HIV Support
Acquired immunodeficiency syndrome (AIDS) is a condition in which the immune system becomes severely weakened and loses its ability to fight infections. Most scientists believe that the disease results from infection with the human immunodeficiency virus (HIV). AIDS is an extremely complex disorder, and no cure is currently available. Certain pharmaceuticals appear to be capable of slowing the progression of the disease. In addition, various nutritional factors may be helpful. However, because of the complicated nature of this disorder, medical supervision is strongly recommended with regard to dietary changes and nutritional supplements.
Dietary changes that may be helpful: Individuals with AIDS often lose significant amounts of weight or suffer from recurrent diarrhea. A diet high in protein and total calories may help a person maintain his or her body weight. In addition, whole foods are preferable to refined and processed foods. Whole foods contain larger amounts of many vitamins and minerals, and individuals with HIV infection tend to suffer from multiple nutritional deficiencies. Nonetheless, no evidence currently suggests that dietary changes are curative for people with AIDS or even that they significantly impact the course of the disease.
Nutritional supplements that may be helpful: Because individuals with HIV infection or AIDS often have multiple nutritional deficiencies, a broad-spectrum nutritional supplement may be beneficial. In one study, HIV-infected men who took a multivitamin supplement had slower disease progression, compared with men who did not take a supplement.
1Vitamin A deficiency appears to be very common in people with HIV infection. Low levels of vitamin A are associated with greater disease severity
2 and increased transmission of the virus from a pregnant mother to her infant.3 However, there have been no studies to determine whether vitamin A supplements are helpful.Beta-carotene levels have also been found to be low in HIV-infected individuals, particularly those with more advanced disease.
4 However, studies on the effect of beta-carotene supplements have produced conflicting results. In one double-blind study, supplementing with 300,000 IU per day of beta-carotene significantly increased the number of CD4+ cells (an infection-fighting type of white blood cell that is low in patients with AIDS).5 In another study, the same amount of beta-carotene had no effect on CD4+ cell counts or various other measures of immune function.6Thiamin (vitamin B1) deficiency has been identified in nearly one-quarter of people with AIDS.
7 It has been suggested that a deficiency of this vitamin may contribute to some of the neurological abnormalities that are associated with AIDS. In another study, vitamin B6 deficiency was found in more than one-third of HIV-positive men, and a deficiency of this vitamin was associated with decreased immune function.8 Low blood levels of folic acid and vitamin B12 are also common in HIV-infected individuals.9 Alpha lipoic acid has been shown to inhibit the replication of the HIV virus in the test tube.10 However, it is not known whether supplementing with alpha lipoic acid would benefit HIV-positive people.Vitamin C has been shown to inhibit HIV replication in test tubes.
11 Some doctors recommend large amounts of vitamin C for patients with AIDS. Reported benefits in vitamin C preliminary research include greater resistance against infection and an improvement in overall well-being.12In test tube studies, vitamin E improved the effectiveness of the anti-HIV drug zidovudine (AZT) while reducing its toxicity.
13Blood levels of coenzyme Q10 were also found to be low in individuals with HIV infection or AIDS. Six patients with HIV infection received 200 mg per day of coenzyme Q10. Five of these individuals experienced no further infections for up to seven months, and the white blood cell picture improved in three cases.
14In the category of minerals, both zinc
15 and selenium16 levels are frequently low in people with HIV infection, and iron deficiency is often present in HIV-infected children.17 Zinc supplements have been shown to reduce the number of infections in individuals with AIDS.18 HIV-infected people who received selenium supplements experienced fewer infections, better intestinal function, improved appetite, and improvements in heart function (which had been impaired by the disease).19The amino acid N-acetyl cysteine (NAC) has been shown to inhibit the replication of HIV in the test tube.
20 In a double-blind study, supplementing with 800 mg per day of NAC slowed the rate of decline in immune function. NAC may work better when glutamine (another amino acid) is also supplied. In combination, these two amino acids promote the synthesis of glutathione, a naturally occurring antioxidant that is believed to be protective in people with HIV infection.21Are there any side effects or interactions? (Refer to individual supplement for complete information.) Women who are or could become pregnant should take less than 10,000 IU (3,000 mcg) per day of vitamin A to avoid the risk of birth defects. For other adults, intake above 25,000 IU (7,500 mcg) per day can in rare cases cause headaches, dry skin, hair loss, fatigue, bone problems, and liver damage. Beta-carotene does not cause any side effects, aside from excessive intake (more than 100,000 IU per day) sometimes giving the skin a yellow-orange hue.
