Important note: Information in this article was accurate in November 2001. The state of the art may have changed since the publication date. Well, can you believe that it's already November? With that comes the shorter days and the cool, brisk autumnal air -- wait a minute -- it was 90 degrees today!!! And, of course, Thanksgiving! I want to give special thanks to all of the individuals who have been assisting with the efforts in New York, Washington, DC and the Pittsburgh area, and my heart goes out to all the people and families that have been impacted by the terrible tragedy of September 11. Let's all say a special blessing at the Thanksgiving table this year for a peaceful and speedy resolution to this conflict and for the return of "normalcy" to our nation.
Are you asking yourself how you can "punch up" your Thanksgiving meal? Try some of the recipes that I included in my December 2000/January 2001 article, or go to www.Epicurious.com on the Internet.
Here are this month's questions:
I get horrible hay fever every spring and I was wondering if there is something that I can take to help with this problem that isn't an allergy medicine, since these always make me drowsy.
Allergies can be caused by a number of things from pollen blowing in the breeze to leaf mold, another allergy-inciter -- which can be just as bad. And unfortunately, the more pollen you're exposed to, the more likely you'll develop allergies. And if you are prey to pollen, you are also prone to messy, mucous-filled reactions to animal dander, molds, and dust mites. These microscopic buggers live in your bed and feast on human skin cells and (dare I say it?) cockroaches.
I share your concerns about over-the-counter and prescription allergy medicines that can cause drowsiness and dry mouth or blurred vision. I know of no known interactions between anti-allergy and anti-HIV drugs, but people with heart disease, diabetes and other conditions, as well as tranquilizer-takers, should call their doctor before taking any of these remedies. Fast acting nasal sprays are also very popular, but can sting and/or take a week of "spritzing" to show signs of working and can create a "rebound" effect -- which means that you end up with more mucous than you started with.
Another alternative is allergy shots (immunotherapy) which consist of small injections two times a week at first, then less often, for three to five years, with only one third of patients treated this way ridding themselves of the allergies for good; the rest relapse.
A natural remedy would be a combination of quercitin (400 mg, twice daily); vitamin A (25,000 IU daily for one month; and zinc lozenges (50-80 mg). And, yes, the jury is still out about whether or not zinc plays a role in HIV stimulation, and at what levels -- so exercise caution when taking it and always check with your doctor first. Also, health food stores have stinging nettle and ginger (capsules, tincture or tea). For homeopathy, try Allium cepa, Arsenicum album or Euphrasia officianalis.
Then there's the cheapest anti-allergy approach: Avoid pollen altogether. Stay indoors when the pollen count is high (5 am to 10 am is peak), lawns are mowed, and weather is dry and windy. Keep your windows closed and air conditioners on, and sleep with your head elevated. So now that you are thinking of going out and buying that plastic bubble to live in... I don't see how someone could live in such a "shut up" environment. You could always try an air purifier/filter, but try to use one that doesn't require charcoal (e-mail me for some sources.) And one last tip: A hint of horseradish or a dash of cayenne pepper -- with food or not -- will have your nostrils passing the white glove test in seconds! And don't forget about the wasabi that I mentioned in my August 2001 article.
I've been thinking about starting an herbal regimen to accompany my meds. Is there anything that I should be cautious about or avoid?
Well, I've talked before about herbs (see November 1999) but I read something in POZ magazine (September 2000, pages 73-74) that caught my eye. It seems that taking the "commonly used, relatively safe anti-anxiety South Pacific root extract" Kava Kava can increase the tranquilizing effect of some of the HIV meds. And the vote is already out about taking St. John's Wart -- don't! It lowers blood levels and effectiveness of Indinavir (Crixivan) and can have other side effects on other protease inhibitors and NNRTIs (see "Curb the Herb," POZ, April 2000). Remember that herbs work on an individual basis, with the body's own biochemical individuality -- the unique sensitivity to various substances.
The article goes on to say that with certain herbs, long-term use and high doses are inappropriate and can lead to side effects, especially for people with HIV. "Licorice extract, for instance, can be used in small quantities for four to six weeks in a Chinese herbal formula. But large doses for short periods or small amounts for more than six weeks can cause high blood pressure, potassium loss, edema (swelling from fluid accumulation) and hormonal imbalances." They even warn that single doses of some powerful herbal stimulants used for bronchitis or low sexual energy, such as ephedra, guarana and yohimbe, can pose a risk, especially for people with high blood pressure or heart problems. Always get an expert's advice first, either a healthcare practitioner or an herbalist. Depending on how "open" your doctor is to alternative therapies, he or she may be able to assist you in these choices.
Some herbs like chamomile, cayenne, echinacea, garlic, kava kava, kelp and valerian can cause allergic reactions such as rash, nausea or upset stomach in those who are sensitive to them, especially when first starting a remedy. If you think that you are having an allergic reaction, stop taking the herb and talk to your doctor immediately. Toxic herbs -- ones that contain certain types of alkaloids (a large family of complex chemicals) -- can be toxic to the liver and kidneys, because they can trigger dangerous reactions. They include aconite, chaparral, comfrey, germander (often substituted for the safe sedative herb skullcap), mistletoe, pennyroyal and sassafras. So kiss under the mistletoe, but don't eat it afterwards!
