- Preventing and Combatting Wasting
Dr. Donald Kotler (in 1989) found that death quickly followed a loss of more than 46 percent of a person's lean tissue or 'body cell mass'(cited in Krales [August, 1999], Weighing in the modern way: Bioelectrical Impedance analysis and body composition, Body Positive XII(8).
Wasting is associated with a decrease in subcutenous fat (the kind of fat that migrating birds and ultra-long-distance runners burn) according to a more recent report by Kotler (2002) from the Barcelona AIDS Conference (cited in Medscape/Reuters Health). Kotler also says in the 2002 report that wasting may be associated with cardiovascular problems.
According to Project Inform, "[o]ne interesting but unexplained observation was that people with fat loss in the face, arms or legs (lipoatrophy) had fewer mitochondria while people who developed a buffalo hump had an increased number," but, Project Inform says, this may be the result of the anti-HIV therapy.
The use of protease inhibitors should be monitored carefully, as these drugs may elevate fat and sugar levels in
the blood and reduce protein levels, thereby leading to a decrease in lean tissue. Nucleoside analog reverse transcriptase inhibitors such as AZT may also be associated with wasting.
The body's fat may provide a reservoir for HIV according to recent research, and, at the same time, AIDS may destroy important fatty insulation.
Like the CD4 T-cells, the body's fat cells "have CCR5 receptors, and now it appears HIV uses these to infect fat cells, Jacques Leibowich and Pietri-Rouxel--of the Institut Cochin in Paris--reported at a meeting of the Institute of Human Virology at the University of Maryland in Baltimore" (November, 2002; AIDS Reader; cited in in Reuters Health/Medscape); similar findings have been reported by others: the HIV virus may possibly target human adipose cells which express the CD4 and other receptors, according to U. Hazan, I. A. Romero, and R. Cancellero (reported in Medscape's Medline [Reuter's Health], August, 2002). (According to some researchers, including Marjolein Visser, Lex M. Bouter, Geraldine M. McQuillan, Mark H. Wener, and Tamara B. Harris. "Elevated C-Reactive Protein Levels in Overweight and Obese Adults," in JAMA, interleukin 6 is one of the proteins associated with inflammation in the adipose tissue--this is associated with obesity in adults, and also with some types of diabetes; I note that interleukin 6 production is increased in HIV infection, although no studies have been done of its role in inflamming the adipose tissue in HIV.)
(Does this mean pump iron and run, run? Who knows? Or maybe consume foods rich in omega 3 fatty acids, the unsaturated fats in fish oils and olive oil?)
Biolectrical Impedance can measure wasting. It involves hooking electrodes to the body. Also, as you lose muscle mass, you may float more readily in water.
Diarrhea can be brought on by the use of drugs such as protease inhibitors, as well as by opportunistic infections, and even by HIV itself! Since diarrhea can lead to wasting, it is important to control it! Acidophillus and lactobacillus taken with yogurts or cottage cheese help restore the boyd's natural fauna and flora--which are essential to good digestion, and which are often destroyed by drugs and disease! Also, calcium and natural fibers, among other things, may help to control diarrhea! In addition, IAPAC (the International Association of Physicians in AIDS Care) has looked at controlling diarrhea and wasting with L-glutamine (an amino acid, a major component of muscular tissue; also possibly a digestive enzyme) and human growth hormone, as noted in the table above.
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Acidophillus and Lactobacillus are bacteria that live in the body, part of the body's natural fauna and flora. These bacteria are essential to good digestion, especially to the digestion of milk. Since antibiotics destroy these bacteria, it's especially important to make sure you get these when you take antibiotics! These bacteria may be used to help prevent and cure yeast infections, since these bacteria 'compete' with yeast in the body! Yogurts containing active cultures contain one or both of these bacteria. Health food stores sell these bacteria in capsules. However, the Food and Drug Administration says that capsules may not be the best way to get these bacteria deep into the digestive tract where they are needed. According to the FDA, the acidophillus and lactobacillus in capsules may be absorbed or die before getting to where they are needed. According to the FDA, the best way to get more of these bacteria into the digestive system is to consume more milk products, since these bacteria need milk products to live. However, it may not hurt to take a small amount of acidophillus and lactobacillus with milk everyday.