Vitamin B1 is nontoxic even in very high amounts. Although side effects from vitamin B6 supplements are rare, at very high levels this vitamin can damage sensory nerves, leading to numbness in the hands and feet as well as difficulty walking. Vitamin B6 supplementation should be stopped if these symptoms develop. Pregnant and lactating women should not take more than 100 mg of vitamin B6 per day. For other adults, vitamin B6 is usually safe in amounts of 200–500 mg per day, although occasional problems have been reported in this range. Any adult taking more than 100–200 mg of vitamin B6 per day for more than a few months should consult a doctor. Side effects from vitamin B6 become more common when intake exceeds 2,000 mg per day; consequently, this supplement level should be avoided.
Folic acid is remarkably safe. However, folic acid supplements can mask a vitamin B12 deficiency in individuals lacking adequate vitamin B12, which could lead to permanent neurological damage. Although this problem is rare, folic acid and vitamin B12 should always be taken together, to prevent masked vitamin B12 deficiencies.
Vitamin B12 supplements are not associated with side effects.
Side effects with alpha-lipoic acid are rare, but can include skin rash and the potential of hypoglycemia in diabetic patients. Although no studies have documented any dangers of using alpha-lipoic acid during pregnancy, until it is shown to be safe it is prudent for pregnant women to avoid supplementation with alpha-lipoic acid. Individuals who may be deficient in vitamin B1 (such as alcoholics) should take vitamin B1 along with alpha-lipoic acid supplements. Chronic administration of alpha-lipoic acid in animals has interfered with the actions of the vitamin biotin whether this has significance for humans remains unknown.
Some individuals develop diarrhea after as little as a few thousand milligrams of vitamin C per day, while others are not bothered by ten times this amount. However, high levels of vitamin C can deplete the body of copper, an essential nutrient. It is prudent to ensure adequate copper intake at higher intakes of vitamin C (copper is found in many multivitamin/mineral supplements).
Vitamin E toxicity is very rare; supplements are widely considered to be safe.
Congestive heart failure patients taking coenzyme Q10 should not abruptly discontinue taking supplements without first consulting a physician.
Individuals who take 30 mg or more of zinc per day for more than a few months should balance the zinc with copper in order to prevent copper deficiency. For 30 mg per day of zinc, 2 mg per day of copper is usually taken. For 60–90 mg per day of zinc, 3–4 mg per day of copper is a reasonable amount. Zinc intake in excess of 300 mg per day may impair immune function. Although the preliminary research is contradictory, patients with Alzheimer’s disease should avoid zinc supplements until further studies clarify the role of zinc in this disease. Zinc has been reported to increase glycosylation with IDDM (insulin dependent diabetes mellitus)—an indicator of trouble. (This problem does not occur with NIDDM.) While doctors of natural medicine believe this increase may be an error, people with IDDM supplementing with zinc should consult a nutritionally oriented doctor. Zinc competes for absorption with iron, calcium, and magnesium. A multimineral supplement will prevent mineral imbalances that can result from taking high doses of zinc for extended periods of time.
Selenium is very safe, although taking more than 1,000 mcg per day may cause loss of fingernails, skin rash, and changes in the nervous system.
Hemochromatosis, hemosiderosis, polycythemia, and iron-loading anemias (such as thalassemia and sickle cell anemia) are conditions that involve excessive storage of iron. Supplementing iron can be quite dangerous for people with these diseases. Only individuals who have been diagnosed with iron deficiency should take iron supplements. Supplemental doses required to overcome iron deficiency can cause constipation.
No consistent adverse effects of N-acetyl cysteine (NAC) have been reported in humans.
Herbs that may be helpful: Many different herbs have been shown in test tube studies to inhibit the function or replication of HIV. Few of these studies have been followed up with any kind of investigation in infected humans. Some notable exceptions to this rule are discussed below.
Garlic may be helpful. In one study, administration of an aged garlic extract reduced the number of infections and relieved diarrhea in a group of patients with AIDS.
22Licorice has shown the ability to inhibit reproduction of HIV in test tubes.
23 Studies on injections of glycyrrhizin isolated from licorice showed it could have a beneficial effect on AIDS.24 Preliminary evidence on orally administered licorice has also found it to be safe and effective for long-term treatment of HIV infection.25 A physician should monitor the blood pressure of anyone taking licorice or glycyrrhizin long term. Deglycyrrhizinated licorice (DGL) will not inhibit HIV. Approximately 2 grams of licorice root should be taken per day in capsules or as tea.St. John’s wort is most well known as an antidepressant. However, it also possesses known effects against HIV.
