Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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AIDS TREATMENT NEWS Issue #300, August 7, 1998
John S. James
* We are most interested in what you have learned from personal experience (either your own, or of persons you know). Are you convinced that any particular supplement or program has helped you, or a friend or other associate--or has failed to help--or has been harmful in some way?
Let us know what you used (including how much, and how long), why you tried it, and why you think it did or did not work for you. Email or call John S. James, aidsnews@aidsnews.org, or 415-255-6259.
Some of the difficulties in reporting on nutritional supplements are:
* U.S. culture draws a sharp line--probably too sharp-- between "foods" and "drugs." Not all cultures do; for example, there are Chinese restaurants where you can order by describing certain ailments to the cook, who will prepare a meal accordingly. In the U.S. they have needed to keep a low profile, making a potentially fascinating and useful area difficult to find or study.
* The food/drug divide has hurt research on both sides. Nutritional research has often been ignored or greatly underfunded. On the drug side, great sums are spent on poorly designed research shaped by regulatory and promotional purposes--especially clinical trials that look only or primarily for statistically significant differences between averages, while ignoring mechanisms of action, how and why patients differ from each other, and who should or should not be using the drug. (And a major but seldom-noted element of the cost of medical care is that only expensive potential remedies are likely to be developed, since they can finance careers--even when cheaper approaches may be safer and more appropriate.)
* Because nutritional supplements have less research data than drugs while at the same time being more accessible, the community of users is often well ahead of the academic world in understanding their use. The lack of data, and the disagreements among experts, can make reporting difficult.
* Sometimes the leading expertise on nutritional supplements is in the sports world, especially body building. HIV/AIDS uses may be similar or may be different.
* The supplements industry has become a money machine, with far less government scrutiny over promotional statements than applies to the pharmaceutical industry. It is hard to distinguish the credible from the hype.
Where hard news is lacking, we may only be able to outline plausible possibilities, which people may try to see what works for them.
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