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AIDS/HIV Naturopathic Treatment
Psychoneuroimmunology
Integrative Therapies

definition

Treatment Principle #8
Psychoneuroimmunology

Cranioelectrical stimulation (CES) -- 0.1 mA, 100 Hz, 20 min twice daily; or Alpha Stim
• Decreases anxiety and insomnia 228
• Effective in treating depression 229



Individual psychotherapy, Support groups
• Significantly elevated physical health risk among gay men who conceal their homosexual identity. 230
• Support groups reduce depression, hostility, and somatization 231
• Long term coping skills fostered in HIV+ support groups232
• Participation in an AIDS support group decreases levels of anxiety and hopelessness 233


Hypericin (St. Johnswort) Can decrease depression.

• In 23 randomized trials with a total of 1757 patients on Hypericum, the botanical was more effective than placebo and similarly effective to stabdard antidepressants with fewer adverse events for Hypericum (Linde K et al. St. Johns Wort for depression: An overview and meta-analysis of randomized clinical trials. British Medical Journal 313 (7052): 253-8, 1996)



Magnesium -- slowly increase dose up to 1,000 mg/day
• Fifty-nine percent of HIV+ patients had low concentrations of magnesium compared with 9% of controls,, which may be particularly relevant to HIV- related symptoms of fatigue, lethargy, and impaired mentation. 234
• Absolute number of T4 cells was directly correlated with the serum Mg concentration. 235

Meditation
• As part of a stress management program which effected significant improvement by all dependent measures 236
• Demonstrated positive relationships between hardiness and: perception of physical, emotional, and spiritual health; participation in prayer and meditation; and participation in exercise and the use of special diets. 201
• Increase in corticotropin-releasing hormone immunoreactivity follows meditation 237

Spiritual practice
• Positive correlation between hardiness and patients perception of spiritual health and participation in prayer and meditation 201
• Health of terminally ill patients is based more on spirituality and ability to relate to others than on pathology 238


Tryptophan
• Psychological distress declined with normalization of vitamin B6 status from inadequate to adequate status (p < 0.02). A decrease in psychological distress was also observed with increased tryptophan intake in subjects who were vitamin B6 adequate. 239


Vitamin B1 (Thiamin)
• Wernicke's encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine-deficiency, and may be found undernourished AIDS patients. The triad of confusion ataxia and ophthalmoplegia may be present. However, it should be recognized, that these three symptoms are not always present at the same time. 240
• Thiamine deficiency found in 9/39 (23%) of patients with AIDS or ARC, with no history of alcohol abuse. 241
• Thiamine as the cause of Wernicke's encephalopathy in two non-alcoholic patients with acquired immunodeficiency syndrome. 242

Vitamin B6 (Pyridoxine)
• Psychological distress declined with normalization of vitamin B6 status from inadequate to adequate status (p < 0.02). A decrease in psychological distress was also observed with increased tryptophan intake in subjects who were vitamin B6 adequate. 239

Vitamin B12 (oral dosing or 1000 mcg i.m./week for a course of 6 weeks)
• Normalization of plasma cobalamin inadequacy in HIV-1 disease may provide significant improvement in memory. 243
• Reversal of apparent AIDS dementia complex in one patient following treatment with vitamin B12. 244
• Concurrent vitamin B12 deficiency may be a cofactor in subtle cognitive changes observed in the asymptomatic stages of HIV-1 infection. 245
• Most B12 deficient HIV-infected patients with neurological dysfunction had a therapeutic response with B12 supplementation 246

Yoga, Qi Gong
• Yoga produces increased perceptions of mental and physical energy and feelings of alertness and enthusiasm 247
• Yoga participants report decreased tension, fatigue, confusion, depression, and anger as measured by mood and personality inventories 248
• Storing of qi gong energy in various materials and drugs (qi gongnization): its clinical application for treatment of pain, circulatory disturbance, bacterial or viral infections, heavy metal deposits, and related intractable medical problems by selectively enhancing circulation and drug uptake. 249.



Promising appearing substances to be further investigated:
Methyl donors (N-dimethylglycine (betaine), methionine, and S-adenosylmethionine (SAMe)) (see also Glutathione, section 2)
(betaine is found in beet, and is similar to choline, but instead of CH3 at A, it is at B position)
• Deficiencies of folate and vitamin B12 have been found to reduce CNS SAMe concentrations. Both folate and vitamin B12 deficiency may cause similar neurological and psychiatric disturbances including depression, dementia, myelopathy and peripheral neuropathy. SAMe has a variety of pharmacological effects in the CNS, especially on monoamine neurotransmitter metabolism and receptor systems. SAMe has antidepressant properties, and preliminary studies indicate that it may improve cognitive function in patients with dementia. 250
• Cerebrospinal fluid S-adenosylmethionine (SAMe) and glutathione concentrations decreased in HIV infection. 251
• HIV-infected patients had lower concentrations of methionine in plasma. 252




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:

228. Philip P, Demotes-Mainard J, Bourgeois M, Vincent JD: Efficiency of transcranial electrostimulation on anxiety and insomnia symptoms during a washout period in depressed patients. A double-blind study. Biol Psychiatry 29:451-6, 1991
229. Healy D: Rhythm and blues. Neurochemical, neuropharmacological and neuropsychological implications of a hypothesis of circadian rhythm dysfunction in the affective disorders. Psychopharmacology (Berl) 93:271-85, 1987
230. Cole SW, Kemeny ME, Taylor SE, Visscher BR: Elevated physical health risk among gay men who conceal their homosexual identity. Health Psychol 15:243-51, 1996
231. Kelly JA, Murphy DA, Bahr GR, Kalichman SC, Morgan MG, Stevenson LY, Koob JJ, Brasfield TL, Bernstein BM: Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons. Am J Psychiatry 150:1679-86, 1993
232. Hedge B, Glover LF: Group intervention with HIV seropositive patients and their partners. AIDS Care 2:147-54, 1990
233. DiPasquale JA: The psychological effects of support groups on individuals infected by the AIDS virus. Cancer Nurs 13:278-85, 1990
234. Skurnick JH, Bogden JD, Baker H, Kemp FW, Sheffet A, Quattrone G, Louria DB: Micronutrient profiles in HIV-1-infected heterosexual adults. J Acquir Immune Defic Syndr Hum Retrovirol 12:75-83, 1996
235. Beck KW, Schramel P, Hedl A, Jaeger H, Kaboth W: Serum trace element levels in HIV-infected subjects. Biol Trace Elem Res 25:89-96, 1990
236. Taylor DN: Effects of a behavioral stress-management program on anxiety, mood, self-esteem, and T-cell count in HIV positive men. Psychol Rep 76:451-7, 1995
237. Harte JL, Eifert GH, Smith R: The effects of running and mediation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood. Biol Psychol 40:251-65, 1995
238. Fryback PB: Health for people with a terminal diagnosis. Nurs Sci Q 6:147-9, 1993
239. Shor-Posner G, Feaster D, Blaney NT, Rocca H, Mantero-Atienza E, Szapocznik J, Eisdorfer C, Goodkin K, Baum MK: Impact of vitamin B6 status on psychological distress in a longitudinal study of HIV-1 infection. Int J Psychiatry Med 24:209-22, 1994
240. Andersson JE: Wernicke's encephalopathy. Ugeskr Laeger 158:898-901, 1996
241. Butterworth RF, Gaudreau C, Vincelette J, Bourgault AM, Lamothe F, Nutini AM: Thiamine deficiency and Wernicke's encephalopathy in AIDS. Metab Brain Dis 6:207-12, 1991
242. Schwenk J, Gosztonyi G, Thierauf P, Iglesias J, Langer E: Wernicke's encephalopathy in two patients with acquired immunodeficiency syndrome. J Neurol 237:445-7, 1990
243. Shor-Posner G, Morgan R, Wilkie F, Eisdorfer C, Baum MK: Plasma cobalamin levels affect information processing speed in a longitudinal study of HIV-1 disease. Arch Neurol 52:195-8, 1995
244. Herzlich BC, Schiano TD: Reversal of apparent AIDS dementia complex following treatment with vitamin B12. J Intern Med 233:495-7, 1993
245. Beach RS, Morgan R, Wilkie F, Mantero-Atienza E, Blaney N, Shor-Posner G, Lu Y, Eisdorfer C, Baum MK: Plasma vitamin B12 level as a potential cofactor in studies of human immunodeficiency virus type 1-related cognitive changes. Arch Neurol 49:501-6, 1992
246. Kieburtz KD, Giang DW, Schiffer RB, Vakil N: Abnormal vitamin B12 metabolism in human immunodeficiency virus infection. Association with neurological dysfunction. Arch Neurol 48:312-4, 1991
247. Wood C: Mood change and perceptions of vitality: a comparison of the effects of relaxation, visualization and yoga. J R Soc Med 86:254-8, 1993
248. Berger BG, Owen DR: Mood alteration with yoga and swimming: aerobic exercise may not be necessary. Percept Mot Skills 75:1331-43, 1992
249. Omura Y: Storing of qi gong energy in various materials and drugs (qi gongnization): its clinical application for treatment of pain, circulatory disturbance, bacterial or viral infections, heavy metal deposits, and related intractable medical problems by selectively enhancing circulation and drug uptake. Acupunct Electrother Res 15:137-57, 1990
250. Bottiglieri T, Hyland K, Reynolds EH: The clinical potential of ademetionine (S-adenosylmethionine) in neurological disorders. Drugs 48:137-52, 1994
251. Castagna A, Le Grazie C, Accordini A, Giulidori P, Cavalli G, Bottiglieri T, Lazzarin A: Cerebrospinal fluid S-adenosylmethionine (SAMe) and glutathione concentrations in HIV infection: effect of parenteral treatment with SAMe. Neurology 45:1678-83, 1995
252. Muller F, Svardal AM, Aukrust P, Berge RK, Ueland PM, Froland SS: Elevated plasma concentration of reduced homocysteine in patients with human immunodeficiency virus infection. Am J Clin Nutr 63:242-8, 1996


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.