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Using Nutrients to Protect the Body and Counter HIV Symptoms and Drug Side Effects
by Lark Lands
Many studies have shown that people living with HIV/AIDS develop multiple nutrient deficiencies in early disease stages, and that they worsen over time. The nutrient deficiencies contribute to both immune dysfunction andthe development of many different symptoms. Protecting the body with a plentiful supply of nutrients-from both anutritious diet and nutrient supplements-provides three very important benefits.
G First, optimal levels of nutrients will boost the immune response, both before and after antiretroviral
drugs (HAART) are taken.
Researchers have shown that people with higher levels of nutrients progress more
slowly. The reason is that the immune response is dependent on the nutrients that make up immune cells and
chemicals. The body's need to crank out an immune response to HIV, day in and day out, makes this is a very
nutrient-depleting disease. The result is that you rapidly use up your antioxidants and the other nutrient building
blocks that are key in your immune response. Thus, it's very important to always replenish nutrients.
G Second, for those who are on HAART, appropriate nutrient supplementation can greatly decrease or
eliminate many drug side effects.
In turn, that can help prevent drug failure since you are much more likely to
properly adhere to drugs when they aren't making you feel sick or causing symptoms that you hate. Both studies
and anecdotal reports from the community have shown that far too many people are skipping doses to try to lessen
side effects. When that happens, it's highly likely to lead to drug resistance and failure. Using nutrients to help
prevent side effects can make it much more likely that drugs will be consistently taken as directed, thus maintaining
their effectiveness. That means that your meds-and their ability to save your life-may remain effective for years
and years instead of months.
G Third, your quality of life can be immensely improved when life-degrading symptoms are eliminated or, at
least, lessened with nutrient supplementation.
Whether symptoms are caused by HIV itself or by HAART meds,
nutrients can often help eliminate them and greatly improve quality of life. The result will be that you can gain the
benefits that the drugs can give you, while avoiding the side effects that can make taking them so difficult. And that
can help you live well with HIV, not just longer.
One of the most important parts of a formula for living well is to do a long-term program that
provides protection against (1) oxidative stress, (2) mitochondrial damage, and (3) inflammation.
G Oxidative Stress. A great many studies have shown that oxidative stress begins in early HIV disease stages and
worsens over time. In essence, oxidative stress occurs when the body's supply of antioxidants is insufficient to
counter the various body processes-including the body's immune responses to HIV-that generate unstable
molecules called free radicals and reactive oxygen species. These unstable molecules may serve an initial purpose
such as destroying organisms like viruses or participating in normal body processes but they can then cause cellular
damage when they bounce around through the body, picking off electrons from places they shouldn't and damaging
cells and tissues along the way. So throughout this disease, much higher than normal levels of the antioxidants
which can stop these unstable molecules in their tracks are needed to prevent this damage. When there are not
enough antioxidants, both immune cells and vital organs like the liver can be harmed.
For example, research has shown that cellular levels of glutathione, the most important intracellular antioxidant, begin to decrease within weeks of HIV infection, and go downhill from there. Those decreased levelsof glutathione have been shown to be tied to the death of immune cells. In addition, the liver is absolutelydependent on adequate supplies of glutathione to break down toxic chemicals. If its supply of glutathione isinadequate, it's more likely to be damaged when it has to break down drugs. Using the nutrients that help tostabilize glutathione levels-particularly alpha-lipoic acid, N-acetyl-cysteine (NAC), glutamine, and vitamins Eand C-can help maintain immune cells, protect the liver through years of taking HAART meds, and support thebody, in general, against oxidative stress. In addition to glutathione, there are many other antioxidants in the bodywhich work in different ways and in different places to protect it against oxidative stress, so keeping all theantioxidants-especially vitamin C, vitamin E, superoxide dismutase (SOD), the carotenoids (like beta-caroteneand lycopene and lutein), selenium, alpha-lipoic acid, and coenzyme Q-10-at optimal levels is important.
G Mitochondrial Damage. Recent research has shown that the function of mitochondria (the energy factories
inside cells) is negatively affected by nucleoside analogues (nukes, the drugs like AZT, d4T, 3TC, abacavir, etc.)
