The more women I see in my practice, the more questions I get regarding the role of vitamins and minerals in the treatment of HIV. Many women fear the vast number of medications prescribed to them and the limited knowledge of their effects on women as compared to men. So women are looking to include a more "natural" approach to therapy. For this reason, it's important to review what is known and not known, in general, about the role of vitamins and minerals and their effect on HIV.

Current research is conclusively demonstrating the importance of optimal nutrition in maintaining immune function. As more studies are being undertaken, and clinical experience progresses, much is being learned about the relationship between vitamins and minerals, and specific aspects of the immune system.

The term "vitamin", thought to mean Œvital amine", was introduced by a Polish chemist, in the 1920's, to designate the accessory food factors necessary to life. The term mineral means the elements are in their simplest elemental form (calcium, magnesium, potassium etc.) There are 22 mineral elements known to be essential in nutrition. Well balanced diets provide us with the right blend of vitamins and minerals. Unfortunately, most Americans don't eat well balanced diets, and the fast food circus of options, just doesn't cut it.

What we do know is that multiple nutritional abnormalities occur relatively early in the course of HIV infection and appear to facilitate disease progression. For many persons with HIV, nutrient deficiency is often the result of inappropriate dietary intake, and intestinal malabsorption. However, trying to correct these deficiencies in a scientific manner is very difficult. First of all, measuring levels in the blood is often very unreliable, and very, very expensive. Furthermore, it is not well known how each nutrient is absorbed by patients at various stages of the disease, and what role medications play in affecting nutrient absorption.

Nonetheless, many natural therapies are thought to enhance immune function, while others are thought to inhibit viruses, thus offering hope for improving quality and possibly length of life in persons with HIV. Much more research is needed, as well as a clearer understanding of how traditional Western medicine and nutritional therapies can work together to improve a person's overall health.

That brings us to the next logical question. How many vitamins and minerals should I take if they do all of these wonderful things and they don't hurt me, is megadosing a good thing? This is one of the most frequently asked questions. My response to each person is, "I don't know". Most of the time we're left with our best "guestimate". Many use my mother's equation: 'If a little is good, then more is better.' But, I urge caution with that calculation, especially with regard to vitamin A and D.

Recently, researchers determined that the recommended daily allowances (RDA) of many vitamins and minerals are inadequate for persons with HIV. Higher levels are required to maintain adequate blood nutrient status. They proposed some dietary recommendations, pending further controlled clinical trials. They are as follows: 5x RDA for zinc; 6x RDA for B2; 6x RDA for Vitamin C; 6x RDA for vitamin E; greater than 10x RDA for vitamin B6; and 25x RDA for vitamin B12. Higher levels of certain vitamins were recommended for patients with malabsorption. Keep in mind that this is by no means gospel, it is strictly one researchers quantitative findings.

The same researcher found that a large proportion of AZT treated patients exhibited decreased levels of zinc and copper. The level of zinc appeared to be particularly important in maintaining immune function, in persons being treated with AZT. Again, all of this varies with the stage of disease process, so before embarking on a major diet change, I strongly urge you to invest in a good nutrition book or see a reputable HIV-educated nutritionist.

To maximize your supplemental intake, I recommend taking supplements with meals. Vitamins and minerals are absorbed better with food, especially foods that already contain them (e.g. Vitamin C and broccoli). In addition certain nutrients are better absorbed when other nutrients are present in the same meal (e.g. B12 with other B vitamins).

Keep in mind that no supplement will ever work if it is not substantiated by an appropriate diet. Any diet will work as long as it provides a balanced intake of the basic food groups in large enough quantities to sustain you and prevent weight loss.

When purchasing vitamins, remember that they should be bioavailable and hypoallergenic. Try to get reasonably priced vitamins. There is a large and lecherous market out there for people willing to spend their money. There is no need to purchase the latest, greatest, high-tech, high priced vitamin on the market.

Determine what you need, get what is affordable to you, and stick with it for a reasonable period of time to determine whether it is doing you any good. By all means, don't get pills that only a horse could swallow, or will clog the kitchen sink if you drop it in.

In conclusion, I hope this article has given you a reasonable look at how vitamins and minerals can play a role in the treatment of HIV disease. If you are thinking of trying to optimize your treatments with vitamins and minerals, I strongly urge you to educate yourself about the benefits, side-effects, and recommended doses of each nutrient. If nothing else, remember that you are the final judge on whether a treatment, any treatment, is beneficial to your quality of life, especially when this treatment has not been formally tested on patients similar to you.

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Copyright © 1993 - Women Alive Reproduced with permission of Women Alive, 1566 S. Burnside Ave., Mid-City Los Angeles, CA 90019; Phone (323) 965-1564, FAX: (323) 965-9886. You need permission from Women Alive to make more than one copy of any article in this section.

ÆGiS is made possible through unrestricted grants from Boehringer Ingelheim, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 1993. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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