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References

Restoring Hormone Balance

The final component of a healthy nutrient and supplement approach to HIV/AIDS is to correct the hormonal imbalances caused by the disease. Before beginning supplementation with hormones, the Life Extension Foundation recommends testing the blood to determine the levels of major steroid hormones, including pregnenolone, DHEA, testosterone, estrogen, and progesterone. A comprehensive hormone restoration program seeks to return hormone levels to those of a healthy person in his or her middle 20s. A number of hormone deficiencies have been associated with HIV/AIDS.

Low serum levels of dehydroepiandrosterone (DHEA)

Low DHEA levels are associated with high HIV load and tend to indicate a negative disease course (Ferrando SJ et al 1999). DHEA declines in patients as they progress from the latency phase of HIV infection to AIDS (Jacobson MA et al 1991; Mulder JW et al 1992). These declines in DHEA have been associated with the development of opportunistic infections. DHEA also helps maintain healthy functioning of the immune system while HAART reduces viral load (Clerici M et al 2000).

Cortisol

Cortisol is a major hormone produced by the adrenal glands. At normal levels, cortisol assists in the metabolism of glucose, protein, and fats. It also has a strong impact on the immune system. At consistently high levels due to illness or stress, however, cortisol suppresses immune response and accelerates aging. In general, rising levels of cortisol are associated with physical and mental stress. Similarly, cortisol levels are increased in people infected with HIV, and cortisol has been shown to cause T-cell death (Clerici M et al 2000).

With progression of HIV, cortisol rises and DHEA decreases (Christeff N et al 2000). Therefore, it is in the patient’s best interest to restore a more normal, healthy cortisol/DHEA ratio. This could be done by increasing DHEA (see above).

Growth hormone

Supplemental growth hormone is an approved treatment for the HIV-associated wasting syndrome. A 2-week course of growth hormone at the time of acute opportunistic infection is also beneficial (Paton NI et al 1999). The dose of growth hormone in HIV infection therapy is much higher than the dose used for replacement therapy in the healthy aging adult.

Many insurance companies will underwrite the cost of growth hormone therapy if it is used in conjunction with HAART.

Melatonin

Melatonin is a hormone secreted by the pineal gland. It exerts a regulatory effect over many body systems. Evidence suggests HIV immune suppression may be slowed by nightly intake of melatonin. Melatonin enhances the production of T-cells and other components of the immune system. In addition to enhancing the immune system, melatonin is a formidable antioxidant and can prevent immune system cell loss (Lissoni P et al 1989; Maestroni GJ 1993, 1999).

Testosterone

In both men and women, testosterone declines with HIV progression. Because a low testosterone level is very common in men with HIV, it may also contribute to wasting syndrome. Because treatment with HAART does not reverse the testosterone deficiency, testosterone replacement is required (Rietschel P et al 2000). Testosterone therapy helps depression and improves decreased energy and libido (Rabkin JG et al 2000). It also decreases opportunistic infections and dementia and improves quality of life (Kopicko JJ et al 1999).

Thymosin alpha-1

Thymosin alpha-1 has been extensively studied for its effects on immune response. Thymosin alpha-1 is found in highest concentrations in the thymus, but has also been detected in the spleen, lungs, kidneys, brain, blood, and a number of other tissues. In more than 70 studies, thymosin alpha-1 showed immune-enhancing benefits (Sjogren MH 2004). It may work best in combination with other immunomodulators (Roch-Arveiller M et al 1991; Serrate SA et al 1987; Svedersky LP et al 1982).

The benefits of thymosin alpha-1 are due mostly to its ability to enhance T-cell function. Studies have shown the following benefits:
Increased activity from natural killer (NK) immune cells (Favalli C et al 1989; Roch-Arveiller M et al 1991; Serrate SA et al 1987).
Enhanced production of T-cells in patients with chronic hepatitis B (Mutchnick MG et al 1991) and cancer (Salvati F et al 1996).
Decreased replication of HIV-1 in human blood cells (Moody TW et al 1993).
Thymosin alpha-1 is currently being considered for phase 3 clinical trials in the treatment of hepatitis. It is not yet approved in the United States, but has been approved for various uses in more than 30 countries.

