Since Sex was such a popular column, I thought perhaps drugs may be appealing too. 

There was a time in my life when I had to recognize that food was not enough for me.  I’m not the best cook, nutritionist or dietitian in the world, or probably even on my block, but I would like to say I that I have some basic idea of how to get food into me.  But never enough of the right stuff, it seems.  And when that included juggling medications and two hours before or one hour after and with food or only with water became a real hassle, I thought, perhaps more drugs might be the answer.  And thus an interest in supplements began.  Though just a neophyte, I started looking into them and explored what worked and didn’t for me. 

My dealer is a black muscle man named Ty at the health nutrition store.  He’s much nicer and friendlier than previous dealers from days gone by.  With help from naturopaths, colleagues, weight training friends (I love you Chris!) and others in the fitness industry, I found some additional assistance that not only benefits me and the lifestyle I live, but what I hope can benefit you the reader, and other Poz friends (and non-Poz friends) in having a better life too.  

Supplements, to me, are much more reminiscent of the spell enhancements my Lvl 50 Half-Elf Paladin would get before the heat of battle on one of my old video game systems.  They are a means to stay in better shape, and access vitamins and minerals in higher doses that I can get from the regular foods I eat.  With eating, daily morning yoga practice, working out, and the physical exertion on my body through teaching yoga, and many of those in a heated room, the addition of extra bio-chemical assistance is greatly welcomed. 

Since a friend of mine called me the King of Supplements, (I think I’m more of a duke), here are my favourite supplements and the reasons why I take them.  I tried to rank them in order of my personal importance.  My reasoning in the ranking was overall general health and the supplement’s ability to tackle its specific function and role that it plays in my overall health goals.  I also tried to factor in how I think it can benefit you, the reader.  The list may be different for you ,so please adapt.  

Also please note that before taking anything new into your body, check with your doctor. OK, hang on!  Many of us don’t do that.  So at the very least, check with your pharmacist.  They can let you know if any of the supplements you may consider taking affect or interact with your medications and/or allergies.  Everything that I take I have checked with my own pharmacist.  I am also not a healthcare professional.  I’m just a crazy yogi who loves his health drugs and acid!  I take about 20 and narrowing it down to 10 was too hard to do.  So here are my top 15 favourites! 

15.  CLA (Conjugated Linoleic Acid)

Reason it’s on list – fat loss – specifically belly fat

It comes in a large liquid pill form and it’s a fatty acid that helps burn fat.  It assists in losing weight whether you are working out or not.  It’s this little bit of bonus that helped it make the list.  The dark side is if you are really overweight, this may have the potential to cause diabetes. 

Reason for rank - other weight-reducing supplements on the list that I believe perform better. 

 14. Greens+

Reason it’s on list – Overall health and well-being

Greens+ is one of my newer supplements but they have been around for a couple decades (more info found here). They claim to help a broadband of conditions.  I use the Greens+ Original Powder.  I started one teaspoon a day in one of my shake or drink concoctions for the first week then upped it to two.  My body disliked three teaspoons a day and so I have kept it at two. 

Reason for rank - Since I have only been using it for a few months I don’t have enough experience with it to see if it’s been helpful enough.  Also, in the ingredients list there is Green Tea extract and I am leery of any additional caffeine into my system. 

13.  Fiber

Reason it’s on list – Digestive Health

Years of poor eating and chemotherapy (yes, our HIV pills are a form of chemotherapy) have brought me to this point.  It helps re-align digestive distress whether it goes to either extreme.  I personally find a teaspoon of fiber added to a protein shake handy once a day.  You may want to start with only half a teaspoon if you are unfamiliar with fiber powders.  They don’t always blend well in water so a juice may be more efficient if you don’t protein shake.  I find it works better taken during the day or early afternoon.  The kind I use has high amounts of Psyllium and flax seed.

Reason for rank – Belly-bloated feeling sometimes.  Out of all the supplements I take, I seem to forget this one quite often.   But some of you may be in more stellar digestive health than I, which makes this a moot point. 