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Fiber: According to Ecosafe which produces natural pet products, 'it is well-established that animals provided a diet containing raw foods maintain good intestinal health, assimilate their food more efficiently, and are less susceptible to parasites.' Humans are animals too and also need fibers. Senna is an excellent source of fiber common in many fiber supplements! Gentle Dragon™ tablets made by EcoSafe for pets contain senna, fennel, myrrh, nettle, hyssop, white oak bark, and dandelion. These are designed for carnivorous intestines, according to EcoSafe, and humans, of course, are omnivores, not carnivores. Nevertheless, these are crunchy in cottage cheese, and mixed with chives or garlic, could be pretty good, and they are cheap!
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AIDS-related Anemia has been linked to decreased amounts of hematopoeitic growth factor, according to Alexandra Levine, Pathogenisis and evolving treatment options in HIV-infected patients (May, 2001), HIV/AIDS Clinical Management 10. HIV may infect the growth factor necessary for the production of red blood cells, so stimulating red blood cell growth is a possibile treatment option. Click here to view a summary of some sections of a current Medscape report on anemia in HIV/AIDS patients by Levine!
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Whey Supplements may contain proteins needed by the immune system. These also contain calcium, recommended at least for felines with AIDS, according to Feline AIDS: A Pet Owner's Guide. Blended Soy and Whey Proteins are available for persons who cannot digest lactose, and many dairy whey supplements are lactose-free. (Make sure to use whey only in cold milkshakes, or in hot drinks that have been cooled to lukewarm; excessive heat may destroy the amino acids in whey.)
Dave Miller, who is HIV positive, believes that AIDS patients are malnourished, and recommends a whey-based supplement, Immunocal, in an interview in Chronicillnet.org.
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- Green Supplements and Algaes
Some algaes have been shown to have anti-HIV properties, although not blue-green algaes. In this author's opinion, all green supplements and algaes are excellent because they include proteins and amino acids as well as vitamins and minerals, include fibers too, and do not have an
excess of any vitamins or minerals (they may contain 50% to 200% of the minimum daily requirement of most vitamins and minerals whereas many commercial vitamins contain as much as ten times the minimum daily requirements of the vitamins)--making the green supplements less toxic. Barlean's Greens
is a relatively inexpensive supplement that contains chorella growth factor and blue-green algae; kelp (a natural source of B-12); plenty of vitamin A (vitamin A deficiency has been linked to increased HIV secretion in the mucosal areas!); flax and other sources of fiber; astralagus
(which may support the immune system); and curcumin (an element in turmeric, being studied for possible anti-HIV properties).
Vitamin A and many other nutrients found in green supplements are anti-oxidants. One anti-oxidant, glutathione (GSH), vital to lymphocyte function, is believed to be often deficient in patients with HIV/AIDS. N-A-C (N-Acetyl-L-Cysteine) is considered a precursor of glutathione, and is available through some AIDS buyers clubs, but according to AIDS.org, may work better when used with glutamine, Vitamin C, and alpha lipoic acid, as well as with "an overall healthy diet." Aegis.com provides information about alpha lipoic acid. N-acetyl-L-cysteine may cause stomach upset too, so fiber may be a good idea, as well as caution!
A trial sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), is studying alpha lipoic acid for its immune-modulating and anti-viral effects in persons unresponsive to anti-retroviral therapy.
Good nutrition is needed for enzymes and for the cellular components of the immune system to do their job. Without nutrition and rest, drugs are less
effective and more toxic.
Foods believed to help immune function include:
- High-protein plants such as algaes;
- Green tea;
- Shitake mushrooms;
- Whey, which as noted, may be rich in proteins used by the immune system;
- Whole chicken and fish, cooked with the bone, rich in B vitamins and proteins.
- Foods rich in fiber--because fiber can improve the health of the intestines and colon, which are actually part of the body's immune system!
Dave Miller, who is HIV positive, believes that AIDS patients are malnourished, and recommends a whey-based supplement, Immunocal, in an interview in Chronicillnet.org.
