AIDS treatment

What helps it?

• A number of studies have shown the blood of HIV-positive patients to be low in folic acid. The decrease may arise in part from the fact that many of the drugs used to treat the unusual infections that befall AIDS patients can deplete folic acid. Because of its role in building new body proteins, genetic material, and blood cells, a deficiency of folic acid would contribute to weakening the immune system. Recommendation: 1 to 2 mg per day is an adequate beginning point. The maximum dose available without prescription is less than 1/2 mg, so you must double, triple, or quadruple the over-thecounter dose or obtain a prescription from your physician for 1 mg folic acid. In either event, to assess your response, ask your physician to draw blood to check a red blood cell folate level. If it is still low, increase your dose to 3 to 4 mg per day and have your physician recheck the response with a red blood cell folate level in 6 weeks and at this time perhaps also check your B12 level. It is important to keep the balance of folic acid and B12. If folic acid is given to someone already deficient in B12, that deficiency will become severe, and vice versa.

AIDS treatment• A number of studies on both patients with AIDS (as well as people who only test positive for HIV) documented B12 deficiency. You should ask your physician to perform a blood test to check for deficiency of B12, and if present, begin to supplement by injection. Recommendations: 1000 micrograms by injection into the muscle, weekly for about 4 to 6 weeks, then monthly indefinitely.

• Several research studies have documented thiamine deficiency in patients with AIDS, and others have implicated the low blood levels of thiamine as a possible cause of the nerve damage and dysfunction seen in some AIDS patients. Supplementing thiamine, therefore, should correct the deficiency and lessen the likelihood of developing nerve problems. We could find no hard science to verify a clear role for thiamine in this regard, but the trail certainly leads that way. Since the vitamin has virtually no toxicity, even at large doses, we would recommend supplementation. Recommendation: Begin with a minimum dose of 10 to 25 mg per day. You can gradually increase to as much as 100 mg to 200 mg without danger. Your kidneys will excrete any excess that your body doesn't need. Illness and especially fever increases your thiamine requirement; therefore, at such times, you should increase your dose to the 100 mg to 200 mg level.

• In studies on laboratory mice that serve as AIDS treatment models (those being certain types of mice specifically bred to be able to develop an AIDS-like syndrome), supplementation with vitamin A reduced the risk of their developing cancers. Early human studies with vitamin A seem to point the same way. Recommendation: Try doses of vitamin A at doses of no greater than 10,000 to 20,000 IU to begin. With great caution, or under the care of your personal physician, you may increase the dosage to 50,000 IU It'symptoms of deficiency (see page 39) of the vitamin persist. Remember, however, that vitamin A levels can build up and in some cases may cause severe symptoms of too much of the vitamin. Refer to the listing of vitamin A for toxic side effects and reduce your dose if you develop these kinds of symptoms.

AIDS treatment• Very recent studies have shown that large doses of vitamin C in AIDS treatment (ascorbic acid) not only inhibited the ability of HIV to duplicate itself in patients with AIDS, but improved the function of the crippled immune cells, markedly reduced the number of people developing unusual infection, and shrank the size of the unusual cancer, Kaposi's sarcoma (the purple-pink skin tumors that afflict some AIDS patients). Recommendation: Using crystalline (powdered) vitamin C with a strength of 4 grams per teaspoon, begin with 1/2 teaspoon (2 grams) twice daily for one week. Increase to 1 teaspoon (4 grams) twice daily for one week. Gradually increase the daily dose by V: teaspoon daily until you develop loose stools. This effect, called bowel tolerance, lets you know that you've reached the maximum dose you will be able to take at this time. Your ability to tolerate more vitamin C will increase if you become ill, run a fever, or are under added emotional or physical stress, and you can sneak the dose up in 2 gram increments at these times. Some people tolerate doses as high as 250 grams (given by vein) in a single day without problems; however, because your own ability to tolerate vitamin C may not permit a dose of this magnitude no matter what physical assault you may be under, begin at 2 to 4 grams per day and slowly work up until your bowels tell you "enough!"