12. Probiotic – Acidophilus & Bifidus

Reason it’s on list – Digestive Health

These days there are so many ways to access this than in years previously.  Yogurt is a simple way.  For a few years I drank Bio K+ as these tiny shots but they tasted awful and were hugely expensive.  Now I have gone pill form.  They are hugely potent - way more than you’d get from a yogurt, contrary to popular belief.  My suggestion would be to ask your pharmacist or health care professional for a quality brand of these you can buy.  I keep mine refrigerated to keep the probiotic at its strongest. I take either one or two pills a day.  If I am taking two, I split them up at different times.

Reason for rank – Similar to the fiber, I seem to forget this one the most.  It’s kept in the fridge away from the other drugs and supplements and since it doesn’t fit into the crazy pill caddy container I have, I have to remember on my own which is challenging when you’re juggling about 40-50 pills a day. 

11.  Fish Oil and/or Flax Oil

Reason it’s on list – Health and Well Being

Fish Oils contains Omega 3 Fatty Acids which are critical for optimum health.  They help in many areas with heart health and cholesterol.  I take mine in pill form.  Four pills broken out in three doses (1 am, 2 midday, 1 evening)  Since many of my medications call for food, this isn’t a problem for me to take them together.  Flax Seed oil essentially does the same thing.  I am still unsure why I take both but there ya go!  This is easier to access as you can buy it at the grocery store.  It would be in a refrigerated section sometimes near the organic foods or speciality foods, and sometimes near cheeses.  I take 1-2 tsps a day in a protein shake.  It needs to be kept in the fridge and has an expiry date.

Reason for rank – Fish Oils can be a bit pricy and you go through so many.  Also for the first month or so, you may have a fishy aftertaste (there’s a reason they come in Lemon and lime flavours!).  Flax seed Oil is a little less expensive, but since it must be cold and can’t be used in cooking, and doesn’t like to be blended, you have to mix it into whatever you’re drinking manually.  It’s kinda like having a nice refreshing beverage covered in grease. 

10. Electrolytes

Reason it’s on list – Hydration and Balance

I sweat a lot every day.  To replace those minerals quickly,  I found it best to add that to water.  Even if you aren’t moving around too much but drinking the night away guess what?  That morning after hangover is the body cringing from dehydration and an electrolyte imbalance.  So even if you don’t workout or move – it’s got a great use!  Gatorade is an alternative that seems to be popular and accessible.  It doesn’t have the necessary ones in a high enough dose.  Most hot yogis would cringe though if you drank one in class.  There are many types out there. The most popular are Emergen-C, Ultima, which is “sweetened” with Stevia, and my personal favourite, Vega Sport Electrolyte Hydrator.  Vega is a newer company that uses only natural plant-based components (More about Vega can be found here: http://myvega.com/) 

Reason for rank – The product is great, wonderful and helpful if one is active, moving and sweating a lot.  If you aren’t sweating so much, may not be as useful.  Suggestion: Sweat more! ;-) 

9.  Taurine

Reason it’s on the list – Energy

Yup!  More acid!  Taurine (2-Aminoethylsufonic Acid) is an amino acid that is found within the body.  It is one of the first ingredients listed in popular energy drinks (I love you, Sugar-Free Rockstar!) Taurine has been known to be used by the body during exercise and in times of stress.  I buy mine as a powder and add ¾ of a tsp to a protein shake.  There has been huge debate on its benefits, so over a year ago I tested it out.  At the time I drank little to no caffeine each day so it would be a good way to see if I felt a rush from it being there or not.  I would have to say that there was a shift in energy and endurance when using it about 30min before activity.  Not the same as from a caffeinated drink but enough that it was noticeable. And in times when you’re tired and you need that little bit extra, it was nice to have.  It mixes half-decently in a glass of water too.

Reason for rank – It’s controversial.  Many people go one way or the other with it.  My advice is to research for yourself and make a choice that works for you where you are today. 