Interactions: Since herbs act as medicines, it is possible for them to counteract or potentiate (increase) the effects of pharmaceuticals or other herbs taken simultaneously. Some plants may have both effects: Herbal stimulants can significantly -- sometimes even dangerously -- increase the action of any other type of upper, while counteracting the intended effects of some sedatives and downers. A good rule of thumb is to avoid combining an herb with similar-acting drugs or herbs. Example: If garlic or ginko biloba are combined with warfarin (Coumadin), heparin or aspirin -- all of which act as blood thinners -- can cause excessive bleeding. For the same reason, people with hemophilia in particular should not use garlic and ginko together.
The other side of the coin is that some herbs may counteract the negative effects of certain drugs. For instance, milk thistle can reduce liver damage from several toxic drugs while not interfering with their therapeutic action.
Unfortunately, the lack of government-mandated quality assurance means that herbal products can vary in potency and quality and may even be misidentified. So getting a product recommendation from an alternative practitioner or herbalist is a good idea, it might also be advantageous to buy from a reputable company that's known to sell quality products. Experts (and myself) advise avoiding self-prescribed (as opposed to practitioner-recommended) premixed Chinese herbal products, some of which are known to be mislabeled, adulterated with pharmaceuticals or mixed with toxic herbs or heavy metals.
Okay, now that I have scared you away from ever using herbs in your HIV regimen, let me say that there is assistance available. I would recommend talking with a pharmacist who is knowledgeable about anti-HIV meds and herbs, as they may be more adequately trained when it comes to medicinal plants and some are aware of interactions, and most can help with diagnosing problems or side-effects. Always keep your doctor, pharmacist and alternative practitioner informed about all of the treatments that you are taking. Do what I do -- make a "med list" and keep a copy of it with you to show your doctor and have them make a copy for your chart.
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A good question. Tea trees are indigenous to parts of Australia, and most likely are found in others areas around the globe. The health food and alternative medicine markets touted tea tree oil in the 1990s, but only recently has it found shelf space with such mainstream retailers as nationwide department stores and specialty chains. Suzanne Dean, an Australian plantation owner who has amassed nearly 15 million tea trees on about 2000 acres near New South Wales, opened Tea Tree Therapy in Ventura three years ago to push the product in the US. (The trees stay Down Under because of the wet, humid climate and slightly volcanic soil found there.) The active ingredient in tea tree oil is Melaleuca alternifolia.
As a topical antiseptic it is said to have medicinal properties that can help with everything from acne, toe fungus, head lice and gum disease as well as germ-riddled bathrooms. You can buy it in its pure oil form or in a dozen hygiene products including soap, shampoo, acne lotion, dental floss, toothpaste, mouthwash, deodorant and foot balms.
Tea tree oil should never be swallowed, as it is slightly toxic. In its pure form, it is best used topically on mild infections after diluting it in mineral or olive oil. Also, there's a one-in-five chance of being allergic to tea tree oil (according to Dr. Michael Hirt, Center for Integrative Medicine, Tarzana, California.) To test for allergic reactions, like a bad rash, he recommends dabbing a drop on the forearm and letting it sit for three days. If you develop small bumps or a raised area, then you'll known that you are allergic.
Now the bad news: Hirt says that tea tree oil should not be used on anyone with a serious disease, such as a weakened immune system, and/or HIV or anyone undergoing chemotherapy. He also warns that using tea tree oil too often could reduce its bacteria-killing powers in some individuals as certain bacteria can become resistant after frequent exposure. (Source: Daily News, Monday, July 17, 2000, LA Life, page 7.)
Junk Foods, or Are They? Here are five popular "junk foods" fit for a healthy menu:
Chicken and fish remain your best bets as far as meats are concerned. Eat them broiled, grilled or blackened. Just say no to deep-fried anything! In the mood for steak? Go ahead. Just limit yourself to a three or four ounce serving, not a 24-ounce bet-ya-can't-eat-it-all special. Or, try a nice grilled or baked pork chop! Hey, it's the other white meat and it can be very diet friendly. A good rule of thumb should be a nice veggie-rich salad for starters. Order a light dressing and ask for it on the side.
Dip your fork into the dressing before spearing some of your salad. Salads not only give you some great nutrients, but also help curb the gnawing hunger that could lead you to overdoing it on your main course.
If the restaurant has a salad bar, but you can't trust yourself to show restraint ask your waiter or waitress to make you a regular side salad. You're paying good money to dine out -- let your servers do the work!
Wendy's: a single burger has 360 calories and 16 grams of fat (6 saturated) and is more than you would get with a plain Grilled Chicken sandwich, which has 310 calories and 8 grams of fat (1.5 saturated).
Carl's Jr.: The Charbroiled BBQ Chicken Sandwich has 280 calories and 3 grams of fat. You can have a plain baked potato for 290 calories and zero fat. Include a Charbroiled Chicken Salad-to-Go and you add another 200 calories and 7 grams of fat. When choosing the salad bar select fresh greens, tomatoes, onions, peppers and fresh fruit. Go with a "light" dressing and try to avoid the nobody knows what that meat is...), while a Monster Taco has 270 calories and 17 grams of fat. The Garden Chicken Choice salad has 200 calories and 9 grams of fat, but remember that some of the dressings have more calories than the salad!
Well, that's it for now. Best wishes for a safe and happy Thanksgiving holiday!! In my next article I will continue my trek down fast food lane, as well as answer your nutritional questions. Until then, stay healthy, eat healthy, and stay connected!
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