VITAMINS & MINERALS
A well balanced diet will almost
definitely meet all your vitamin and mineral needs, but many People Living with
HIV also take a multivitamin and mineral tablet every day.
Vitamin and Mineral Deficiencies are seen in
people with HIV who are unwell and have weak immune systems.
Some research has shown that taking
nutritional supplements can slow HIV disease progression. However, other
research failed to find any benefit.
HIGH DOSES OF VITAMINS
& MINERALS
There is little evidence that taking large doses
of vitamins and minerals have any benefit for People Living with HIV. Indeed,
it is worth noting that large doses of some can cause very unpleasant
side-effects and can even be dangerous.
Vitamin A
Doses above 9,000mcg (micrograms) in men and
7,500mcg in women may be harmful. Large amounts can cause liver and bone damage, vomiting and headache. If you are pregnant, or thinking about
becoming pregnant, you should talk to your doctor before taking vitamin A as
large doses can harm
an unborn child, and high levels
of the vitamin have been associated with increased viral load in breastmilk.
Vitamin C
Doses above 1000mg per day can cause kidney stones, and special care is needed if you are taking the protease
inhibitor Indinavir (Crixivan) or Atazanavir (Reyataz) which can also cause kidney stones. It has also been shown that large doses of
vitamin C can lower blood levels of
Indinavir (Crixivan).
Vitamin E
Doses above 800mg a day may interfere with normal immune function. Special care is needed if you are taking
anti-coagulants or if you have haemophilia.
Zinc
Doses above 75mg a day have been linked with copper deficiency, a shortage of immune system cells called neutrophils, and anaemia.
Selenium
Doses of more than 750 micrograms per day have
been associated with immune
suppression.
Vitamin B6
More than 2g a day can cause nerve damage, but doses as low as 50mg a day have been associated with peripheral neuropathy.
HERBAL SUPPLEMENTS
Herbal remedies are also widely used by People
Living with HIV. However, some herbal remedies can interact with
anti-HIV medication meaning that the amount of the HIV drug that gets into the
blood is too low to effectively fight the virus leading to the emergence
of drug-resistant HIV.
Because the use of herbal supplements is not
studied as extensively as the use of prescription medications not all the
potential interactions are known about.
Some of the most concerning interactions seen so
far are:
AFRICAN POTATO
This herb is widely used in Africa by people
with HIV, but test tube studies have
shown that the body uses the same mechanism to process it as it does for HIV
drugs, meaning that not enough anti-HIV drug may get into the blood.
GARLIC
Supplements of garlic
have been shown to stop the body processing protease inhibitors and NNRTIs
properly. A study involving
HIV-negative volunteers taking a protease inhibitor found that a twice-daily
garlic supplement lowered blood concentrations of the protease inhibitor. This
finding is very concerning as garlic is often taken by people with high levels
of fat in their blood, and high blood fats can be a side-effect of anti-HIV
drugs. However, there is no evidence that garlic used for cooking interacts
with HIV medicines.
ST. JOHN’S WORT
This popular herbal antidepressant has been
shown to lower blood levels of Indinavir and the UK’s Medicines Control Agency
has warned that it could affect blood levels of all protease inhibitors and the
NNRTIs Efavirenz (Sustiva, also in the
combination pillAtripla) and nevirapine (Viramune).
SUTHERLANDIA
A herb which is used in Africa for the treatment
of people with HIV has been shown by laboratory studies to interact with
anti-HIV drugs.
ADVICE
Before you take any vitamin, mineral or herbal
supplement talk to your HIV doctor or specialist HIV pharmacist first. They
will be able to tell you if there is a risk of an interaction with anti-HIV
drugs.
A dietitian can analyse your diet and
advise you on how to optimise your nutritional intake so you can meet your
vitamin and mineral requirements through both foods and supplements.
Also remember, vitamins, minerals and herbals
supplements can have side-effects, just
like prescription medicines and you should never take more than the recommended
dose.
Source: http://www.aidsmap.com/Vitamins-minerals-and-herbal-supplements/page/1045173/#item1045176
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