It's been shown that the resulting mitochondrial dysfunction may be a cause of fat changes in the body, especially
the lipodystrophy-associated fat loss called lipoatrophy, as well as of neuropathy (nerve damage), myopathy
(muscle aches), pancreatitis (inflammation of the pancreas), fatty liver, white blood cell and platelet decreases,
anemia, and, in its severest form, potentially lethal lactic acidosis, a condition in which lactic acid builds up in the
blood, sometimes to life-threatening levels. Research has shown that countering oxidative stress, as discussed
above, may be one key for preventing the nuke-caused damage to the mitochondria. The mitochondria produce lots
of free radicals during normal body processes and without sufficient antioxidant protection, the mitochondria may
be damaged. Studies have shown that giving antioxidant nutrients along with the drugs may help prevent this
damage, so the antioxidants listed above are an important part of a mitochondria protection program.
Also of great importance is the amino acid carnitine. Acetyl-L-carnitine is a naturally occurring molecule in the body that's derived from carnitine. It is involved in the normal transportation of free fatty acids into themitochondria, and the normal oxidation of free fatty acids. Without carnitine, the mitochondria cannot functionproperly. The B vitamins are also crucial nutrients for mitochondrial support. In particular, thiamine (vitamin B-1)and riboflavin (vitamin B-2) are needed for proper mitochondrial function. There have been recent reports showingdramatic improvement in people with lactic acidosis (resulting from mitochondrial damage) after administration ofthese vitamins. Because standard thiamine supplements have to be converted in the body to an active form, the bestsupplement to use is benfotiamine. This combination of carnitine, antioxidants, and B vitamins may significantlyhelp to counter mitochondrial toxicity and all the problems that can stem from that.
G Inflammation. Inflammation in the body of HIVers can activate the virus and increase replication, raising your
viral load. Inflammation also contributes to the development of a lot of the things that people are most worried
about today: bone problems, heart disease, diarrhea, gas and bloating, liver dysfunction, myelopathy (spinal
problem), myopathy (muscle aches), nausea, neuropathy, and skin problems. Thus, countering inflammation is
crucial. Anti-inflammatory drugs might increase the risk of infections by over-suppressing the inflammatory
response (a part of the immune system's way of countering infections), and can cause gastrointestinal bleeding.
Luckily, a much less risky approach is to use foods that have natural anti-inflammatory qualities. Such foods have been used for thousands of years with no apparent adverse effects on immune responses, so it seemslikely that long-term consumption of them would be considerably safer than long-term use of drugs. There are anumber of naturally anti-inflammatory foods and seasonings including ginger, turmeric (a seasoning), bioflavonoid-rich fruits (especially all the different berries), and omega-3 fatty acid-rich foods like fatty fish, flaxseed, andwalnuts. Out of those, the best way to get the most potent effect is by either eating fatty fish quite often-thingslike salmon, mackerel, sardines, cod and halibut-or by taking fish oil supplements. The reason is that fish oilprovides the anti-inflammatory omega-3 fatty acids in a ready-to-use form which does not have to be processed bythe body in the complex ways that the other omega-3-containing foods do. Thus, you're more likely to get aconsistent effect with fatty fish or fish oil supplements.
In addition to fish oil, antioxidants can help because early in the process in which inflammation is created in the body, oxidative stress plays a key role. So when you take the antioxidants for all the other reasons discussedabove, you'll also be countering inflammation and all the different problems it can create.
The bottom line is simple. Everyone living with HIV needs to be doing a base program that will replenish all the
nutrients that are so often deficient, boost the immune response, counter miserable symptoms, and ensure the
presence of adequate amounts of nutrients to help counter the MIO problem: M for mitochondrial toxicity, I for
Inflammation, and O for Oxidative stress. When you do that with the combination of a good diet and the proper
supplements, you'll go a very long way toward giving your body long-term protection against the virus and the
damage it causes, against the drug side effects, and against life-disabling, misery-making symptoms.
Lark Lands, 2004
Nutrient Supplementation for Living Well with HIV Disease
by Lark Lands
Ideally, everyone living with HIV would take the first three items listed here daily ( a great multiple, an
antioxidant formula, and anti-inflammatory fish oil) for all the reasons discussed above. These are the base of a
great, protective program!
Where needed, other nutrients can be added to more fully protect the body and eliminate
drug side effects and other symptoms. You can save money by ordering hugely discounted supplements at near-
wholesale prices from the Houston Buyers Club (800-350-2392);
Multiple vitamin/mineral: a potent multiple contains a broad spectrum of many different antioxidants, B vitamins,
carotenoids, A, C, D, E, minerals (including calcium, magnesium, zinc, selenium, chromium, etc) and other important
nutrients; take with 3 meals/day. Excellent brand: SuperNutrition's SuperBlend (8 tablets per day for the full dose).