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- Thymic Reconstitution:
Thymic reconstitution--summarized at Project Inform has to date had less side effects than chemotherapy with alpha interferon, or therapy with interleukin 2. It may help the
thymus
(described in this link by Dennis Blakeslee of JAMA),
where the variety of cells in the immune system mature and develop
their ability to reconize various foreign 'antigens'. Maturation in the
thymus takes place possibly with the help of the
Dendritic cells, according to Blakeslee (of JAMA). (In this author's opinion, thymic reconstitution is more 'wholistic' than therapy with alpha interferon or interleukin 2, which both inject into the body massive doses of a single protein produced by the immune system.)
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- Remune Therapy:
Dr. Moss reported in the May, 2002 issue of Clinical and Experimental Immunology that possibly a pool of CD4 helper cells was needed for the immune system to develop a strong response to HIV antigens with stimulation from Remune, according to an article in Medscape's Medpulse.
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- Chinese Compound Q or Chinese Cucumber Root.
Chinese Compund Q may stimulate the body's natural killer cells to kill infected cells according to Project Inform's information. It is injected at 'Underground Clinics,' according to Project Inform. It is an extract of the Chinese cucumber root, and its active ingredient is a protein called trichosanthin. People who've used it claim to have had beneficial results, but it has not been studied much in the U.S. Dried powder sold in health food stores is probably ineffective, according to the CDC, as the active ingredient is probably destroyed in the drying process. There is only one lab in Shanghai which produces Compound Q in an effective form, but it does sell to buyers in the United States and elsewhere! The U. S. Center for Disease Control (CDC) advises caution with this product, as it is still being studied here, and some dangerous side effects were reported in 1989 by users. According to the Shanghai lab, the protein crystals are now being mutated to make them less toxic! Nevertheless, new users might wish to start with very low doses. To learn more about this product, or to purchase it directly from the Shanghai lab that manufactures it, go to The Shanghai Lab's web site. Buyers' clubs for people with HIV often purchase medicinal products like this for their members: (212) 689-8140, at 31 East 30th Street, 2A, New York, New York, locates buyers' clubs. Or you might call Project Inform's treatment hotline, toll free in the U.S., at (800) 822-7422; or at (415) 558-9051 in the San Francisco Bay Area, 9-5 Monday-Friday, Pacific Time; and 10-4 on Saturdays.
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- Prostratin, a natural plant ester, found in a tropical plant.
Prostratin may help to eliminate reserves of HIV that persist after antiretroviral therapy, according to the November 15th, 2001 issue of Blood: 98: 3006-3015 (reported in Mescape this week!) Prostratin seems to help prevent apoptosis, or the death of immune system cells, and may work to improve the immune response, possibly using enzymes.
Both prostratin and compound Q seem to work with the immune system; however much is not understood about the immune system's response. How the immune system responds to HIV and how HIV affects it is being studied. Low natural killer cell activity has been observed with HIV; in addition, apoptosis, or the death of cells, both those infected and other cells mistakenly killed when the immune system overreacts, has been observed with HIV.
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Elevated blood cholesterol, another side effect associated with some protease inhibitors, may actually help HIV to reproduce according to an article by Akira Ono and Eric Freed in the November, 2001 Processings of the National Academy of Science of the United States of America. The gag protein, which HIV uses to dock with the cells it infects, interacts in the cellular membrane where HIV reproduces. It seems that reducing blood cholesterol seems to result in less HIV in the blood, possibly because the gag protein-host cell membrane interaction is affected. So it may be worthwhile to monitor blood cholesterol levels, whether taking protease inhibitors or not! And--good news--a recent stury indicates that Pravastatin, a drug that can help lower cholesterol levels and does not seem to produce a lot of harmful side effects when used in conjunction with HART regimens, may be useful, according to Moyle, et. al. (2001), AIDS(15): 1503-1508. It's worth noting too that adding a nucleoside analog anti-HIV drug, such as AZT, may worsen the effects of protease inhibitors.