Living With HIV/AIDS

Twenty years ago, a diagnosis of HIV/AIDS was a death sentence. Yet, with current drug regimens, patients with HIV/AIDS can now hope to live longer, more productive and more comfortable lives than patients who had HIV/AIDS in the past. By drawing on the best of both conventional and complementary medicine, patients with HIV/AIDS can design a holistic therapy that can help suppress HIV while supplying the body with a robust nutritional intake to support immune system function and general health.

Because patients with HIV/AIDS often have malabsorption problems, particularly in the later stages of the disease, it is a good idea to add a comprehensive digestive enzyme formula to the program to encourage the most efficient digestive activity.

After a physician has diagnosed HIV/AIDS, it is important to carefully monitor therapy by testing T-cell and viral loads and by having complete blood tests that measure antioxidants and other nutrient levels. Regular blood testing will also help you and your physician decide when is the best time to begin HAART (Fauci AS et al 2004).

Life Extension Foundation Recommendations

Dietary supplementation in HIV/AIDS is an important part of the overall strategy.

With any program of dietary supplementation in patients with HIV/AIDS, it is important that no supplement or nutrient is added to the diet without the approval of the patient’s physician. Fortunately, more physicians are beginning to understand the value of robust nutritional supplementation for patients with HIV/AIDS. The Life Extension Foundation suggests:

Glutathione boosters:

N-acetylcysteine—600 milligrams (mg) twice daily
Vitamin C—1000 mg three times daily
R-lipoic acid—210 mg twice daily
Whey protein isolate—30 to 60 grams (g) of powder in two or three divided doses
Glutathione—500 mg twice daily

Antioxidants:

Vitamin C—1000 mg three times daily
Selenium—200 mcg three times daily
Beta-carotene—25,000 IU daily
Vitamin E—400 IU daily
Green tea extract (93 percent polyphenols)—three 725-mg capsules three times a day
Life Extension Mix—As directed on label.
CoQ10—200 mg daily

Micronutrients:

Zinc—30 mg daily
Magnesium—160 to 500 mg daily
Vitamin B12—one 5000-mcg sublingual lozenge daily in the form of methylcobalamin

Amino acids:

L-glutamine—1 to 2 g daily. Do not take with other proteins or amino acids.
L-carnitine—3 to 4 g daily in two divided doses. Do not take with other proteins or amino acids.

Natural antivirals:

Lactoferrin—300 mg daily
Olive leaf extract (containing 23 percent oleuropein)—one 500-mg capsule four times daily
Deglycyrrhizinated licorice (DGL)—760 mg of deglycyrrhizinated licorice (2 tablets a day)
Thymic extract—2 capsules daily of Thymic Immune Factors
Silymarin—100 mg of silymarin or silibinin, 2 to 6 capsules daily

Digestive enzymes:

Super Digestive Enzymes—2 capsules with each meal

Hormonal treatments:

Growth hormone—After testing and with supervision of a physician
Testosterone—After testing and with supervision of a physician
DHEA—After testing and with supervision of a physician. Usual dosages are 15 to 75 mg daily.
Melatonin—3 mg at bedtime

HIV/AIDS Safety Caveats

An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Beta-Carotene

Do not take beta-carotene if you smoke. Daily intake of 20 milligrams or more has been associated with a higher incidence of lung cancer in smokers.
Taking 30 milligrams or more daily for prolonged periods can cause carotenoderma, a yellowish skin discoloration (carotenoderma can be distinguished from jaundice because the whites of the eyes are not discolored in carotenoderma).

Coenzyme Q10

See your doctor and monitor your blood glucose level frequently if you take CoQ10 and have diabetes. Several clinical reports suggest that taking CoQ10 may improve glycemic control and the function of beta cells in people who have type 2 diabetes.
Statin drugs (such as lovastatin, simvastatin, and pravastatin) are known to decrease CoQ10 levels.

