Kaiser chief
Experienced US HIV physician Jon Kaiser believes
his vitamin formula could slash millions from the NHS HIV drug budget. Supplement
sceptic Chris O’Connor asks him how
Tell
us about your background.
I have practised HIV medicine in San Francisco for almost 20 years. Back in
1985, the HIV virus made people very ill and we had no drugs to treat it.
Many were unwilling to give up and die, so we tried many things; diets, vitamins,
herbs, acupuncture, exercise. Many of these fell off along the way because
they clearly didn’t work. So when I speak about natural things it’s
because they’ve worked for 20 years.
I published Immune Power in 1993 on how to combine standard and natural HIV
therapies. I have 250 HIV patients and do quite a bit of tele-medicine because
HIV care is like a chess game; you need a good strategy and a lot of good
information to make good decisions. If you do those things you can stay healthy;
the goal is a living a normal, healthy lifespan.
How would you describe yourself?
An integrative medicine specialist. Every day I write prescriptions for HIV
medicines. I’m confident that a HIV consultant prescribes the right
medicines to get someone’s viral load down to zero. What they don’t
know are all the ways to help make your immune system stronger, aside from
suppressing HIV. I help my patients combine the best of the drugs with the
best of the natural treatments. But there is no doubt that there is an HIV
virus and no doubt the meds have saved millions of lives.
Can you summarise your approach to boosting the immune system?
Ninety five per cent of oxygen and the sugar and fat you eat go to mitochondrial
cells to make energy. HIV makes the cell need more energy. HIV side effects
directly affect the mitochondrials as do reverse transcriptase drugs. I put
together a list of micronutrients to help counter the effect on free radical
toxins and it worked really well.
A complete programme for HIV should include micronutrients; keeping the gut
healthy; hormonal therapy and antiretroviral drugs. Intestinal parasites need
to be treated and retested. Most doctors won’t test unless you have
pains or diarrhoea. You need to eat vegetables, fruit and protein, and avoid
foods heavy in sugar and high in processed carbs. Our bodies need protein
to make CD4 cells; HIV positive people need plenty of protein.
Hormones, DHEA, testosterone and thyroid should be in the upper levels of
the normal range. Weight loss, depression, fatigue, declining CD4 counts and
muscle wastage can all be caused by low hormone levels. These are my recommendations
to my patients. But people must talk to their own doctor before making changes.
What are the benefits of improving the immune response of a HIV positive person?
When protease inhibitors arrived in 1995, consultants hit hard and hit early.
By putting their patients on triple therapy regardless of CD4 count, they
thought they were treating them correctly. After five years they saw the side
effects: lipodystrophy, osteopaenia, lactic acidosis, neuropathy, heart, kidney
and liver problems.
So do we really have to put people on the drugs so soon? The most effective
way to guard against the side effects is not to be on the meds. It would be
good to delay the need, hopefully by a few years. If people are already on
meds, improving the immune system can increase CD4 count above and beyond
what the drugs have done. Many people start the meds at 200 and go up to 380.
At that point there is no safe way to break from the drugs. But if you get
up to 600-700 you may be able to take a break.
Once you start taking a drug the clock starts ticking and there are only a
limited number of drugs on the shelf. So, if HIV figures them out, where do
you go? If I start my patients on three drugs and this programme I can usually
count on about five years before resistance. The average time, according to
medical literature, is one year.
In the UK getting hormone treatment and tests for gut parasites is difficult
to say the least.
The NHS has very conservative guidelines and you may not be able to immediately
get your doctor to do the things I talk about. But my goal is to inform and
stimulate people to think about these issues. If you are not HIV positive
it may not be a big deal, but, if you’re positive it, makes sense.
What
about the the SMART study, which saw no benefit in structured drug interruptions?
That study that was designed to run for nine years but was stopped prematurely.
It told people to stop treatment the minute their CD4 went over 350 and that’s
much too low. If you went down to a CD4 of 250 you went back on the drugs.
However, 96 per cent of patients in the treatment interruption arm had no
problem whatsoever.
The newer Staccato study looked at people starting treatment interruptions
at CD4 counts of over 500 and going back on meds at under 350. Staccato demonstrated
lower levels of lipodystrophy, no deaths, no infections, less cholesterol
and cost savings.
I tell patients you have to be over 500 for over a year to lock in the benefits
and even then it depends on factors like your lowest ever CD4 count. I also
put my programme in place: protein, vitamins, no parasites and testosterone
and thyroid if you need it. You should never take breaks without doctors’
advice: for example nevirapine and efavirenz have a long length of time in
the blood, so we have to be careful about just stopping.
How have your colleagues reacted to these approaches?
Mixed. Donald Kotler at Columbia University, for example, is a big supporter,
and there are others in the nutrient field. The average HIV specialist is
generally against these interventions. Pharmaceutical companies drive the
agenda and the information that is available.
Is the general attitude that the case for nutrient supplements is not proven?
