Disorders

HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a disorder in which the immune system becomes severely weakened and loses its ability to fight infections. Although some scientists question whether or not the human immunodeficiency virus (HIV) has actually been proven to cause AIDS, most researchers do believe that HIV causes AIDS.

Certain drugs and nutritional supplements appear to be capable of slowing the progression of the disease. However, patients are encouraged to consult with a physician prior to making dietary changes because of the complexity of this disorder.

Dietary Recommendations
Weight loss and diarrhea are two major concerns with HIV/AIDS. Therefore, a diet high in calories and protein will help maintain body weight. In addition, whole foods such as fresh meats, fresh fruits and fresh vegetables are preferable to refined and processed foods (i.e. ready-to-eat foods such as chips, candy and other snack foods). Whole foods will provide individuals with a higher concentration of valuable vitamins and minerals. This is very important considering that people with HIV infection tend to suffer from malnutrition and nutritional deficiencies.

Abnormal intestinal function is usually the culprit in regards to AIDS-related weight loss and chronic diarrhea which is usually referred to as HIV enteropathy. Individuals with this condition may respond to a gluten-free diet (wheat-free diet). Clinical studies suggest this is an effective way to manage HIV enteropathy.

Exercise and Weight Training
HIV/AIDS is usually accompanied by muscle wasting and weight loss. Though drug therapy with anabolic steroids is sometimes used to counteract these losses, clinical trials suggest that progressive resistance training (i.e., weight training) may be used as an alternative or in conjunction with steroids. Studies have found that weight training just three times per week could increase lean body mass and, thus, prolong the duration of the disease. In fact, exercise of any type three to four times per week or more has been associated with slower progression to AIDS.

Which Supplements Should You Choose?
Though there are various prescription drugs that are used to treat HIV/AIDS (antivirals, antibiotics, antifungals, corticosteroids), some nutritional supplements may be helpful in treating HIV/AIDS. A multivitamin may provide essential vitamins and minerals that may be lacking in the diet or have been depleted. Some clinical trials have found that supplementing with a multivitamin may slow the progression of the disease.

CoQ10 and creatine monohydrate are also nutritional supplements that are currently being used as an AIDS treatment. Both of these supplements have been clinically evaluated and findings suggest that they may helpful as an AIDS treatment. HIV-positive people are often deficient in CoQ10; therefore, supplementation may be of benefit. It works by strengthening the mitochondria (powerhouse) of cells and, thus, slows the rate of cell death. By slowing cell death, it is thought that CoQ10 may help slow the rate at which AIDS progresses. Creatine monohydrate works similarly but it is also thought to help strengthen muscles and prevent wasting.

Neuraegis is a product by Enhanced Life Sciences that combines the effectiveness of both of CoQ10 and creatine monohydrate in a delicious meal replacement powder. Neuraegis can be used as a supplement or as a tube feeding formula.

What is CoQ10?
CoQ10 is an antioxidant (vitamin), manufactured in the human body, and also present in small amounts in some foods -- unsaturated oils, fish, meats and nuts. As we age, we produce less CoQ10; and it would be difficult to get a significant amount from foods.

Medications and CoQ10 - Interactions
Some medications may interfere with the action of CoQ10 or perhaps decrease its production in the body. Such medications include "statins", some diabetes drugs, chemotherapy drugs and other medications. Many doctors now routinely prescribe supplements of CoQ10 for their patients who are taking cholesterol-lowering statins including lovastatin (Mevacor), simvastatin (Zocor), and pravastatin (Pravachol), and the dietary supplement Cholestin.

Persons using some oral diabetes drugs (glyburide [Diabeta, Glynase, Micronase], phenformin, and tolazamide) should speak with their doctors regarding CoQ10, which may lower blood sugar. It's possible that beta-blockers (propranolol [Inderal], metoprolol [Lopressor, Toprol], and alprenolol), phenothiazines, tricyclic antidepressants, methyldopa, hydrochlorothiazide, clonidine, and hydralazine may create a need for CoQ10, but this is not firmly established.

And there is a single report that CoQ10 interfered with the medication warfarin (Coumadin), an anticoagulant. People using warfarin should not take CoQ10 without first consulting their physician.

How much CoQ10 is safe to take?
The typical recommended dosage of CoQ10 based on various past studies is 30 to 300 mg daily; however, recent studies have used amounts of up to 1200 mg per day. Do not take such a large amount without consulting your doctor. If you do take supplements, it's best to take these in divided doses, two or three times a day, rather than all at once.

What's the best form to use?
CoQ10 comes in hard capsule or soft-gel form. Which ever form you take it is important to remember that CoQ10 is fat soluble--that means it should be taken with a small amount of fat to help it get absorbed into the body and be most effective. Vitamin E may also enhance the absorption of CoQ10 (30 IU vitamin E is a good amount to take). It appears that CoQ10 and vitamin E work synergistically (better together than separately).

Side effects
There appears to be none to few adverse effects associated with the usual amounts used in studies -- 30 to 300 mg per day. A very small percentage have some rare reported side effects including minor stomach upset, minimal loss of appetite, nausea, diarrhea. People taking CoQ10 late at night have reported insomnia.

Studies on the safety of CoQ10 have not been conducted on women who are pregnant or breastfeeding, or on children, and these individuals should not use CoQ10 prior to consulting with their physician.

Clinical Studies
Biochem Biophys Res Commun. 1988 Jun 16;153(2):888-96.

Biochemical deficiencies of coenzyme Q10 in HIV-infection and exploratory treatment.

Folkers K, Langsjoen P, Nara Y, Muratsu K, Komorowski J, Richardson PC, Smith TH.

Institute for Biomedical Research, University of Texas, Austin 78712.

AIDS patients (2 groups) had a blood deficiency (p less than 0.001) of coenzyme Q10 vs. 2 control groups. AIDS patients had a greater deficiency (p less than 0.01) than ARC patients. ARC patients had a deficiency (p less than 0.05) vs. control. HIV-infected patients had a deficiency (p less than 0.05) vs. control. The deficiency of CoQ10 increased with the increased severity of the disease, i.e., from HIV positive (no symptoms) to ARC (constitutional symptoms, no opportunistic infection or tumor) to AIDS (HIV infection, opportunistic infection and/or tumor). This deficiency, a decade of data on CoQ10 on the immune system, on IgG levels, on hematological activity constituted the rationale for treatment with CoQ10 of 7 patients with AIDS or ARC. One was lost to follow-up; one expired after stopping CoQ10; 5 survived, were symptomatically improved with no opportunistic infection after 4-7 months. In spite of poor compliance of 5/7 patients, the treatment was very encouraging and at times even striking.

PMID: 3382410 [PubMed - indexed for MEDLINE]

CoQ10 has been found to increase a number of immune parameters as well, including IgG, T4 cells, and the ratio of T4/T8 lymphocytes (Folkers et al. 1988, 1991, 1993). In a pilot study in AIDS patients, coenzyme Q10 supplementation provided significant benefits. It is suggested that HIV patients take at least 200 mg daily of coenzyme Q10 (Folkers et al. 1988, 1991, 1993; Yamashita et al. 1997).

**Although CoQ10 is definitely not a cure, studies such as these suggest how it may be beneficial to individuals with CHF and other heart ailments. However, as always, please consult your physician prior to starting any treatment plan.