8.  DAA – D-Aspartic Acid

Reason it’s on the list – Testosterone Enhancer

Yup. It’s another acid! This one is a natural boost to one’s own system.  It’s replaced Tribullus as the popular booster.  Do I need me to actually spell out how extra testosterone can be handy? J  I take this as a cycle so as not to lose its effect.  During that cycle I try to get to the gym more than normal and really demo more chatturangas in class.  Now some of my students may know why I can dolphin plank for so long!

Reason for rank – Not everyone may want to boost their testosterone for everyday life.  Hence it’s right in the middle of the list! 

7.  B12

Reason it’s on list – Energy & Feel Goodiness

Oh yes.  You want to feel happy?  Have more life and energy?  A spring in your step?  This may help.  Having low levels of B12 can make one feel depressed, fatigued and forgetful.  That and there are so many things in our life that deplete it within our bodies so it’s a great enhancement and  there’s little effect to taking too much of it.  It doesn’t do well as a swallowed pill form so save your money and don’t buy pills.  It does work well as sublingual (under the tongue).  My preference, however, is by injection.  It has the best rate of absorption and you don’t have to sit there with something in your mouth you can’t swallow... not that I have a problem with that sort of thing.  I would suggest having a family doctor or medical profession administer it. You can buy them at the drug store from a pharmacist and have your doctor’s offices hold it for you for your visits.  If you wanted to do it yourself, then you would need to purchase Intramuscular needles as well. All other form of needles wouldn’t get it deep enough into the muscular tissue and it would only bubble up on the surface and not absorb enough.  There are several YouTube videos on how to do the rest of the work if you are interested.

Reason for rank - Since this may involve a little more planning it isn’t always user-friendly.  It is however worth it. 

6.  Protein Powder

Reason it’s on list – Diet and Nutrition

It takes an incredible amount of protein to sustain an average human body that does an ordinary amount of activity.  For an active life and working out, even for regular day-to-day life, it’s tough to get all that protein in.  I have found shakes to be a godsend.  You can get larger doses of required building block with less effort.  Even if you aren’t working out just think.  If you are skipping breakfast often, just add a quick shake each morning before you leave for work and see what happens.  The result speaks for itself and isn’t a lot of effort.  They come in so many kinds now – including vegan (See Vega link above).  Since you’re mixing the protein shake already, perhaps throw in a few of the other “ingredients” on this list while you’re at it.  Get them all done in one shot!

Reason for rank – They save less time cooking and take up much less time to breakdown and digest.  Buying high quantities of powders all the time can be costly. 

5. Raspberry Ketones

Reason it’s on list – Fat loss

Raspberry Ketones are the next big thing in weight-loss this year since they were mentioned on the Dr. Oz show. They can explain it better than I.  The prices have gone up since the rise in popularity  and are $15-25 a bottle.

Reason for rank – Although it will help you lose weight, that may not be something you wish to do. 

4. ZMA

Reason it’s on list – Strength and Men’s Health

ZMA is a combination of Zinc, Magnesium and Vitamin B6.  They help enhance muscle strength and endurance.  Zinc and Magnesium play a major role in sperm production and libido.  Do I need to say more?  I take mine about 30min before bed.  It’s best not to take with milk as that block zinc absorption.

Reason for rank – It’s awesome.  Take it for 2 weeks and let me know how it goes.  Better yet, let someone you enjoy the company of know how it goes. 

3.  Multi-vitamin

Reason it’s on list – Overall Health and Well-being

Doctors have been saying it for years.  There are just some things in our regular diet, that for whatever reason, we don’t get enough of.  Instead find a good multi-vitamin to help compensate.  For many it may turn your urine an ever-so-lovely shade of neon yellow.  However, it is my experience that when you are more deficient in your diet, or have been working out and sweating more than normal, the body uses those extra vitamins and minerals and urine colour remains normal.  It all depends.  I would suggest one with some great multi-minerals such as Magnesium, Zinc, Copper, Manganese, Chromium and Selenium.  Reason for rank – Ask almost any doctor: this would be the one Supplement we all must have. 

2.  Glutamine

Reason it's on list – Digestive Health, Muscle Growth and Weight Loss.

