FRANÇAIS HIV AND NUTRITION PREVIOUS PAGE NEXT PAGE SUBSCRIBE Chester Myers' Nutrition Series HIV & Nutrition: Vitamin & Mineral Supplementation - updated
Studies have shown that even people who eat good food are likely to have vitamin and mineral deficiencies when they have HIV. Zinc, selenium, magnesium, carotenoids and vitamins A, B2, B6, B12, and E have all been shown to be often low. This can happen before visible sicknesses occur, and before the stage that we call AIDS.
Normal rules for vitamins and minerals are often not correct if you have HIV/AIDS. FOOD ALONE IS NOT ENOUGH. Supplementation has been shown to be associated with significant slowing of disease progression.
The information here gives you starting information. Articles by Dr. Lark Lands, registered dietitians Diana Davis-Kelly, Charlie Smigelski and Jennifer Jensen, and myself provide more information about this important area.
You can start with a good multivitamin with minerals, choosing one that contains at least 25 mg of vitamin B6 (preferably about 10% of it as the "phosphate" form). It should contain the minerals zinc, chromium, selenium and molybdenum. These guides help ensure the other vitamins are at okay levels. Don't take additional vitamin A because it can be poisonous at high levels. It's better to eat food high in carotenoids from which your body should make vitamin A.
An extra B-complex (B-25 or B-50, again making sure some of the B6 is in the phosphate form) may be important if you drink alcohol or have a lot of stress.
Extra vitamin C is used by many - perhaps 1 gram a day (2x 500 mg, or 4x 250 mg). Some take more. Extra vitamin E is also a good idea - 400 to 800 IU of a natural form.
The multivitamin should contain 10-25 mg of zinc. At the 1992 Amsterdam AIDS Conference, recommendations were made for a total of 75 mg/day. There are tablets that give 30-50 mg of zinc. This should be enough besides that in your multivitamin and food. Zinc methionine complex may be the best form. 1-3 mg of copper twice a week helps balance the zinc.
An additional selenium at 200 micrograms daily is advisable from current information.
Additional vitamin B12 is important. A preferred type is hydroxo-cobalamin by injection, 1X/wk; second best choice is cyano-cobalamin by injection, 1X/wk. Third choice is an under-the-tongue (sublingual) form, 2X/day. Don't rely on the stomach route for B12 if you have HIV. Also, blood tests for B12 are unreliable if you have HIV.
To provide balance with B12, you also need a vitamin called folic acid. You may get enough of this from your multivitamin, and vegetables and cereals. Some prescription drugs block the body's use of folic acid so you may need more. These drugs include Septra, pentamidine and pyrimethamine. Your doctor can give you more folic acid, or buy it as a supplement (it's cheap!). An additional 1 mg/day may help. With some prescription drugs, you may need more. Your blood tests (RBC/ERC folate) will tell you if you are getting enough of this vitamin.
Don't forget about NAC (N-acetyl cysteine) - many people take 3 to 6 capsules (@500 mg each) a day. Don't take acetaminophen (Tylenol) if at all possible, since this can cancel some of the help you get from NAC. Aspirin is much better than acetaminophen, and it is an antioxidant which may also be of help. A compound carnitine may be good to take, especially if serum triglycerides are high. If diarrhea is a problem, then the amino acid glutamine may also be important to take as a supplement.
Magnesium (300-600 mg/day) is important - helps prevent oxidative stress, leg cramps - helps for energy and keeping the body in repair. BUT, if you have kidney problems don't take extra magnesium
Take these supplements at meal time.
Many people living with HIV/AIDS are aggressive in taking charge of their wellness. For most, this means eating well, which is important since the immune system requires protein to fight infection. But in order for the body to properly use the protein, fat and carbohydrate in food, it needs adequate levels of vitamins and minerals.
For many, one of the earliest, often undetected, signs of HIV infection is deterioration of the small intestine where absorption of nutrients occurs. Moreover, it appears there are increased requirements for certain nutrients. These are two reasons why, for many people, HIV results in decreases in many of the body's vitamins and minerals.
Many people, concerned for their wellness, supplement their diet with vitamins and minerals at levels above those considered necessary in the absence of HIV. This pamphlet was written to encourage people to learn about ways in which they may be able to improve their quality of life.
If you don't already supplement your diet with vitamins/minerals, the information here may help you start a program to fit in with your total approach to living with this disease.
contact Community AIDS Treatment Information Exchange (CATIE)
555 Richmond Street West
Suite 505
Toronto, Ontario M5V 3B1
Phone: 1-800-263-1638
Fax: 1-416-203-8284
or contact your local AIDS organization
Author, Chester Myers, held both honours B.Sc. and M.Sc. (1969) degrees in physical chemistry from Dalhousie University, and a Ph.D. (1975) from the University of Toronto (biophysical chemistry) where he investigated the mechanism of action of one of the digestive enzymes. In addition to publishing in the scientific literature and having authored several patents, he wrote extensively on topics regarding health and HIV. The latter include articles in The Positive Side, Canadian AIDS News, and monographs available from the AIDS Committee of Toronto (ACT), the Community AIDS Treatment Information Exchange (CATIE), and various other organizations.
Disclaimer:
The material in this publication is for information purposes only. It does not endorse any particular treatment program nor strategy; neither is it intended as medical advice nor as a replacement for medical advice.
©This document is copyrighted by Chester Myers. All materials may be reprinted and/or distributed without prior permission. However, reprints may not be edited. |