26 Extremely high doses were given initially, which caused people to develop rashes when exposed to sunlight.27 Long-term studies have found injected hypericin from St. John’s wort and oral standardized St. John’s wort extracts to prevent progression to AIDS and opportunistic infections.28 One study of oral St. John’s wort found that although some HIV infected people had mild liver damage, those who had never taken AZT showed improvements in their CD4 counts.29 The liver damage encountered has not been reported in any other study of St. John’s wort. Standardized St. John’s wort extracts in higher amounts (600–900 mg three times each day) is generally safe for treating HIV infection.Echinacea is believed by some nutritionally oriented physician to be unsafe for use in HIV infection. This comes from the fact that complex sugars isolated from echinacea can cause an increase in blood levels of the immune system compound called tumor necrosis factor,
30 which may worsen the progression of HIV disease. However, when humans take tinctures of echinacea, no such increase occurs.31 Other studies have found that echinacea strengthens the immune cells taken from people with HIV.32 Many HIV positive people report using echinacea with no apparent difficulties.33 Similar immune-stimulating plants often used by doctors of herbal medicine include Asian ginseng, eleuthero (Siberian ginseng), ashwagandha, and the medicinal mushrooms, including shiitake and reishi.Maitake mushrooms contain polysaccharides, including beta-D-glucan, that is currently under review as a supportive tool for HIV infection.
34 35Bitter melon contains two proteins known as alpha- and beta-momorcharin that inhibit the AIDS virus, but this research has only been demonstrated in test tubes and not in humans.
36Are there any side effects or interactions? (Refer to individual herb for complete information.) Most people enjoy garlic; however, some individuals who are sensitive to it may experience heartburn and flatulence. Because of garlic’s anticlotting properties, persons taking anticoagulant drugs should check with their nutritionally oriented doctor before taking garlic. Those scheduled for surgery should inform their surgeon if they are taking garlic supplements. There are no known contraindications to the use of garlic during pregnancy and lactation.
Licorice products without the glycyrrhizin removed may increase blood pressure and cause water retention in some people. Long-term intake of products containing more than 1 gram of glycyrrhizin per day can cause these side effects. Deglycyrrhizinated licorice extracts do not cause these side effects.
St. John’s wort makes the skin more light-sensitive. Persons with fair skin should avoid exposure to strong sunlight and other sources of ultraviolet light, such as tanning beds. It is also advisable to avoid foods like red wine, cheese, yeast, and pickled herring. St. John’s wort should not be used at the same time as prescription antidepressants. St. John’s wort should not be used during pregnancy or lactation.
Echinacea is essentially nontoxic when taken orally. People should not take echinacea without consulting a physician if they have an autoimmune illness, such as lupus, or other progressive diseases, such as tuberculosis or multiple sclerosis. Those who are allergic to flowers of the daisy family should take echinacea with caution. There are no known contraindications to the use of echinacea during pregnancy or lactation.
Used as recommended, Asian ginseng and eleuthero are generally safe. In rare instances, ginseng may cause overstimulation and possibly insomnia. Consuming caffeine with ginseng increases the risk of overstimulation and gastrointestinal upset. Persons with uncontrolled high blood pressure should not use ginseng. Long-term use of ginseng may cause menstrual abnormalities and breast tenderness in some women. Ginseng is not recommended for pregnant or lactating women.
Shiitake has an excellent record of safety but has been known to induce temporary diarrhea and abdominal bloating when used in high dosages. Its safety during pregnancy has not yet been established.
Side effects from reishi can include dizziness, dry mouth and throat, nose bleeds, and abdominal upset; these rare effects may develop with continuous use over three to six months. As it may increase bleeding time, reishi is not recommended for those taking anticoagulant (blood-thinning) medications. Pregnant and lactating women should consult a physician before taking reishi.
There have been no reports of toxicity in humans from the use of maitake.
Excessively high doses of bitter melon juice can cause abdominal pain and diarrhea. Small children or anyone with hypoglycemia should not take bitter melon, since this herb could theoretically trigger or worsen low blood sugar, or hypoglycemia. Furthermore, diabetics taking hypoglycemic drugs (such as chlorpropamide, glyburide, or phenformin) or insulin should use bitter melon with caution, as it may potentiate the effectiveness of the drugs, leading to severe hypoglycemia.
Nutritional Supplements |
Herbs |
Homeopathic Remedies |
| Multiple
vitamin/mineral
(continued) |
Garlic
(continued) |
No homeopathy commonly used for this condition |
References:
1. Ince S. Vitamin supplements may help delay onset of AIDS. Med
Tribune, November 9, 1993, p. 18.
2. Semba RD, et al. Increased mortality associated with vitamin A deficiency during human
immunodeficiency virus type 1 infection. Arch Intern Med 1993;153:2149-2154.
3. Semba RD, et al. Maternal vitamin A deficiency and mother-to-child transmission of
HIV-1. Lancet 1994;343:1593-1597.
4. Sappey C, et al. Vitamin, trace element and peroxide status in HIV seropositive
patients: asymptomatic patients present a severe beta-carotene dificiency. Clin Chim Acta
1994;230:35-42.