I love Glutamine.  It is, again, another acid.  I originally started taking it as a naturopathic prescription for enhancing digestive health and strength.  Glutamine is used throughout the body to help repair tissue and many athletes and weightlifters use it to enhance strength.  It’s an anti-catabolic agent, in that it has a way of protecting the muscles from being used as fuel for the body.  And along with its ability to enhance stomach lining, it also enhances muscle cell volume.  It also helps the body heal, repair and recover from surgeries, injuries and illnesses.  Yes.  Illnesses.  I would suggest buying it in powder form and starting with 1tsp a day in a glass of water or protein shake (or after a workout).  It sort of has a salty taste to it.  The dosage can go higher to two or three tsps a day, but to be perfectly honest, I take about four to six tsps a day.

Reason for rank – In one natural acid you have the ability to add to your body something that aids it in all levels.  If you want to enhance your muscle growth, slim down and get a stronger gut and heal faster, take some. 

1.   Water

Reason it’s on list – General health and well-being, mood, fat loss, diet and nutrition, energy,

Yes.  You probably wouldn’t have guessed it.  Water.  H2O.  It is, in a way, a supplement.  In western culture it is not always our number one choice in a beverage and thus not really part of our diet.  And I’m not taking about juice, or cola, or flavoured water – just pure filtered water.  When lacking it our mood, behaviour and balance can be thrown out of whack.  We cannot live without it and yet many of us don’t get enough of it.  I drink about 3L of water a day.  More than most.  My suggestion on getting more of it into your system is perhaps filling a jug or a large canteen, metal bottle, or recycled bottle with water at the start of the day (of the evening before and chill in the fridge) and take it with you as you go and make it a goal to drink the entire container before the end of the day.  If you have it on you and it becomes a part of your habits, it becomes easier to remember to drink it. 

Reason for rank - Our bodies are about 70-85% made of it.  Do yourself a favour and replenish your supply.  Have a drink of water right now! 

Jai!

When it was recently suggested that I go see a naturopath a couple months ago, I shrugged it off. I’ve gone this route before and It’s been helpful and I’ve learned a lot from those visits. But in the end I’d slide back into my old ways and some of the underlying issues didn’t seem to get dealt with  - such as my lack of energy.

When I picked up this nasty bug from Italy and had to take Flagyl, a drug with warnings that it is possibly carcinogenic, at it’s maximum dosage, it felt like chemotherapy.

In the end it didn’t work and it was suggested that I go back on it again. Even after taking it, a week was needed to recover from it. There was simply no way. This was when I decided to make an appointment with someone who came highly recommended to me.

I made the appointment. The first one lasted for about an hour and a half. It sounds like a lot, but the time passed very quickly. What I liked about this particular naturopath is that he has extensive experience working with addictions and knows a lot about the 12 step programs, a lot of the issues that go with it, as well as HIV.

What we spoke about turned out to be part info-sharing, part guidance, and part counselling. looking at what’s going on in all aspects of my life, not just the physical health.

This was the first time I had this experience. When I go to my regular doctor it’s about the meds, and sometimes we talk about other stuff. The focus is really on medication and monitoring.

Because of this experience I thought I’d journal a bit about it as I go through this process. This goes without saying, yet needs it anyway: Do not follow any supplements that I do unless you check it out with a qualified naturopath or your physician. There are many potential interactions that can happen. There you go; you were warned.

One of my major issues is depression, and worse, seasonal depression. The first thing we discussed was Vitamin D. I had been taking it, but only a couple thousand milligrams a day, and cheap drug store brands. We switched that to 5000 a day via liquid drops.

Now maybe it’s placebo effect or my imagination but I started to feel a “brightness” that I haven’t felt for a long time. I was told it would take from a week to 10 days to feel a difference. If need be, I can increase it even more, but this was our starting point.

I also spoke about my tendency to isolate with my TV, and lack of structure in my life which in turns leads to anxiety as I feel like I don’t have a handle on a myriad of things I’ve taken on, but not this website.