NOTE: many multi's put in tiny doses and then CLAIM that they have everything; in fact, the doses are often
absurdly small; always compare ingredient amounts to a great multi like the SuperBlend.

Antioxidant formula: take with meals; should contain multiple antioxidants such as carotenoids, selenium, vitamin E,
vitamin C, alpha-lipoic acid, N-acetyl-cysteine, Co-Q-10, lutein, lycopene, etc. (Note: the therapeutic range for selenium
is 400-800 mcg/day; more than 1000 mcg daily from all sources can be toxic; selenium is found in most multiples so
check daily totals). Excellent brand: SuperNutrition Antioxidant Power.
Anti-inflammatory omega-3's (fish oil): Fish oil; 1000-2000 mg daily; contains anti-inflammatory omega-3 fatty acids
(including EPA & DHA); very important to help prevent viral activation, immune dysfunction, fatigue, and many
inflammation-caused problems, as discussed above. Excellent (no nasty fishy taste) brands: Natural Factors (264 mg
EPA, 2-4 caps daily), or less expensive liquid Carlson's fish oil, 1-2 teaspoons daily.

Acetyl-L-carnitine: 500-1000 mg twice daily (1-2 capsules twice daily); very important for protection against
mitochondrial toxicity and all the problems which can result from that, including lipodystrophy; can help reverse
neuropathy; can help lower blood fats. Excellent brand: Jarrow Acetyl-L-Carnitine (500 mg).
Acidophilus and other probiotics: 1-2 capsules daily, preferably taken with water ½ hour before a meal. Intestinal
microorganisms (probiotics), often deficient in HIVers, aid digestion & produce vitamins for the body. Crucial for those
on antibiotics or those with yeast problems. Probiotic supplements can help to prevent candida overgrowth, digestive
tract damage and malfunction, and diarrhea; may also help to prevent other infections from taking hold in the intestines.
Excellent brands: Jarrow Shelf-Stable Acidophilus and Essential Formulas Probiotics 12 Plus.
Alpha-lipoic acid: 600-1200 mg/day (1-2 capsules, twice daily); very important antioxidant; helps protect and repair the
liver; can improve insulin sensitivity; helps improve neuropathy, helps prevent mental changes. Because it's broken
down quickly, a time-released form is crucial Great brand: Jarrow Sustained Release Alpha Lipoic Acid (300 mg).
Vitamin B-12 and folic acid: B-12, 1000 mcg, 2-7 times per week, depending on needs; critical to prevent or eliminate
fatigue, neuropathy, tinnitus (ringing in the ears), and some forms of cognitive dysfunction (memory and other mental
problems). Excellent brand: Jarrow B-12 (cyanocobalamin, 1000 mcg sublingual tablet). Always take B-12 and
folic acid together. Folic acid, at least 800 mcg/day; larger doses of folic acid, up to 5-10 mg (5,000 to 10,000 mcg) per
day may also help prevent cervical or anal dysplasia (the cellular changes that may lead to cancer). Excellent brand:
Bluebonnet Folic Acid (800 mcg tab).
B-12 can also be taken via prescribable nasal gel (Nascobal) or injection.
Benfotiamine: 450 - 600 mg/day (150 mg capsules, 3-4 times daily); advanced form of thiamine; crucial for countering
mitochondrial toxicity and thus helping to prevent neuropathy and many other problems. Excellent brand:
Benfotiamine.Net, Inc.'s Benfotiamine
(150 mg capsule)
Vitamin C: 500-2000 mg with each meal; tolerable amount is very individual; excessive amounts will cause intestinal
gas and diarrhea so watch for this. Vitamin C is a powerful antioxidant and natural anti-inflammatory. [The SuperBlend
multi has 1500 mg in the recommended 8 tabs.] Great brand: SuperNutrition Big Rose Hips C (1000 mg tab)
Coenzyme Q-10: 100-300 mg/day; critical for immune function, heart muscle health, periodontal health, prevention of
mitochondrial toxicity, including lactic acidosis; levels decline as HIV progresses; high levels (6,000 mg daily) shown in
Japanese research to help reverse congestive heart failure. Excellent brand: Jarrow Coenzyme Q-10 (100 mg cap).
