www.immunet.org
www.interlog.com/~akash/
www.catie.ca
www.critpath.org
www.medibolics.com
hivinsite.ucsf.edu (Don't use "www." for this one.)

From a variety of studies, the importance of vitamin/mineral supplementation cannot be overemphasized. This must be first based on good diet that includes a wide variety of foods. I think the Food Guide is a reasonable place to start, provided whole grains and whole foods are used in preference to processed foods. While there is no significant evidence that disease progression has varied significantly with the range of foods that people eat, it is only common sense that if we don't provide the body with its building blocks, then it will deteriorate and waste away. High quality protein is especially important. It may make sense to supplement the normal diet with a whey protein supplement and extra glutamine (an amino acid). Also take from 1000 to 4000 mg daily of N-acetyl cysteine (NAC - a modified amino acid, and this is preferable to directly taking cysteine which could cause toxicity). My personal preference is to include (cooked!) flesh meats (chicken, red meat, fish), but I know many who've done very well on a vegetarian diet. However, if one's a vegetarian, it's important to be aware that potential deficiencies that may already tend to occur with HIV may be worsened. But again, aggressive vitamin/mineral (VM) supplementation is important in any case.

A generous multivitamin is the place to start for the VM supplementation. Choose one that contains at least 25 mg of vitamin B6, at least 50 micrograms each of selenium, chromium, molybdenum and vanadiaum, and between 6 and 12 mg of iron, and this usually means the others will be also at reasonable levels. Take this multivitamin for a week or two before starting the others listed here (make changes slowly, and don't shock your body). In addition, take extra vitamin C (1-10 grams daily, but spread out, and don't suddenly increase from whatever you're already taking as diarrhea may result), extra vitamin E (400IU to 800 IU, daily), an extra 250-850 mg daily of magnesium (be careful that high doses don't cause loose bowels), and an extra 200 micrograms of selenium.

For more information on nutrition, I recommend one of my monographs called "HIV & Nutrition: Vitamin and Mineral Supplementation - updated" at www.catie.ca, monographs called Pyramid Power and Alphabet Soup by Jennifer on her Picnic Basket page, and then material by Dr. Lark Lands at www.bgladco.com (click on "Health/Nutrition").

Remember that exercise, meditation, and other holistic/complementary approaches should be practised. But, again, the importance of vitamin/mineral supplementation added to a good diet is essential - several studies indicate at least a halving of the rate of disease progression from supplementation of vitamins and minerals while similar results did NOT result from the levels of vitamins and minerals found in food alone!!

Charlie Smigelski, RD responds:

There can be a short or long list of nutritional agents to take to support the immune system and maybe even reduce viral load. Here are some minimal essentials...

First, take 500mg vitamin C and 400iu vitamin E....twice a day. These two antioxidants were shown to produce a 0.5 log drop in viral load over 12 weeks of use, in the Allard group/Toronto study.

Full support of antioxidant processes in the body says to support the glutathione systems, so take 2 grams of N-acetylcysteine (NAC) a day. Next, methylation reactions are key to immune function, and B-complex vitamins, especially B-6 matter there; take a B-complex 25 or B-complex 50 pill once a day.

A multivitamin that contains 100% RDA for all elements is important. Additional 200 mcg selenium and 30-50 mg zinc are wise too.

Beyond the minimum....but very wise to use....
The list of supportive vitamin plans can expand a great deal from here. Some people feel strongly that 2-3 grams of the fish oils (DHA and EPA) also help support the immune system in an important way. Co-enzyme Q10 at 50-100 mg a day is a good addition too, as it is an important immune cell fuel. L-glutamine at 5-10 grams a day is also smart immune cell support.

There are even more extensive vitamin and supplement plans listed at the NYC buyers club web site...www.daair.org.

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