-IBIS-1.7.0-
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AIDS/HIV Naturopathic Treatment
Improve Nutritional Status
Integrative Therapies
definition
Treatment Principle 2: Improve nutritional status
a. Improve GI nutrient absorption and mucosal immunity
Lactobacillus acidophilus -- 2 capsules twice daily away from food (Thorne HMF)
Effect of Bifidobacterium bifidum & Lactobacillus a. on gut mucosa & peripheral blood B lymphocytes. 51.
May influence survival of HIV in female genital tract 52
Persists in stomach longer than other bacteria and may be useful in managing conditions associated with altered GI flora 53
Review of literature on Lactobacillus acidophilus 54
Nystatin -- 500,000 units three times daily x 30 days for GI candida (if candida antigen is positive and/or abnormally high levels of candida antibodies treat even if patient is asymptomatic. Candida is both the effect and the cause of HIV-related health problems. Nystatin appears safe since it is not absorbed into the circulation from the gut)
Efficacious in oral and gut antifungal prophylaxis 55
Effective in reducing yeast contamination in neonates 56
Effective in eradicating systemic candidiasis 57
Capryllic acid -- swish and swallow for thrush
Effective in the treatment of candidiasis 58.
Readily absorbed in the intestines 59
Phytostan (NF Formula) 2 tablets three times daily (capryllic acid, grapefruit seed extract, B-carotene, rosemary, thymus vulgaris, glutamic acid)
Grapefruit seed extract significantly inhibits commonly pathogenic bacteria while reserving the normal flora 60
Constituents of rosemary found to be effective HIV protease inhibitors 61
Butyric acid -- 2 caps three times daily with meals
Is a source of energy for colonic epithelial cells which are critical in mucosal immunity 62
Acts therapeutically in treatment of colitis 63
Is a luminal trophic factor for the cecal epithelium 64
Digestive enzymes 1-2 three times daily with major meals
Complete digestive stool analyses often detect poor pancreatic output in many patients with digestive complaints, including HIV+ patients. Digestive enzymes taken with meals can assist enzymatic degradation of foods necessary for absorption.
An increase in serum enzymes, commonly found in HIV is associated with pancreatic damage 65.
The pancreas is often infected or neoplastic during HIV infection 66
Pancreatitis is a common cause of morbidity in patients with AIDS 67
Garlic -- 2 capsules twice daily
Effective in hypermotile intestinal disorders 68
Acts as an antioxidant 69
Increases serum insulin and improves liver glycogen storage 70
Glutamine
Glutamine deficiency is hypothesized to be a causal factor in HIV-associated wasting 71
Role of glutamine in slowing malabsorption. 72
Deficiency of l- glutamine is associated with atrophy and degeneration of the small intestine 73
Carnitine -- 2000 mg/day in wasting and high serum triglycerides
Deficiencies in carnitine can lead to critical metabolic dysfunctions 74
Improves lymphocyte proliferation in response to mitogens 75
AIDS patients with a deficiency are at risk for alterations in fatty-acid oxidation and energy supply 51
Permeability Factors (Tyler) -- 2 caps three times daily away from food
1500 mg l-glutamine, 750 mg n-acetyl-d-glycosamine, 400 mg gamma-linolenic acid, 200 mg oryzanol)
Localized protection of GI mucosa by oryzanol may be an effect of its potent antioxidant activity 76
Gamma-linolenic acid prevents and treats GI mucosal inflammation (see Cod liver oil).
Localized protection of GI mucosa by oryzanol may be an effect of its potent antioxidant activity (see Oryzanol, and Rice bran).
Saccharomyces boulardii -- 2 capsules three times daily away from food
Significantly reduces antibiotic associated diarrhea 77 and 78
Stimulates secretory IgA with oral administration 79
Ultra Clear Sustain (Metagenics) -- 2 scoops twice daily as fruit smoothie or in water,
rice or soy milk
Fructooligosaccharides and inulin promote proliferation of Bifidobacteria and Lactobacillus in digestive tract 80
Oligoantigenic diets that provide GI nutrition are associated with reduced GI symptoms and potentially toxic bacterial metabolites 81
_ Deficiencies of vitamins and minerals are well documented in HIV 82
b. Therapeutic and dietary nutrition
Assume food sensitivities and try therapeutic trial of elimination diet -- eliminate all gluten/gliadin grains, all milk & dairy, and food allergies/sensitivities for at least two weeks to observe change in symptoms.