• Vitamin E in AIDS treatment, because of its role in maintaining a healthy cell membrane, has also begun to receive attention in AIDS research. It indeed appears that supplementation may be beneficial, but the final data simply are not in yet. Recommendation: At this point, 1 would recommend a conservative 800 IU to 1200 IU per day. Recommendation: While the jury is still out on any specific application for HIV, 1 would recommend that you ask your physician to check to see if your level of calcium or magnesium is low or "low normal" (still technically normal but on the lowest edge of the normal range). In either of these events, we would recommend an intake of these minerals sufficient to bring the level in your blood up to normal. In the case of "low normal," that may mean simply eating more foods rich in calcium and magnesium, whereas if your level lies truly below the normal level in blood, correction would likely require supplements of calcium of 500 to 1500 mg per day or of magnesium (Slo-Mag)

Some studies document lower than normal blood levels of calcium and magnesium in AIDS treatment in people infected with HIV. As yet, we could not find any published data that addresses whether these deficiencies contributed to specific health risks for HIVpositive people. However, both calcium and magnesium are critically important minerals for muscle, bone, and heart health, as well as for proper nerve transmission, and so for reasons of good health you would not want to be deficient in either of them.

Low levels may occur for many reasons besides inadequate intake (such as low vitamin D intake or inadequate exposure to sunlight), so we refer you to the specific listings for calcium and magnesium.

• Germanium is a trace mineral that improves cellular oxygenation. It fights pain, enhances the functioning of the immune system, and rids the body of toxins and poisons. Because it carries oxygen to the cells, germanium, when obtained through foods, is an effective way to increase tissue oxygenation. Foods containing germanium include garlic, shiitake mushrooms, and onions. Japanese scientist Kazuhiko Asai found that an intake of 100 to 300 mg of germanium per day improved many illnesses, including AIDS.

• Attention has focused on zinc deficiency as a contributor to furthering the immune system problems in AIDS patients. Zinc deficiency causes the tissues that produce immune-fighting cells to shrink, weakening the defense system and leaving the person more vulnerable to disease. Recent studies demonstrate that many AIDS patients are zinc deficient, which may be one of the nutritional factors leaving them vulnerable to infection by the virus upon exposure. Zinc deficiency may also hasten the progression from symptom-free HIV-positivity to a worsening of their disease and the development of AIDS. Recommendation: 150 mg chelated zinc daily for 3 to 6 months. Warning: Supplementation of zinc in its ionic form can create deficiencies of other minerals, such as copper, by competing with them for absorption from the intestine. Chelation of the minerals (see pages 30-31 on chelation) prevents this competition to get into the body, allowing you to fully absorb each of them.

• Certain of the amino acids in AIDS treatment, which are the basic subunits for building protein, appear to bolster immune function. Let us first underscore the importance of avoiding general protein deficiency in any debilitating disease and the value of eating a diet rich in complete protein (containing all the essential amino acids) sufficient to provide for the lean tissues. (See "Leveling the Playing Field," pages 23-24.) Providing your body with extra amounts of specific amino acids in supplemental form over and above your basic protein requirement, however, also appears to benefit the immune system in HIV, so let us discuss these amino acids in greater detail.

Arginine taken in doses of 30 grams per day for 3 days increases the activity of natural killer cells (a certain type of immune fighter cell crippled by HIV infection). Because one of the ways in which the virus takes control of the immune system is by silencing these killing immune fighters, enhancing their ability to keep on killing would logically be a benefit to you.

Cysteine has a twofold role in HIV It has been shown to slow down the reproduction of immunodeficiency viruses in the laboratory and is necessary in staving off attack by free radicals. The latter effect occurs because cysteine is made into glutathione, one of the body's potent antioxidant scavengers of free radicals, and therefore, a deficiency in dietary cysteine results in your body's not being able to make as much glutathione as it needs to protect your tissues from free radical attack. 1 refer you to pages 19-23, where we discuss free radicals and their role in damaging the body's tissues. The recommended dosage is a total dose of 1600 to 1800 mg daily, as a single 600 mg tablet three times daily, or in powder form, a 400 mg dose taken four times daily. Please see the entry for glutathione (page 168) for other supplementation suggestions.