I have started to create a small foundation of structure for the day. No matter what time I get up, I have my coffee in the living room and read the paper on my laptop. I have my breakfast, shower and take the dog out. I am now ready for work.

Before I’d wake up, grab a coffee and sit and start working. There were no boundaries to what was work time, me time, housecleaning time, relaxing time. With the exception of my weekly Shabbat (beginning Friday evening to Saturday evening) every day was almost the same as the other.

The other piece I’ve added is going to my 12-step meetings everyday, with Fridays off, and sometimes Thursday. I have my conversion class on Thursday night (another imposed structure).

Bit by bit it is coming together.

I thought I’d share what my homework is for the next two weeks. Again, this is tailored to my needs, however if you deal with some generic issues such as lack of structure etc, some of these points may apply to you.

1) Probiotic-  HMF Intensive 1 cap per day take at least 2 hours away from antibiotic.  Before bed would be best, will give the most benefit but this mean taking your antibiotic with your meals.

2)  VItamin D.  5 drops on your hand and lick it off, once a day-doesn't matter when

3) Diet diary, fill out and return to me weekly.

4) work on a daily/weekly structure for your time

5) follow up with the GP who is giving you the antibiotic for blood test-specifically CBC and Liver function tests, also get a copy of any test within the last 6 months

6) consider B12 shots

7) continue with meetings, get up off your chair every hour,

8) drink water - goal is 2 liters a day

9) Be gentle with yourself during this process- you don't have to be perfect- just make some progress.

Point number one, refined sugar is by and large the worst additive for the immune cells. Refined sugar is immunosuppressive.  No mincing words about it.

To boost your immune system, it is important to try to stay on diet ideally free of foods with refined sugars such as corn syrup and fructose, hydrogenated oils, trans fats, unnecessary additives and preservatives.   Your glutathione level is fastest depleted by toxins, sugar and chemicals ingested into the body.   Glutathione’s deficiency has been linked to many “age related diseases such as muscle weakness and fatigue, mitochondrial dysfunction, Alzheimer’s and Parkinson’s, cancer, inflammatory illness” (Dr. Mercola).  HIV infection accelerates the aging process and also linked to the inflammatory process in the body due to HIV replication, immune activation, cell death, etc.

The beauty of glutathione is that it works on an intracellular level. It helps protect the mitochrondria (the energy factory) in the cell.  Many of the side effects of HIV medication are due to mitochrondial toxicity.  Glutathione helps boosts the activity of other antioxidants such as vitamin C, E, alpha lipoic acid and CoQ10 and the fruits and vegetables consumed.  As a side note, Coenzyme Q₁₀ is found in the heart muscle.  However, anti-cholesterol drugs or statin drugs deplete Coenzyme Q₁₀ in body, you might want to consider supplements.

Nutrients for Health:  Many antioxidants like beta-carotene, selenium and vitamins A, C and E are present in healthy living foods.  First and foremost, it must be real food.  Real food is defined as wholesome food that is minimally processed, does not have tons of sugar, dubious chemicals you cannot pronounce and foods that actually rot (not full of chemicals and preservatives that it last a lifetime in a landfill).   Avoid, reduce and/or eliminate pop/soda (full of sugar) and processed meats (full of nitrates) gradually from your grocery list.   If this sounds overwhelming to you- take baby steps to your goal.

Omega 3 is excellent to maintain cardiovascular and mental health and has anti-inflammatory effects. Curcumin from tumeric also has anti-inflammatory effects and is believe to be useful in minimizing dementia.  Omega 3 supplements have been found to have equally beneficially effects as Prozac for depression

An ideal healthy diet is high in complex carbohydrates vs. simple carbohydrates.  Complex carbohydrates are whole grains (bread) & whole grain cereals (not whole wheat), vegetables and fruits. The cereal must have 3 to 5 grams of fibre and preferably not more than 8 grams of sugar.  Simple carbohydrates are sugars, fresh or dried fruits, honey, jam or syrups.  Add fats such as good fats from nuts, seeds, avocado, olive oil (omega 9) and fish(omega 3 from deep sea cold water fish such as mackerel, sardines, salmon, anchovies). 

