Nutrition and weight maintenance

November 2004     View PDF     En español

Consider using supplements
In HIV disease, even when CD4+ cell counts are high and there are no apparent signs of disease, some nutritional deficiency may still exist. Many people attempt to give their bodies an edge over the virus by adding vitamins and other nutritional supplements to their diets.

This may help correct minor deficiencies and may strengthen the body’s natural immune defenses. But much research still needs to be done to fully document vitamin and nutritional deficiencies throughout HIV disease and how supplements affect these problems. Still, using a sensible level of supplements to replenish deficiencies just makes common sense.

Vitamins and nutritional supplements should not be used to replace food. Whenever possible, it’s preferable to take in more vitamins through better eating habits. Supplements can be too expensive for people on strict budgets, disability or other assistance. Some people spend hundreds of dollars per month on these products. This is probably unwarranted in most cases. There are little data to support using “mega” doses of vitamins and supplements in HIV disease.

Some states and counties have programs that help cover the cost of alternative therapies and supplements. To find out if programs exist in your area, call your local health department.

Using vitamins, like nutrition and exercise plans, should be re-evaluated periodically. Your doctor can help with this or can refer you to a registered dietitian, a specialist in these issues.

The body’s ability to absorb nutrients appears to decrease in the course of HIV disease. Therefore, adding amino acids and other enzymes that help digest food may be useful. In this case, it’s unclear whether taking ever-larger doses of supplements produces any added benefit.

Some doctors who specialize in the use of vitamins and supplements recommend giving vitamins in the vein (intravenously) when absorption becomes a problem. This is not such a far-fetched idea, as conventional TPN formulas (explained later) include vitamin supplements in their mix. Similarly, some hospitals include intravenous vitamin supplements when patients are restricted from eating food.

One difficulty in making decisions about using vitamins is that the vitamin industry is entirely unregulated. This means that when you purchase a product it may not contain what it advertises on its label. One source that may help you evaluate different brands of vitamins is www.consumerlabs.com.

A “brown bag” medical check-up is an important way to monitor your health. When you visit your doctor, put all the meds you take, regularly and occasionally, into a bag. Include vitamins, herbs, nutritional supplements and prescribed medications. Then, ask your doctor or pharmacist to review your therapies for safety, appropriateness, compatibility and instructions for use. This will help avoid harmful interactions and may help diagnose symptoms caused by side effects of and interactions between therapies.

Remember, just because something is available over the counter or perceived as “alternative” or “natural” does not mean it is not toxic or safe to take with other therapies. For more information, read Project Inform’s publications, Drug Interactions and Herbs, Supplements and HIV Disease.