Whole foods -- reduce simple sugars; ensure essential fatty acids; emphasize protein; and clean fresh fruits and vegetables; increase variety; eliminate caffeine and alcohol
Flax seed oil or cod liver oil -- 1 tbsp 1-2x/day
Gamma linolenate selectively kills HIV infected cells 83
Increases superoxide production of stimulated macrophages in rats 84 Nutr 1993; 123(2):225).
Increases plasma essential fatty acids and decreases urinary excretion of prostaglandin E2 85
Formula fortified with alpha-linolenic acid (1.8 g/day), arginine (7.8 g/day), and RNA (0.75 g/day) resulted in a weight gain (+ 2.9 kg/4 months vs -0.5 kg/4 months with the control formula, P < .05), whereas no changes in CD4+ lymphocyte counts were observed. 86
Gamma-linolenic acid prevents and treats GI mucosal inflammation 87
Fatty acid (FA) composition of erythrocyte membranes in HIV+ patients showed. that saturated FA are higher and poly-unsaturated FA lower than in controls 88
Reduced blood levels polyunsatured fatty acids of phospholipids (PUFA-PL) favor the onset and the development of AIDS 26
A deficiency in dietary gamma-linolenic and/or eicosapentaenoic acids may determine individual susceptibility to AIDS 89
Oat Bran -- add 1-2 tbsp to other food
Rich in glutamine, water-soluble, fermentable-fiber beta-glucans; gastrointestinal surface protection and mucosa reconditioning. 90
Protein powder smoothie -- 2 scoops protein powder with 1 cup nuts/nut butter (not peanuts), 1 cup yogurt, 1 cup fresh fruit/berries, 1 tbsp honey, 1 tbsp flax oil; thin with rice milk/juice to make 24 fluid ounces; drink 8 oz tid.
Multiple vitamin and mineral with or without iron -- 2 caps twice daily (pediatric liquids useful in wasting and malabsorption - 1 tbsp twice daily)
Dietary vitamin and mineral analysis revealed that 88% of AIDS, 88% of HIV seropositive, and 89% of ARC patients were ingesting less than 50% RDA for at least one nutrient. The mean number of deficiencies per patient was 1.8 (J-Parenter-Enteral-Nutr. 1990 Nov-Dec. 14(6)605).
Low blood levels of vitamins A (18%), E (27%), riboflavin (26%), B6 (53%), and B12 (23%), together with copper (74%) and zinc (50%) were documented in HIV-1-seropositive subjects. With the exception of riboflavin, zinc, and copper, a similar prevalence of abnormalities among HIV-1-seronegative controls was not observed. 14
Of a sample of 30 HIV-1 (+) percentages of subjects in study with below normal plasma concentrations include: zinc-30%, calcium-27%, magnesium-30%, carotenes-31%, total choline-50%, and ascorbate-27%. Percentages with above normal values include: folate-37% and carnitine-37%. Some subjects with above normal values for plasma vitamins reported self-supplementation, usually with large doses. 91
Intake of >5X RDA of B1; >5X RDA of B2; B3; >2X RDA of B6, and Beta carotene all associated with increased survival in HIV-1-infected people. Any quantity of zinc was associated with poorer survival 9
Deficiencies of vitamin B12, folate and thiamine may contribute to neurological impairment in HIV 92
Daily multivitamin use associated with a reduced hazard of AIDS. 93
Vitamin A, Folate, Carotene
_ Mean serum levels were significantly lower for vitamin A, folate and carotene in patients with the HIV wasting syndrome than in non-wasting patients with comparable CD4 cell counts. 226
Copper (may be excessively low or elevated)
Copper (40%) and long-chain polyunsaturated fatty acids (21%) were higher in the non-AIDS group than the micronutrient levels in HIV-1-infected children. 94
Low blood levels of vitamins A (18%), E (27%), riboflavin (26%), B6 (53%), and B12 (23%), together with copper (74%) and zinc (50%) were documented in HIV-1-seropositive subjects. With the exception of riboflavin, zinc, and copper, a similar prevalence of abnormalities among HIV-1-seronegative controls was not observed. 14).