Nuts and seeds are high in various essential fatty acids. Do not eat salted and toasted nuts and seeds if you want seek therapeutic benefits. Toasted nuts may taste better, but the heat has destroyed most of the healthy essential fats.  Add soluble fibre and insoluble fibre to your diet.  Avoid buying anything that contains more than five ingredients should be frequently obeyed.

Nutrition is needed by cells, tissues, organs to metabolize and absorb food, anti-HIV drugs and support various processes in the body.  You need the following foods to sustain health within. They are:

l  Amino acids: L-cysteine and L-methionine (sources: eggs, fish, steak)

l  Antioxidants: GSH (glutathione) high rate of oxidation on a cellular level ( food sources see below)

l  Mitochondria protectors: B complex, vitamin C, E, Alpha lipoic acid, NAC

l  Body can make own antioxidants using selenium, manganese, zinc which  works with cysteine in NAC (Brazil nuts are high in selenium)

Shopping for supplements:  Buy it when on sale or in bulk.  A bottle of any supplement has 60 to 90 pills or capsules.  It can be taken every other day if you want more value for your money.

Other foods high in glutathione are whey protein (ion exchange formulation and cold –pressed), and these fruits and vegetables have highest glutathione per serving: spinach, potatoes, asparagus, avocado, squash, okra, cauliflower, broccoli, walnuts, garlic and tomatoes.  The yellow spice turmeric contains curcumin which may be useful to increase glutathione levels.

Some easy ways to boost the intake of antioxidant for overall health are as follows.  Summer is an excellent time to consume as many berries as possible for their high antioxidant content.  It is also advisable to consider freezing blueberries, black berries, raspberries and strawberries.  Exercise helps increase glutathione levels naturally.

Do not taker B-12 close to bed time unless you are planning an exciting evening.  However take calcium/magnesium closer to bedtime, as it is relaxes the muscles.

Oxygen radical absorbance capacity (ORAC). ORAC is a scoring system of foods based on antioxidant capacity of foods. The top 10 fruits and vegetables on the ORAC list –from highest to lowest are  as follows. Prunes followed by raisins, blueberries, blackberries, cranberries, strawberries, pomegranates, raspberries, plums, oranges.  Vegetables; kale, spinach (raw), brussels sprout, alfalfa sprouts, broccoli, red bell pepper, onion, corn and eggplant.   These may not be your favorite picks but it is what nature blessed the foods with.   A simple rule – shop for a grocery list of fresh foods that look colorful and you can be eating lots of high ORAC foods.

To good health and make conscious decisions when eating foods and buying foods. Treat your body kindly by putting real foods into your body. You will reap the benefits of your diet.

Ref:

NAC Info Sheet, http://www.thebody.com/content/art4754.html

Dr. Mercola, Ori Hofmekler .This ONE Antioxidant Keeps All Other Antioxidants Performing at Peak Levels.  www.mercola.com

To build health from within, it is important to understand inflammation and oxidation.Inflammation is believed to be one of the main causes of aging and organ disease in PHAs.

In the early 80’s there was on going research in gut associated lymphoid tissue (GALT).Researchers knew in early HIV infection, the immune cells in the intestinal system are infected and the early symptoms of HIV seroconversion are gastrointestinal (GI) related diarrhoea, wasting, indigestion, and weight loss. However, when the triple combination anti-HIV drugs came about in 1996, research in GALT was abandoned until recently in 2006 it resurfaced (http://www.prn.org/index.php/progression/article/hiv_1_gastrointestinal_galt_267). In the last five years, researchers have found that ARV has revived some of the immune cells in the intestinal system but not all of it.Plus there are many variables; number of CD4+ cells at time of ART initiation, CD8, percentage of CD4+ ,other co-infections, and overall health.