Vitamin E: 800-2000 IU/day; critical antioxidant; crucial for heart disease prevention; may help reduce some menstrual
or menopausal symptoms in women (multiple & antioxidant formula will contain E; check totals). Excellent brand:
Bluebonnet Vitamin E (d-alpha tocopherol, 400 IU or 1000 IU cap).

Fatty acids: gamma linolenic acid (GLA) in borage oil/evening primrose oil/grape seed oil; 480 mg/day; may help
reverse neuropathy. Excellent brand: Barlean's Borage Oil (240 mg GLA per capsule). Flax seed oil contains a
mixture of fatty acids which can help with dry, itchy skin and scalp. Excellent brand: Barlean's Flaxseed Oil (less
expensive liquid (1 TBS=1810 mg), 1-2 tablespoons daily; or capsule (550 mg), 3-6 caps daily).

Glutamine: 5-15 grams daily; more (up to 30-40 grams per day) needed in those with diarrhea or wasting; amino acid
crucial to maintain antioxidant status, build and maintain muscle and intestinal tissue, maintain optimal immune
function; deficiencies contribute to wasting, susceptibility to lung/intestinal/cervical/oral infections, intestinal atrophy,
and malabsorption. Excellent brand: Jarrow L-Glutamine, powdered form (500 grams; 1/4 tsp = 1 gram).
N-Acetyl-Cysteine (NAC): 1500-2000 mg/day; raises glutathione, an antioxidant that is critical to immune function and
liver health; may increase survival and protect liver. Excellent brand: Jarrow NAC (500 mg cap).
Selenium: 400-800 mcg/day; powerful antioxidant; critical to immune function; may help slow progression; (some
multiples have enough; check total from all sources; more than 1000 mcg/day could be toxic). Excellent brands:
Jarrow Activated Selenium (200 mcg capsule)
and Source Naturals Selenomax (200 mcg cap).
Zinc: 25-50 mg/day with any one meal; deficiency common & causes skin problems, taste/smell/appetite/vision
problems (multiple may have enough; toxicity possible at more than 100 mg/day long-term but only likely at very high
levels; long-term use should be balanced with copper, 2-4 mg per day taken at different meal than zinc). Excellent
brand: TWINLAB Zinc, 50 mg capsule.
TWINLAB Copper, 2 mg.
Supplemental drinks: powdered products which provide antioxidants (superoxide dismutase, Coenzyme Q-10, etc.),
carnitine, and B vitamins to support the mitochondria are Millennium Technologies' Resurgex (a potent mix of
micronutrients; 2 drinks daily) and Resurgex Plus (same micronutrients in a meal replacement formula; good for weight
gain with 2 drinks daily).Covered by Medicaid in many states; sold by Houston Buyers Club at large discount.
Nutrient supplementation can significantly improve or eliminate many symptoms and help to prevent or improve serious disorders. Nutrients that may help with each problem are listed in parentheses in descending order of
importance): fatigue (B-12, fish oil, Coenzyme Q ), skin problems (fatty acids, zinc, A, B-6), weight loss/wasting
(glutamine), loss of sense of smell or taste (zinc, fatty acids, potassium), loss of appetite (zinc, multiple vitamin),
memory loss and concentration problems (B , B complex, alpha-lipoic acid), neuropathy (acetyl-carnitine, alpha-
lipoic acid, gamma linolenic acid (GLA), fish oil, biotin, B-12, choline, inositol, benfotiamine, B-6), depression/anxiety
(B-12, B-6, zinc), muscle cramps (magnesium, calcium taken separately from magnesium, E), muscle aches (carnitine),
liver problems (alpha-lipoic acid, NAC, silymarin, C, glutamine), lipodystrophy & mitochondrial toxicity
(antioxidants, carnitine, B vitamins, fish oil), insulin resistance (alpha-lipoic acid, GTF chromium, zinc), cardiac
(fish oil, antioxidants, carnitine, magnesium), bone problems (Vitamin D, calcium, magnesium, fish oil).
LARK LANDS is a medical journalist, editor, and long-time AIDS treatment educator and advocate. A pioneer in
promoting an integrated approach to HIV/AIDS, her articles have been widely reprinted in AIDS newsletters and
described as "the most valuable guides to developing strategies for survival of AIDS in print to date." For additional
fact sheets, including in-depth information on eliminating drug side effects and other symptoms, as well as
information on the "Living Well, Not Just Longer" seminar, go to
The 100's of articles
written in her years with POZ magazine (as Science Editor) and with CATIE's The Positive Side magazine are at: and
Lark Lands, 2004


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