DHEA

Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss.

Green Tea

Consult your doctor before taking green tea extract if you take aspirin or warfarin (Coumadin). Taking green tea extract and aspirin or warfarin can increase the risk of bleeding.
Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea extract may decrease platelet aggregation.
Green tea extract contains caffeine, which may produce a variety of symptoms including restlessness, nausea, headache, muscle tension, sleep disturbances, and rapid heartbeat.

L-Carnitine

L-carnitine can cause gastrointestinal symptoms such as nausea and diarrhea.

L-Glutamine

Consult your doctor before taking L-glutamine if you have kidney failure or liver failure.
L-glutamine can cause gastrointestinal symptoms such as nausea and diarrhea.

Licorice

Do not take licorice extract if you have diabetes, high blood pressure, heart irregularities, abnormal muscle tension, poor kidney function, low blood potassium levels, or chronic hepatitis, cirrhosis of the liver, or any disease that impedes the flow of bile from the liver.
Do not take licorice for more than 6 weeks in a row. High doses of licorice (more than 20 grams of licorice extract daily or 50 grams of licorice root daily) taken for extended periods may lead to excessive loss of sodium from the blood, water retention, high blood pressure, heart irregularities, fatigue, headaches, and muscle cramps.

Lipoic Acid

Consult your doctor before taking lipoic acid if you have diabetes and glucose intolerance. Monitor your blood glucose level frequently. Lipoic acid may lower blood glucose levels

Melatonin

Do not take melatonin if you are depressed.
Do not take high doses of melatonin if you are trying to conceive. High doses of melatonin have been shown to inhibit ovulation.
Melatonin can cause morning grogginess, a feeling of having a hangover or a “heavy head,” or gastrointestinal symptoms such as nausea and diarrhea.

NAC

NAC clearance is reduced in people who have chronic liver disease.
Do not take NAC if you have a history of kidney stones (particularly cystine stones).
NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to detect diabetes.
Consult your doctor before taking NAC if you have a history of peptic ulcer disease. Mucolytic agents may disrupt the gastric mucosal barrier.
NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such as nausea and diarrhea.

Phytosterols

Phytosterols can cause gastrointestinal symptoms such as nausea and diarrhea.

SAMe

Consult your doctor before taking SAMe if you have bipolar disorder. See your doctor frequently if you take SAMe and you have bipolar disorder.
Consult your doctor before taking SAMe if you take antidepressants. See your doctor frequently if you take SAMe in place of or in addition to antidepressants.
Consult your doctor before taking SAMe if you have cancer. Nucleic acid methylation patterns may change in people who have cancer and take SAMe.
Do not take SAMe if you are undergoing gene therapy.
SAMe can cause anxiety, hyperactive muscle movement, insomnia, hypomania, and gastrointestinal symptoms such as nausea and diarrhea.

Selenium

High doses of selenium (1000 micrograms or more daily) for prolonged periods may cause adverse reactions.
High doses of selenium taken for prolonged periods may cause chronic selenium poisoning. Symptoms include loss of hair and nails or brittle hair and nails.
Selenium can cause rash, breath that smells like garlic, fatigue, irritability, and nausea and vomiting.

Vitamin B12 (cyanocobalamin)

Do not take cyanocobalamin if you have Leber's optic atrophy.

Vitamin C

Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.

Vitamin E

Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
Consult your doctor before taking vitamin E if you have a history of any bleeding disorder such as peptic ulcers, hemorrhagic stroke, or hemophilia.
Discontinue using vitamin E 1 month before any surgical procedure.

Zinc

High doses of zinc (above 30 milligrams daily) can cause adverse reactions.
Zinc can cause a metallic taste, headache, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea.
High doses of zinc can lead to copper deficiency and hypochromic microcytic anemia secondary to zinc-induced copper deficiency.
High doses of zinc may suppress the immune system.

For more information see the Safety Appendix

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*These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease.

The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional or any information contained on or in any product label or packaging. You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. You should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem. You should not stop taking any medication without first consulting your physician.