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- When Should Antiretroviral Therapy Be Started? You are the one who has to decide this, because you have to live with the decision. None of the antiretroviral regimens have been shown to cure HIV in most cases, except when they are administered within 72 hours after exposure, usually in the case of a needle-stick injury in a health care setting! If you start therapy right away, the same drugs may not work as well later. Some people wait till they are sick or their t-cell counts fall below 300. Others recommend starting when the t-cell count falls below 500 to try to control the virus and others still suggest hitting the virus hard early, in an effort to slow it down, in spite of the fact that there is no cure. Some new research suggests that while starting too early may not always be advisable, it may be advisable during the acute stage of infection--the flue-like stage a few weeks after getting exposed! (Medscape, 2002). Whatever you do, make sure to have your t-cell counts, viral load, and drug side effects monitored, and note how you are feeling! It's really important to note how you are feeling, because there is no way to measure the viral load in the thymus, and it's here that the HIV destroys your immune system and brings on the onset of AIDS. No matter when you start antiretroviral therapy, you can start nutritional therapy anytime, as the virus does not mutate and become resistant to nutrients, but only to anti-retrovirals which attack it directly. It also may not become resistant to immune reconstitution and some herbal therapies--but of course, some of these alternative therapies do have side effects!
Are Drug Holidays Possible? That's a good question. Some people get tired of their drugs and take drug holidays and yet the drugs still work. But will the drugs always work after a drug holiday? With drug holidays, of course, the human immunodeficiency virus that has survived the onslaught of drugs up to that point does have a chance to grow and multiply and develop a resistant strain. But some short-term drug holidays may not result in the development of that much resistance, and may help reduce some of the side effects of the drug regimen, according to a report at Medscape.com! However, another report suggests that long drug holidays may not be that beneficial, though, at the same time, trying to suppress the human immunodeficiency virus too much may have little or no effects! A 2002 study by Simon D. W. Frost and colleagues discusses the pros and cons of taking holidays from anti-HIV drugs. Medscape reports that AZT takes some time (up to 20 months) to revert to its wild (non-drug-resistant) form, so it's important to try to prevent resistance from developing in AZT! Also, Dr. Christopher Power and Associates of Calgary, reported (AIDS 2002;16:1905-1914; cited in Reuters' Health News/Medscape, October, 2002) that dementia in HIV patients is associated with the growth of HIV mutants "with a predilection for the brain," and that "structured therapeutic interruptions . . . could have the effect of further enhancing viral sequence diversity, thus increasing the risk of neurological disease in susceptible patients."
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Some Info. on Marijuana: Marijuana actually contains over 400 chemicals! The strength of marijuana today is 8-10 times greater than in the 1970's. Like many stimulants it increases the heart rate; however, unlike many stimulants, it also increases the appetite. It has more cancer-causing agents than tobacco, and, when smoked, may increase the risk of lung cancer, as well as cause sore throats and upper respiratory problems. It may have a negative effect on the immune system, but its primary effect is on short-term memory, reaction time, and coordination. It's difficult to pass a drug test on marijuana, since it persists in the body a long time after smoking. (Source: PINKERTON: Committed to a Drug Free Workplace employee handbook.) Injesting marijuana orally, in food, is a way to prevent the lung and throat damage; prescription marinol monitored by a medical person may be safer!
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AIDS Buyer's Clubs: AIDS Treatment Initiatives: 159 Ralph McGill Boulevard, NE, Suite 510, Atlanta, GA 30308-3311; Phone: (404) 659-2437; (888) 874-8485; FAX: (404) 659-2438; Email: [email protected] (I really do not have enough information about this buyer's club to recommend it in any way; I wish I could list another, but this is what I've looked into to date.)
Non-traditional/Alternative Healing: Many people with long-term diseases search far & wide for cures, some effective, some not. I can provide no expertise, except to note that some non-traditional healing comes from 'traditional (and folk) medicine.' Because I am interested in the American Indians, I am interested in the Sweat Lodge, though I have not tried it yet. (I have tried steam, though, for lyme-disease chills/sweats.) Here are some links for those interested, who have an opportunity to try a Sweat Lodge.
Herbal Remedies can be located at the following sites:
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