HIV infection in the GI tract can affects absorption of foods and nutrients in the intestines. “To maximize the efficiency of digestive function, the GI tract has evolved such that it has the largest surface area among all organs. In fact, the 400 m2 surface area of the GI tract is about 200 times larger than the surface area of the entire skin.”(Mehandru.S, 2007). We know HIV also affects the production of B12 in the intestine hence many PHAs are B12 deficient. B12 is important for energy and red blood production. Furthermore HIV infection affects the bone and heart muscles. A health regimen has to integrate the many components of health. As such taking antiretrovirals therapy (ARV) is one part of the plan but not all of it.

Thirty years later, HIV is known to cause many cellular inflammations, from an increase in cytokines, chemokines, interleukins, an imbalance in the two arms of the immune system; the cellular and humoral arm to mention a few. As all of us know our body best, but how do we control inflammation within and keep our health at an optimal level. There is much more one can do to boost cellular health, minimize oxidative stress while living with HIV infection. We are going to take a look at what goes on in the cells and understand inflammation, oxidation and the role of the mitochondria.

The immune system and inflammation: Living with HIV infection means the immune system is constantly activated or stimulated and does not get the vacation it needs. While a person may have a high CD4+ count, the CD8 may also be high which means the immune system is constantly fighting off the infection. In an ideal immune system, it has high CD4+ and low CD8 count. A low viral load or undetectable viral load does not mean HIV is not in the tissues, cells, blood or organs. All it means is HIV cannot be detected by the current diagnostic test.  Over the cause of HIV infection, we are now certain of the increase in inflammation over a long term in living with HIV. The cause of this increase is not completely understood.

When the body is fighting an infection, “or repairs injured tissues, fluids and cells get transported to the site of injury. As the body heals, the cells can swell, get warm, and become sore. One theory is that as HIV chronically infects the body, cells and tissues are destroyed and then heal, activating the immune system. That leads to an over stimulated immune system that can become burned out or weakened. So, even though a lab result may show a high CD4 count, the amount of inflammation in the body may be causing damage on a cellular level. And that can lead to heart, liver, kidney disease, and greater levels of bone loss."For more on HIV and inflammation, http://www.thebody.com/content/art57904.html?ic=700100.

What is oxidation?

Oxidation is a process of breaking food down into energy and involves a chemical reaction. Food breakdown is one of the many oxidative processes in our bodies. During this process, molecules called free radicals are produced. Free radicals are a normal part of the oxidation process. They can damage the membranes of the cells in much the same way that rust damages the body of a car.

During HIV infection, many researchers have observed an increase in free radicals (extra unpaired oxygen molecules, oxygen has two molecules as in O2, in its stable form). ARV and HIV infection both seem to cause an increase in free radical production in the body and this is currently believed to be linked with inflammation.What can you take to minimize oxidation? Increase the intake of anti-oxidants either with foods and/or supplements, and improve your breathing capacity.

Mitochondria, is located in the cells and is the energy production centre of the cell. They are tiny thread like organelles in living cells-they squirm, lengthen, and change shape almost continuously. Enzymes dissolved in the fluid within the mitochondria, carry out reactions in which oxygen is used to break down food. As foods are broken down, energy is released. Some of the fatigue reported in HIV infection, is related to mitochrondria toxicity. Mitochrondria is found in almost all organs, tissue, nerves, and bones muscles in the body. While ARV are important to control viral replication ,it also can damage mitochondria DNA and cells, and cause wide range of side effects including fat loss, peripeheral neuropathy, and high lactate levels amongst a host of symptoms.

The free radical production causes mitochrondia toxicity and cell death (apoptosis). Some research has associated free radical with side effects such as neuropathy, acid lactosis, pancreatitis (Dr. Jon Kaiser, 2003). Inflammation is an ongoing process as long as HIV exists in the body. The inflammation is directly linked with illness associated with aging such as bone loss, cardiovascular disease and decrease in cognitive functions.

What we do know is one potent antioxidant can decrease the impact of free radicals. It is called glutathione, and it is very effective as minimizing the oxidative process at an intracellular level in the cells. Our body in its inherent wisdom produces glutathione in the walls of our cells. Some foods can also minimize inflammation in the body. These will be discussed in Part 3.Translate

I have been recently presenting workshops on HIV and nutrition. What I have come to understand and acknowledge over the 15 years of speaking on nutrition, many poz persons have not fully integrated nutrition as part of their health regimen.