5. Coodley GO, et al. Beta-carotene in HIV infection. J Acquired Immune Deficiency
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6. Coodley GO, et al. Beta-carotene in HIV infection: an extended evaluation. AIDS
1996;10:967-973.
7. Butterworth RF, et al. Thiamine deficiency in AIDS. Lancet 1991;338:1086.
8. Baum MK, et al. Association of vitamin B6 status with parameters of immune function in
early HIV-1 infection. J Acquired Immunodeficiency Syndromes 1991;4:1122-1132.
9. Boudes P, et al. Folate, vitamin B12, and HIV infection. Lancet 1990;335:1401-1402.
10. Baur A, et al. Alpha-lipoic acid is an effective inhibitor of human immuno-deficiency
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11. Harakeh S, et al. Suppression of human immunodeficiency virus replication by ascorbate
in chronically and acutely infected cells. Proc Natl Acad Sci 1990;87:7245-7249.
12. Cathcart RF III. Vitamin C in the treatment of acquired immune deficiency syndrome
(AIDS). Med Hypotheses 1984;14:423-433.
13. Gogu SR, et al. Increased therapeutic efficacy of zidovudine in combination with
vitamin E. Biochem Biophys Res Commun 1989;165:401-407.
14. Folkers K, et al. Biochemical deficiencies of coenzyme Q10 in HIV-infection and
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15. Fabris N, et al. AIDS, zinc deficiency, and thymic hormone failure. JAMA
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16. Dworkin BM. Selenium deficiency in HIV infection and the acquired immunodeficiency
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References (continued):
18. Mocchegiani E, et al. Benefit of oral zinc supplementation as an
adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. Int J
Immunopharmacol 1995;17:719-727.
19. Schrauzer GN, Sacher J. Selenium in the maintenance and therapy of HIV-infected
patients. Chem Biol Interact 1994;91:199-205.
20. Roederer M, et al. Cytokine-stimulated human immunodeficiency virus replication is
inhibited by N-acetyl-L-cysteine. Proc Natl Acad Sci 1990;87:4884-4888.
21. Robinson MK, et al. Glutathione deficiency and HIV infection. Lancet
1992;339:1603-1604.
22. Abdullah TH, et al. Enhancement of natural killer cell activity in AIDS with garlic.
Dtsch Zschr Onkol 1989;21:52-53.
23. Ito M, Sato A, Hirabayashi K, et al. Mechanism of inhibitory effect of glycyrrhizin on
replication of human immunodeficiency virus (HIV). Antivir Res 1988;10:289-98.
24. Hattori I, Ikematsu S, Koito A, et al. Preliminary evidence for inhibitory effect of
glycyrrhizin on HIV replication in patients with AIDS. Antivir Res 1989;11:255-62.
25. Ikegami N, et al. Prophylactice effect of long-term oral administration of
glycyrrhizin on AIDS development of asymptomatic patients. Int Conf AIDS 1993;9:234
[abstract PO-A25-0596].
26. Moruelo D, Lavie G, Lavie D. Therapeutic agents with dramatic antiretroviral activity
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27. Gulick R, et al. Human hypericism: A photosensitivity reaction to hypericin (St.
John’s wort). Int Conf AIDS 1992;8:B90 (abstract #PoB 3018).
28. Steinbeck-Klose A, Wernet P. Successful long term treatment over 40 months of
HIV-patients with intravenous hypericin. Int Conf AIDS 1993;9:470 [abstract #PO-B26-2012].
29. Cooper WC and James J (1990) “An observational study of the safety and efficacy
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30. Luettig B, Steinmuller C, Gifford GE, et al. Macrocytic activation by the
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Natl Cancer Inst 1989;81:669-75.
31. Elsasser-Beile U, Willenbacher W, Bartsch HH, et al. Cytokine production in leukocyte
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References (continued):
32. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea
and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects
and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunpharm
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33. Kassler WJ, Blanc P, Greenblatt R. The use of medicinal herbs by human
immunodeficiency virus-infected patients. Arch Intern Med 1991;151:2281-8.
34. Yamada Y, Nanba H, Kuroda H. Antitumor effect of orally administered extracts from
fruit body of Grifola frondosa (maitake). Chemotherapy 1990;38:790-6.
35. Nanba H. Immunostimulant activity in-vivo and anti-HIV activity in vitro of 3 branched
b-1-6-glucans extracted from maitake mushrooms (Grifola frondosa). Abstract, VIII
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36. Zhang QC. Preliminary report on the use of Momordica charantia extract by HIV
patients. J Naturopath Med 1992;3:65-9.
Copyright © 1998 Virtual Health, LLC
It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your physician, nutritionally-oriented health care practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.The information presented in HealthNotes Online is for informational purposes only.