1. Calcium - 300 mg or more three times per day. Take for strong bones, nerve health, and muscle growth itself. Calcium and magnesium are nutrients that Dr. Jon Kaiser recommends to prevent and treat neuropathy. Optimal calcium intake improves insulin sensitivity, [i] so calcium is another nutrient that might help reduce some lipodystrophy symptoms. Calcium carbonate (not citrate) supplementation at 500 mg twice daily can reduce protease inhibitor-induced diarrhea
2. Magnesium - 200 mg or more three times per day. Necessary for bone, heart and nerve health, and muscle growth and strength. Also involved in healthy insulin metabolism, so magnesium supplementation may reduce the potential for some lipodystrophy symptoms.
3. Zinc - 10 to 30 mg three times per day. Improves healing and immune function. One poorly designed questionnaire-based study suggested that having too much zinc might decrease survival in HIV. [iii] Other studies show; there is a correlation with low zinc status and an increase in bacterial infec-tions [iv] high dose zinc supplementation (200 mg per day) can reduce the incidence of the deadly lung infection called pneumocystis and candida infections, and cause an increase in CD4 T cells and body weight;291 and that low zinc status in HIV is associated with increased risk of death.24 While there is an upper limit to how much zinc is safe (it can interfere with selenium's beneficial antitumor and antiviral effects), after communicating with leading zinc researchers, I find that the potential safe upper dose limit for short term use appears to be approximately 150 mg per day. Zinc is required for healthy testosterone production, [v] and IGF-1 per 50 mg of zinc because copper is required with zinc in the manufacture of a super oxide dismutase, which are important antioxidants that are made in the body.) Zinc is best taken alone before bedtime for optimal absorption. Nutrition expert Dr. Richard Beach at the University of Miami says that many HIV(+) people need 75 or more mg of zinc per day, and Dr. Baum's study, as cited earlier, indicated 90 mg per day was needed to get adequate blood levels for many HIV(+) people
1. While I would not suggest overloading with zinc, poor zinc absorption and increased need for zinc by HIV(+) people makes an optimal level of zinc supplementation very important. (Note: an overload is not well defined, and is very individual.) If a person is ill or is highly progressed, it is possible that they will need as much as 90 to 200 mg of zinc per day. High-dose zinc is generally only advisable for short periods of time, though, and for specific reasons. Ask your doctor or a certified nutritionist or registered dietitian if you think you might need high doses of zinc, and show them this information because they may not be aware of it. Symptoms of zinc deficiency are poor sense of smell and taste, slow healing, poor quality skin and hair, and low neutrophil counts.
4. Selenium - 100 to 200 mcg three times per day. Works with vitamin E, and helps in the generation of glutathione, the body's critically important natural antioxidant. One HIV study found correlations between CD4 T-cell counts, selenium levels, and glutathione levels. [ix] In a study of 125 HIV-infected men and women, Dr. Marianna Baum found that patients with selenium deficiency were 19.9 times more likely to die of AIDS than patients with adequate selenium levels. [x] She theorizes that the link between selenium and mortality is due to selenium's antioxidant function or action in gene regulation that might actually affect the replication of HIV itself. "In selenium deficiency the HIV virus reproduces faster," she said.
5. Copper - 2 mg. Necessary for healing, and helps form super oxide dismutase (SOD), an important antioxidant enzyme in the body. If you are taking high dose zinc (more than 40 mg per day) you may need to take more than 2 mg of copper, as high dose zinc can induce a copper deficiency. Copper is critical to immune health and antioxidant production in the body. Ask your doctor to test for zinc and copper deficiencies.
6. Chromium - 300 mcg three times per day. Chromium supplementation improved insulin sensitivity 40 percent in a study with diabetics without toxicity at 1000 mcg per day, [xi] so chromium is another nutrient that might help reduce some lipodystrophy symptoms. (Chromium's potentially toxic dose is considered to be about 70,000 mcg per day according to the U.S. Environmental Protection Agency.)