• Another nutritional substance made from egg yolk, called egg lipid extract, or AL 721, appears in research studies to render HIV less able to infect—in effect, to cripple it. Let us interject that none of the studies done so far on this very innocuous substance has been a "controlled" study, but the work on AL 721 is at least promising and deserving of more intense scrutiny, which 1 feel sure it will get. Recommendation: Again, for now, you will only have access to the whole-food source— eggs—which 1 would encourage you to eat. Make an egg or two a part of your daily dietary intake. One additional note: Some of you may become concerned about your cholesterol going up if you eat eggs daily. Please rest easily on that score. Most patients with AIDS (or any severe debilitating disease) suffer from too low a cholesterol level, not from an elevated one. And too low a level carries its own health risks in the form of susceptibility to infection and cancer—an added burden you don't need. However, you might ask your personal physician to check your cholesterol level periodically if the specter of rising blood levels alarms you. The number you are seeking for good health purposes is a total cholesterol reading between about 180 mg/dl and 220 mg/dl, but the most important aspect of normalcy in cholesterol is a number representing the ratio between the HDL "good" cholesterol number and the total cholesterol. To calculate this ratio, take your total cholesterol reading and divide it by your HDL cholesterol reading; if that ratio is 4 or less, you're in good shape.

• Glutathione itself comes in tablet or capsule form for supplementary use. It is expensive, however, and the effectiveness of oral formulas is questionable. You would be better off supplying your body with the raw materials it uses to make glutathione: cysteine, glutamic acid, and glycine. NAC is particularly effective for this purpose. What does seem to work well is the combination of supplements of NAC, glutathione, and vitamin C. Studies show that when taken together, the results are more effective than when taken alone. NAC and glutathione have been shown to work together to extend the latency period of HIV Researchers also suggest that the two inhibit expression of HIV. This means that although a person may test positive for HIV, there is no physical evidence of the infection. Both NAC and glutathione are natural and nontoxic. Recommendation: Begin with a dose of 150 mg per day and increase to 300 mg per day.

•  Some recent research shows that AIDS patients develop deficiency in coenzyme Q10 and that supplementation improves their resistance to infections. Recommendation: 200 mg coenzyme Q10 daily and continued indefinitely.

• The essential fatty acids (see the discussion of eicosinoids, pages 24-27) linoleic acid (GLA) and EPA (fish oil) appear to be able to destroy the envelope or protective coat of the HIV and may therefore help in slowing progression of the disease. These fats when taken in the proper ratio also improve immune function. Recommendation: To facilitate the best response from essential fatty acids, begin with the proper macronutrient framework (see Section we, Macronutrients, page 23). Then to that nutritionally sound base add gamma-linoleic acid to EPA fish oil in a ratio of 1:4 (GLA:EPA) one to three times daily. The EicoPro essential fatty acid product manufactured by Eicotec, Inc., of Marblehead, Massachusetts, contains ultrapure sources of linoleic acid and fish oils already combined in the proper ratio. If you cannot get that product, you can purchase linoleic acid in a product called evening primrose oil at most health and nutrition stores, and EPA fish oil as well. Because it is not as pure a form, the milligram dosing will be different. You can make a reasonable substitute by combining evening primrose oil capsules with fish oil capsules plus vitamin E. Take 500 mg of evening primrose oil (a source of linoleic acid in capsule form), plus 1000 mg EPA fish oil, plus vitamin E 200IU one to three times a day. (Warning to diabetics: EPA fish oil can cause blood sugar fluctuations in some diabetics. Carefully monitor your blood sugar if you use this supplemental oil and discontinue its use if your blood sugar becomes difficult to control.)

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