Unfortunately, many staff and volunteers at ASOs/NGOs in Canada or across then world, who work in treatment or outreach with PHAS have minimal knowledge of impact of nutrition on immune system.   As the Vienna Conference is over,

with not a single word, abstract or presentation on nutrition-no big surprise! In 2006 International AIDS Conference there were 2 sessions on nutrition and 3 poster presentations on nutrition and complementary medicine. In 2008 International AIDS Conference, there were a total of 2 abstracts on nutrition and complementary medicine and one presentation on food shortage.

Antiretrovirals (ARV) are crucial to our health, but 70 percent of the immune system is in the gastrointestinal system. Hence the key to maintain optimal immune functions and overall health lies in what foods we ingest. I was reading a recent article in The Body called An Introduction to Dietary Supplements for People Living With HIV/AIDS. You can read it at, http://www.thebody.com/content/art56659.html?getPage=3

Over all, it is a good read and it listed Alpha-Lipoic –Acid, Calcium and Vit D 3, Carnitine, Coenzyme Q10 (CoQ10), Zinc and B 12. However, the article has missed a few gems notably Omega 3 oils and NAC (N-acetyl cysteine). Another comprehensive resource on nutrition is the Practical Guide to Nutrition for PHAS, Get a free copy at www.catie.ca.

As a strong advocate of nutrition for PHAS, there is research documenting the role of micronutrients for good health and minimizing many of the side effects of HIV drugs. Micronutrient depletion starts at the onset of HIV infection, hence it is wise to supplement early vs. when health needs are chronic. In a nut shell, healthy nutrition consists of providing the cells, tissues, and organs of the body with adequate micro-nutrients to function at optimal level. Medications also need nutrition to break it down, be processed, absorbed and metabolized by cells and tissue. And all solid and liquid foods are processed by the liver. New HIV drugs may come onto the market, but all drugs have their slew of side effects.

During HIV infection, many researchers have observed an increase in free radicals (extra unpaired oxygen molecules). The cause of this increase is not completely understood. Free radicals are produced mostly during metabolism and exposure to toxins and cause much damage in the cell. A decrease in antioxidants in general and glutathione in particular, has also been observed. All antioxidants are crucial in eliminating free radicals from your body. To control the oxidation process, our body produces an antioxidant called glutathione in the walls of our cells. Glutathione as a strong antioxidant has a crucial role to combat free radical damage in the cells. An easy source of glutathione is NAC. In all the years, I have presented on nutrition and micro supplements, many PHAS still have never heard of glutathione or NAC

N-acetyl cysteine was first used by PHAS when there was no anti-HIV medication available. In the dark days, PHAS who survived the epidemic, took NAC found it helped to keep their CD4+ at a decent level and prevented opportunistic infections. NAC is converted to glutathione in the body and glutathione is the single most important antioxidant the cells need. It is found inside every single cell in your body. "Glutathione is a vital protein that cells need to function. Many studies have documented low glutathione in people with HIV. Dr. Luc Montagnier's work with CD4 cells from PWAs suggests that even cells without HIV can grow weak and die, but with added GSH can regain their vigor. This is where NAC comes in. NAC is broken down by the body into cysteine. Researchers have also noted that low levels of cysteine in PWAs. The body uses cysteine to replace glutathione" (The Body).

While it is important to eat healthy, since 70 percent of the immune cells live in the gastrointestinal tract. HIV is most abundant where the immune cells are, most of HIV lives in the gastrointestinal cells. We do not know if anti-HIV medications are successful in minimizing HIV replication in the gastrointestinal cells. If you are interested to know more of the gastrointestinal system and HIV, look up GALT online. GALT stands for 'gut associated lymphoid tissue'.
As such digestion is compromised for many PHAS inspite of healthy eating. Only 2 percent of HIV is found in your blood. We also know that HIV infection causes inflammation and on a cellular level accelerates the aging process.