7. Iron - 18 to 50 mg. A 6-year University of California at Berkeley study showed that iron intake was highly correlative with reducing progression of HIV to full-blown AIDS, and 54 mg per day from food and supplements appeared to be about twice as good as 36 mg to reduce HIV progression.308 Iron is poorly absorbed in general, so supplementation can be very important for people who are anemic and suffer from low energy. Iron is necessary for the production of carnitine in the body, the health of the red blood cells, immune health, the body's ability to fight bacteria, and energy production.
Iron is an essential nutrient and the body utilizes iron for optimal health properly when oxidative activity in the body is under control because there is an abundance of antioxidants, like Vitamin E and Beta Carotene that are derived from a healthy diet and/or dietary supplements. Optimal iron status is required for overall health in early HIV, however, there is a potential for iron overload in HIV, especially in the more advanced stages, [xii] or when antioxidant status in the body is compromised, or when there is insulin resistance. [xiii] Iron overload can increase the potential for immune problems and increased infections, so it is advisable to ask your doctor to test and monitor body stores of iron by testing serum ferritin in blood tests.
However, serum ferritin, which is the most commonly used method of testing iron stores in the body may not accurately reflect excess iron stored in the liver, heart, bone marrow, etc., according to Sharon McDonnell, MD, MPH, of the Centers for Disease Control. She says that testing for transferrin saturation provides a more accurate indication of this kind of stored iron, especially if it is elevated in more than one test.
For those of you who do include iron in their daily supplementation, there is one form of iron that is considered to be basically nontoxic, even at doses in the thousands of milligrams. This form is called iron carbonyl, [xiv] and it is the form of iron contained in the SuperNutrition and the AMNI vitamin formulas.
[i] Sanchez, M. et al. Oral calcium supplementation reduces intraplatelet free calcium concentration and insulin resistance in essential hypertensive patients. Hypertension (1997) 29(1 Pt 2):531-536.
[ii] Perez-Rodriguez E, et al. The role of calcium supplements in the treatment of nelfinavir-induced diarrhea. 39th ICAAC, Sept. 26-29, 1999 San Francisco, California. Abstract #1308.
[iii] Tang, AM, et al. Effects of micronutrient intake on survival in human immunodeficiency virus type 1 infection. Am J Epidem (1996) 143(12):1244.
[iv] Koch, J, et al. Zinc levels and infections in hospitalized patients with AIDS. Nutrition (1996) 12(7-8):515-518.
[v] Hunt, CD, et al. Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men. Am J Clin Nutr (1992) Jul;56(1):148-157.
[vi] Dorup, A, et al. Role of insulin-like growth factor-1 and growth hormone in growth inhibition induced by magnesium and zinc deficiencies. Br J Nutr (1991) Nov;66(3):505-521.
[vii] Arens M, et al. Zinc salts inactivate clinical isolates of herpes simplex virus in vitro. J Clin Microbial 2000 May;38(5):1758-1762.
[viii] Petrus E, et al. Randomized, double-matched, placebo-controlled, clinical study of the effectiveness of zinc acetate lozenges on common cold symptoms in allergy-tested subjects. Cur Thera Res 1998, September;59:595-607.
[ix] Dworkin, BM, et al. Abnormalities of blood selenium and glutathione peroxidase activity in patients with acquired immunodeficiency syndrome and AIDS-related complex. Biol Trace Elem Res (1988) 15():167-177.
[x] Baum, MK, et al. Risk of HIV-related mortality is associated with selenium deficiency. J AIDS Hum Retro (1997) 15:370-376.
[xi] Anderson, RA, et al. Elevated intake of _supplemental chromium improve glucose and insulin variables in individuals _with type 2 diabetes. Diabetes (1997) 46:1786-1791.
[xii] Boelaert, JR, et al. Altered iron metabolism in HIV infection: mechanisms, possible consequences, and proposals for management. Inf Agents & Dis (1996) 5(1):36-46.
[xiii] Dandona, P, et al. Insulin resistance and iron overload. Ann Clin Biochem (1983) 20 Pt 2:77-79.
[xiv] Gordeuk VR, et al. Carbonyl iron therapy for iron deficiency anemia. Blood, 67(3):745-52 1986 Mar.