In general, yes. When I have made presentations there are doctors who are
receptive. That’s why I stay hopeful and why I presented to the World
Aids Conference.
I bet if a HIV positive person asked their doctor if taking vitamins could
delay their need to go on meds the doctor would say there was no evidence
- but they are wrong.
Abrams in 1993 (JAIDS) found a 70 per cent decrease in the development of
Aids defining infections in those taking a vitamin supplement. I don’t
recall a bulletin going out to physicians to that effect. But I guarantee
if they found a drug had done that, the pharmaceutical company would have
made sure all of us doctors got the news.
The studies are there but the doctors just haven’t heard of them. As
soon as a study shows a drug is effective I have a drug rep taking me out
to lunch. The dollars and effort aren’t behind supplement studies.
In one study the supplement used cost around 60p a month. Why is
K-PAX so much more expensive?
That’s a really good question. In underdeveloped countries with malnourishment
lower doses of nutrients are needed to be effective. That study did not show
CD4 increases - unlike my study with K-PAX. K-PAX was designed to be the best
performer.
How much does K-PAX supplement cost?
It depends on whether you buy the max or minimum dose. The study used the
max dose: eight pills twice a day at about £90 a month. The minimum
dose is 4 pills a day at £25 a month, but you still experience a benefit.
Did you need research to back this up?
I went to Bristol Myers Squibb (BMS) who made two of the most toxic drugs,
Videx (ddi) and Zerit (d4t). They were shown to have the most toxicity on
the mitochondria and their sales were going down. I said to BMS: “I
think your drugs are really good but because of vitamins and minerals I think
my patients are tolerating the drugs much better. Would you like to help me
do a study to test this theory? They said yes. It was called the HIV Micronutrient
Study.
It’s drummed into you at conferences that randomised double blind placebo
studies are the only studies that matter. Because of BMS support we could
do this. Patients on the study had to be HIV positive, over 100 CD4 cells,
on one or both of those BMS drugs for at least three months, and they had
to have peripheral neuropathy.
We saw a 26 per cent increase in CD4 counts in the vitamin group - up by 64
cells. There were no differences in cholesterol. Neuropathy improved 42 per
cent but it also improved in the placebo group. In a small study you need
a significant difference in two groups and that’s what we got. The study
was accepted for presentation at the World Aids Conference in Toronto and
for publication in JAIDS.
Could the CD4 improvements be due to natural variations?
That’s why the numbers are sent to a statistical company who assess
whether the results are down to natural variation or a consequence of the
treatment. They concluded the latter.
Are there side affects with the supplement
The vitamin C levels may be a factor in diarrhoea if you suddenly take a large
dose.
Why is K-PAX so expensive?
We had a choice: make it as cheap as possible or the best quality; there was
a significant price gap. I knew I had one chance with BMS money, so I went
for highest quality. My patients noticed a benefit above and beyond what they
got from health food store products.
What are your motivations for promoting K-PAX?
To see governments and insurance companies provide K-PAX and to deem it important
and necessary for the long-term well being of HIV positive people. Under New
York State’s Aids Drug Assistance Programme you can go to the pharmacy
with a prescription from your doctor and you don’t have to pay a penny.
I am working hard to expand that to other states and countries.
Is K-PAX profitable?
It hasn’t made a dime. It has cost enormous amounts to make and obviously
they want to move into profit - that’s why they are in business.
In the UK an estimated 15,000 HIV patients are not yet on drugs. If you were
able to boost CD4 count and delay going on HAART by just two years, you could
save £15,000 per patient and this would reduce the NHS drug bill by
over £200m in those two years. And that is already factoring in the
cost of the vitamins.
What’s in KPAX?
Two Packets of double strength formula contains:
Vitamins Minerals
Beta-Carotene 20,000IU
Vitaamin C 2,000mg
Bioflavonoid 300mg
Complex
Vitamin E 800IU
Vitamin B-1 60mg
Vitamin B-2 60mg
Vitamin B-6 200mg
Niacinamide 60mg
Calcium Pantothenate 60mg
Choline 60mg
Inositol 60mg
Folic Acid 800mcg
Biotin 400mcg
Vitamin D3 400IU
Betaine HCL 150mg
L-Glutamine 400mg
Vitamin B12 2.5mg
(Methylcobalamin)
Minerals
Calcium 800mg
(Citrate/Ascorbate)
Magnesium (Citrate) 400mg
Iron (Picolinate) 18mg
Iodine (K iodide) 150mcg
Copper (Picolinate) 2mg
Manganese (Picolinate) 10mg
Potassium (Citrate) 99mg
Zinc (Picolinate) 30mg
Selenium (Picolinate) 200mcg
Chromium (Picolinate) 100mcg
Molybdenum (Picolinate) 300mcg
Boron (Picolinate) 2mg
Highly Potent Antioxidants
Alpha Lipoic Acid 400mg
Acetyl L-Carnitine 1000mg
N-Acetyl Cysteine 1200mg