Folate -- 400 mcg/day if macrocytic anemia or after folate antagonist drugs have been used
Increased incidence of bone marrow toxicity in patients on AZT when folic acid levels are low 95
Absorption of folate is significantly impaired in HIV 96
Vitamin B1 (Thiamin) -- up to 50 mg twice daily
>5X RDA of B1; >5X RDA of B2; B3; >2X RDA of B6, and B-carotene all associated with increased survival in HIV-1-infected people. Any quantity of zinc was associated with poorer survival. 9
Highest levels of total intake (from food and supplements) of vitamins C and B1 and niacin were associated with a significantly decreased progression rate to AIDS. 97
Thiamine disulfide as a potent inhibitor of HIV virus (type-1) production. 46
Vitamin B12 (hydroxycobalamin) -- 1000 mcg i.m.1-2x/week in macrocytic anemia, peripheral neuropathy, depression
Low serum vitamin B-12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression. 98
Vitamin A, E, and B12 deficiency accelerated the development of AIDS. 20
Development of deficiency of vitamin A or vitamin B12 was associated with a decline in CD4 cell count, while normalization of vitamin A, vitamin B12 and zinc was associated with higher CD4 cell counts in 108 HIV-1(+) men. 99
Decreased cobalamin levels found frequently in HIV disease 100
Cobalamins inhibit HIV-1 infection of normal blood monocytes and lymphocytes 101
Subnormal serum B12 levels are common in HIV disease and occur at an early stage. B12 levels fall in most patients with time and may help predict those patients whose disease will progress the most rapidly. 102
Vitamin B12 levels were low in 39% of 36 HIV-infected patients with chronic diarrhea. 103
Low blood levels of vitamins A (18%), E (27%), riboflavin (26%), B6 (53%), and B12 (23%), together with copper (74%) and zinc (50%) were documented in HIV-1-seropositive subjects. With the exception of riboflavin, zinc, and copper, a similar prevalence of abnormalities among HIV-1-seronegative controls was not observed. 14
High dilutional IGF-1 (200C) Orally administered high dilutional IGF-1 was hypothesized to be the high dilutional growth factor responsible for weight gain observed in those HIV+ patients receiving IGF-1 200C 225
DHEA (see previous section)
Testosterone
_ Androgen deficiency combined with classical growth hormone resistance may contribute to the critical loss of lean body and muscle mass in hypogonadal men with the AIDS wasting syndrome. 227
If wasting, consider intravenous nutrition (e.g. vitamin C i.v, Cachexia formula, Myers cocktail, and/or TPN)
Review article on the possibility that the use of vitamin C infusion treatment may be beneficial in the clinical management of AIDS. 104
Improvement of motor disability in patients with HTLV-I-associated myelopathy was 82% in high-dose vitamin C. 105
Cachexia formula (total volume = 558.6 cc w/ 350 cc sterile water/ give over 2-4 hrs)
ACE 6 cc/6
Boron 2 mg
Calcium gluconate 4 gm/40
Chromium 200 mcg/1
Copper 1 mg/.5
Freamine or Travasol 100 cc/100 cc
Lithium 5 mg/1
Manganese 1 mg/.5
Magnesium sulfate 2 gm/4
Molybdenum 200 mcg/.8
Potassium 20 meq/10
Rubidium 100 mcg/.5
Selenium 200 mcg
Strontium 1 mg/1
Vanadium 25 mcg/.125
vitamin A 10,000 IU/.2
vitamin B-6 300 mcg/3
vitamin B-12 3000 mcg/3
vitamin B-complex 3 cc/3
Zinc 5 mg/.5
Myers cocktail
Magnesium chloride hexahydrate (20%) 2-5 cc
Calcium gluconate (10%) 2-4 cc
Hydroxocobalamin (1000 mcg/cc) 1 cc
Pyridoxine hydrochloride (100 mg/cc) 1 cc
Dexpanthenol (250 mg/cc) 1 cc
B-complex 100 1 cc
vitamin C (222 mg/cc) 1-20 cc
Draw up cocktail into one syringe, add 10-20 ml sterile water to reduce hyper-tonicity, and inject slowly over 5-15 min through a 25G butterfly needle
footnotes
HIV/AIDS: Naturopathic Medical Principles and Practice. Standish, Leanna J., Ruhland, John F., DiDomenico, Beth, and Kjersten Gmeiner. Bastyr University AIDS Research Center. November, 1997.
Bastyr Footnotes:
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Special Thanks to Leanna Standish, N.D., Ph.D and the staff of the Bastyr University AIDS Research Center.
Reprinted with permission from Pizzorno J, Murray M, The Textbook of Natural Medicine. Revised Edition. London/New York: Churchill-Livingston, 1999.