
Some swear that taking one supplement or another has made a huge difference to their drug side-effects or CD4 counts, but it is important to remember what appears to work for one might not work for another
Earlier this year a San Francisco doctor called Jon Kaiser published results of a 40 person study that seemed to show his specially-made vitamin pills increased CD4 counts by 25 per cent over three months in HIV positive people taking anti-retrovirals.
The problem is, this was a small study, so the results could have occurred by chance. We don’t know whether the people in the study ate Big Macs or a balanced diet; if they drank alcohol or took recreational drugs; or even what anti-retrovirals they were on, and how well they were working. All these can make a difference.
The only study on this found a much cheaper supplement, which cost about 60p, made a difference to how fast you became sick once your CD4 count fell below 200. That’s really impressive, and important if you live in a country where the drugs aren’t available.
In the UK, doctors recommend you start on an anti-retroviral regimen before CD4 counts reach 200, because that’s when significant damage is done to the immune system. Since anti-retrovirals are much more powerful than micronutrients, it would be very risky to take vitamins instead of medicines because anti-retrovirals can actually reverse disease progression, whereas, at best, micronutrients can only slow it down.
When it comes to side effects of anti-retrovirals, or of HIV disease, research shows taking some micronutrients can make a difference. If you eat badly, or have problems absorbing food, due to diarrhoea for example, then supplementing with some micronutrients can help.
Lack of some of the B vitamins can cause symptoms of neuropathy. But beware that more than 100mg a day of B6 can cause neuropathy.
HIV and anti-retrovirals can cause damage to cells through a process called oxidisation. It is possible taking anti-oxidants helps reverse this. The most powerful antioxidants include n-acetyl cysteine (NAC), selenium, alpha lipoic acid (ALA), the more familiar vitamins C and E, and beta-carotene (a safer version of vitamin A), but this can be toxic to the liver if taken in large quantities.
Several amino acids may also help with side-effects. Carnitine, prescribed in large amounts as l-acetyl carnitine, appears to help with new nerve growth in people with drug-related neuropathy. Glutamine, in large amounts, helps heal the gut and reduce diarrhoea. Both of these supplements can be expensive.
There is no harm in taking micronutrients at normal doses if it makes you feel you are doing something.
Mega-dosing is more controversial, because then you are using them more like drugs. Beware of interactions or even side effects from too high a dose. One study found one gram of vitamin C reduced blood levels of the protease inhibitor, indinavir by 26 per cent.
And remember, micronutrients aren’t called supplements for nothing. They are supplemental to our health, not a cure-all.
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