Nutritional supplements that may be helpful for hiv and aids support
Because people with HIV infection or AIDS often have multiple nutritional deficiencies, a broad-spectrum nutritional supplement may be beneficial. In one trial, HIV-positive men who took a multivitamin-mineral supplement had slower onset of AIDS, compared with men who did not take a supplement.8 Use of a multivitamin by pregnant and breast-feeding Tanzanian women with HIV did not affect the risk of transmission of HIV from mother to child, either in utero, during birth, or from breast-feeding.9
Selenium deficiency is an independent factor associated with high mortality among HIV-positive people.10 HIV-positive people who took selenium supplements experienced fewer infections, better intestinal function, improved appetite, and improved heart function (which had been impaired by the disease) than those who did not take the supplements.11 The usual amount of selenium taken was 400 mcg per day.
Selenium deficiency has been found more often in people with HIV-related cardiomyopathy (heart abnormalities) than in those with HIV and normal heart function.12 People with HIV-related cardiomyopathy may benefit from selenium supplementation. In a small preliminary trial, people with AIDS and cardiomyopathy, 80% of whom were found to be deficient in selenium, were given 800 mcg of selenium per day for 15 days, followed by 400 mcg per day for eight days. Improvements in heart function were noted after selenium supplementation.13 People wishing to supplement with more than 200 mcg of selenium per day should be monitored by a doctor.
The amino acid, N-acetyl cysteine (NAC), has been shown to inhibit the replication of HIV in test tube studies.14 In a double-blind trial, supplementing with 800 mg per day of NAC slowed the rate of decline in immune function in people with HIV infection. NAC also promotes the synthesis of glutathione, a naturally-occurring antioxidant that is believed to be protective in people with HIV infection and AIDS.15
The combination of glutamine, arginine, and the amino acid derivative, hydroxymethylbutyrate (HMB), may prevent loss of lean body mass in people with AIDS-associated wasting. In a double-blind trial, AIDS patients who had lost 5% of their body weight in the previous three months received either placebo or a nutrient mixture containing 1.5 grams of HMB, 7 grams of L-glutamine, and 7 grams of L-arginine twice daily for eight weeks.16 Those supplemented with placebo gained an average of 0.37 pounds, mostly fat, but lost lean body mass. Those taking the nutrient mixture gained an average of 3 pounds, 85% of which was lean body weight.
In a double-blind trial, the non-disease-causing yeast Saccharomyces boulardii (1 gram three times per day) helped stop diarrhea in HIV-positive people.17 However, people with severely compromised immune function have been reported to develop yeast infections in the bloodstream after consuming some yeast organisms that are benign for healthy people.18 19 For that reason, people with HIV infection who wish to take Saccharomyces boulardii, brewer’s yeast (Saccharomyces cerevisiae), or other live organisms should first consult a doctor.
A deficient level of dehydroepiandrosterone sulfate (DHEAS) in the blood is associated with poor outcomes in people with HIV.20 Large amounts of supplemental dehydroepiandrosterone (DHEA) may alleviate fatigue and depression in HIV-positive men and women. In a preliminary trial, men and women with HIV infection took 200–500 mg of DHEA per day for eight weeks.21 All participants initially had both low mood and low energy. After eight weeks of DHEA supplementation, 72% of the participants reported their mood to be “much improved” or “very much improved,” and 81% reported having significant improvements in energy level. DHEA supplementation had no effect on CD4 cell (helper T-cell) counts or testosterone levels.
Vitamin A deficiency appears to be very common in people with HIV infection. Low blood levels of vitamin A are associated with greater disease severity22 and increased transmission of the virus from a pregnant mother to her infant.23 However, in preliminary 24 and double-blind25 26 trials, supplementation with vitamin A failed to reduce the overall mother-to-child transmission of HIV. HIV-positive women who took 5,000 IU per day of vitamin A (as retinyl palmitate) and 50,000 IU per day of beta-carotene during the third trimester (13 weeks) of pregnancy, plus an additional single amount of 200,000 IU of vitamin A at delivery, had the same rate of transmission of HIV to their infants as those who did not take the supplement. However, lower rates of illness have been observed in the children of HIV-positive mothers when the children were supplemented with 50,000–200,000 IU of vitamin A every two to three months.27
Little research has explored whether vitamin A supplements are helpful at halting disease progression. HIV-positive children given two consecutive oral supplements of vitamin A (200,000 IU in a gelcap) in the two days following influenza vaccinations had a modest but significant decrease in viral load.28 In one trial, giving people an extremely high (300,000 IU) amount of vitamin A one time only did not improve short-term measures of immunity in women with HIV.29
Beta-carotene levels have been found to be low in HIV-positive people, even in those without symptoms.30 However, trials on the effect of beta-carotene supplements have produced conflicting results. In one double-blind trial, supplementing with 300,000 IU per day of beta-carotene significantly increased the number of CD4+ cells in people with HIV infection.31 In another trial, the same amount of beta-carotene had no effect on CD4+ cell counts or various other measures of immune function in HIV-infected people.32
In HIV-positive people with B-vitamin deficiency, the use of B-complex vitamin supplements appears to delay progression to and death from AIDS.33 Thiamine (vitamin B1) deficiency has been identified in nearly one-quarter of people with AIDS.34 It has been suggested that a thiamine deficiency may contribute to some of the neurological abnormalities that are associated with AIDS. Vitamin B6 deficiency was found in more than one-third of HIV-positive men; vitamin B6 deficiency was associated with decreased immune function in this group.35 In a population study of HIV-positive people, intake of vitamin B6 at more than twice the recommended dietary allowance (RDA is 2 mg per day for men and 1.6 mg per day for women) was associated with improved survival.36 Low blood levels of folic acid and vitamin B12 are also common in HIV-positive people.37
Preliminary observations suggest a possible role for vitamin B3 in HIV prevention and treatment.38 A form of vitamin B3 (niacinamide) has been shown to inhibit HIV in test tube studies.39 However, no published data have shown vitamin B3 to inhibit HIV in animals or in people. One study did show that HIV-positive people who consume more than 64 mg of vitamin B3 per day have a decreased risk of progression to AIDS or AIDS-related death.40 41 Clinical trials in humans are required to validate these preliminary observations.
Vitamin C has been shown to inhibit HIV replication in test tubes.42 Intake of vitamin C by HIV-positive persons may be associated with a reduced risk of progression to AIDS.43 Some doctors recommend large amounts of vitamin C for people with AIDS. Reported benefits in preliminary research include greater resistance against infection and an improvement in overall well-being.44 The amount of vitamin C used in that study ranged from 40 to 185 grams per day. Supplementation with such large amounts of vitamin C must be monitored by a doctor. This same researcher also reports some success in using a topical vitamin C paste to treat herpes simplex outbreaks and Kaposi’s sarcoma in people with AIDS.
In test-tube studies, vitamin E improved the effectiveness of the anti-HIV drug zidovudine (AZT) while reducing its toxicity.45 Similarly, animal research suggests that zinc and NAC supplementation may protect against AZT toxicity.46 It is not known whether oral supplementation with these nutrients would have similar effects in people taking AZT.
Blood levels of coenzyme Q10 (CoQ10) were also found to be low in people with HIV infection or AIDS. In a small preliminary trial, people with HIV infection took 200 mg per day of CoQ10. Eighty-three percent of these people experienced no further infections for up to seven months, and the counts of infection-fighting white blood cells improved in three cases.47
Blood levels of both zinc48 and selenium49 are frequently low in people with HIV infection. Zinc supplements (45 mg per day) have been shown to reduce the number of infections in people with AIDS.50
Iron deficiency is often present in HIV-positive children.51 While iron is necessary for normal immune function, iron deficiency also appears to protect against certain bacterial infections.52 Iron supplementation could therefore increase the severity of bacterial infections in people with AIDS. For that reason, people with HIV infection or AIDS should consult a doctor before supplementing with iron.
The amino acid, glutamine, is needed for the synthesis of glutathione, an important antioxidant within cells that is frequently depleted in people with HIV and AIDS.53 In well-nourished people, the body usually manufactures enough glutamine to prevent a deficiency. However, people with HIV or AIDS are often malnourished and may be deficient in glutamine.54 In such people, glutamine supplementation may be needed, along with NAC, to maintain adequate levels of glutathione. It is not known how much glutamine is needed for that purpose; however, in other trials, 4–8 grams of glutamine per day was used.55 In a double-blind trial, massive amounts of glutamine (40 grams per day) in combination with several antioxidants (27,000 IU per day of beta-carotene; 800 mg per day of vitamin C; 280 mcg per day of selenium; 500 IU per day of vitamin E) were given for 12 weeks to AIDS patients experiencing problems maintaining normal weight.56 Those who took the glutamine-antioxidant combination experienced significant gains in body weight compared with those taking placebo. Larger trials are needed to determine the possible benefits of this nutrient combination on reducing opportunistic infections and long-term mortality.
People with AIDS have low levels of methionine. Some researchers suggest that these low methionine levels may explain some aspects of the disease process,57 58 59 especially the deterioration that occurs in the nervous system and is responsible for symptoms such as dementia.60 61 A preliminary trial found that methionine (6 grams per day) may improve memory recall in people with AIDS-related nervous system degeneration.62
In a preliminary trial, a thymus extract known as Thymomodulin® improved several immune parameters among people with early HIV infection, including an increase in the number of T-helper cells.63
Whey protein is rich in the amino acid cysteine, which the body uses to make glutathione, an important antioxidant. A double-blind trial showed that 45 grams per day of whey protein increased blood glutathione levels in a group of HIV-infected people.64 Test tube65 and animal66 studies suggest that whey protein may improve some aspects of immune function.