-IBIS-1.7.6-
tx
immune system
AIDS/HIV
Nutrition
dietary guidelines
eating principles:
low sugar, low cholesterol
calorie percentages: 70% complex carbohydrates, protein 12-15%, fat 15-18%
high fiber
elimination/rotation diet, rotation diet, rotation diet expanded
vegetarian cleansing diet or short fasts
Fasting, General Sample Diet, General Guidelines for Eating, Sample Vegetarian Diet
therapeutic foods:
increase omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil, black currant oil
increase foods that tonify the Kidney
increase foods that tonify the Qi, Xue (Blood), Yin and Yang
foods high in carotenoids, bioflavonoids, Zinc, Vitamins A, C, and E
Ganoderma mushrooms, Maitake, Chinese Black and Shiitake mushrooms
black beans
astragalus added to meat broths
barley congee with astragalus (Zeff)
therapeutic foods:
» for Kidney Yang Xu (Deficiency):
Warming and easily digested foods, cooked foods
foods that tonify and warm Kidney Yang: chicken, lamb, scallions, sesame seeds, fish, baked tofu, soybeans, walnuts, egg, lentils, black beans, lotus seeds, ginger, cinnamon bark tea
steamed vegetables, nourishing soups
» for Kidney Yin Xu (Deficiency):
Cooling foods, foods that tonify the Kidney: mulberries, apples, peaches, pears, most beans, soybeans, tofu, soy sprouts, chrysanthemum flowers
fresh juices:
carrot
celery
avoid:
food intolerances
trans-fatty acids, hydrogenated oils (margarine, vegetable shortenings, imitation butter spreads, most commercial peanut butters) oxidized fats (deep fried foods, fast food, ghee, barbequed meats)
refined, simple carbohydrates: sucrose, white flour, processed foods
hot and spicy foods, smoking, alcohol, stress and strong emotions, recreational drugs
raw and Cooling foods, cold foods, fruits, diaphoretic foods, eliminative foods, excessively sweet or salty foods, fresh ginger
supplements
See the many options presented in the Integrative Therapeutics section of Materia Medica.
Beta-carotene 300,000 IU once daily; can do carrot juice 1 cup = 150,000iu (approximately).
B-carotene (180 mg/day) increase in total WBC, % change in CD4 (rise of 17%), and % change in CD4/CD8 ratio (Coodley, Nelson, et al, 1993).
vitamin A: mixed reviews
- rate of HIV transmission was much greater in women who had very low vitamin A levels (Semba et al, 1994).
however, potentially contraindicated:
- high doses of zinc and vitamin A were associated with faster progression to AIDS (Tang et al, 1993).
- Vitamin A deficiency was associated with lower CD4 levels among both HIV seropositive and seronegative intravenous drugs users; In HIV+ subjects, vitamin A deficiency was associated with increased mortality (Semba, Graham et al, 1993).
Vitamin C IV or buffered 10-60 g once daily (Give calcium also).
Some in vitro work suggests that ascorbate can suppress HIV replication in both chronically and acutely infected T-lymphocytes (Harakeh, et al, 1990).
Vitamin E
Vitamin B12
Antioxidants: vitamin E, selenium. (Marz, p. 465, 1996)
High potency multivitamin and mineral with trace minerals
- Vitamins B1, B2, B6, C and niacin associated with slowed disease progression; high doses of zinc and vitamin A associated with faster progression to AIDS (Tang et al, 1993).
- Higher intakes of micro-nutrients at baseline were associated with higher CD4 counts. Daily multivitamin use was associated with a reduced risk of AIDS and a reduced baseline risk of low CD4 count (Abrams, Duncan and Hertz-Picciotto, 1993).
- Among seropositive women, higher levels of ferritin and lower levels of B12, zinc and selenium were associated with lower CD4 counts. (Smith, et al, 1996).
IV vitamin therapy (Marz, p. 465, 1996)
Germaniumup to 1.5 mg. (Marz, p. 465, 1997)
Selenium
Zinc picolinate 30-50 mg once daily; however, potentially contraindicated: high doses of zinc and vitamin A were associated with faster progression to AIDS (Tang et al, 1993).
Essential fatty acids, GLA, MCT (Marz, p. 465, 1997)
Hyperimmune bovine colostrum: lyophilized Colostrum from cows immunized against cyptosporidium given orally in 10 gram doses, reconstituted in water, four times a day, as a treatment for AIDS-related cryptosporidial diarrhea
N-acetyl cysteine: to enhance glutathione levels; increased the ratio of CD4 to CD8 and the changes were based upon dose. (Fidelus, RK et al. Cellular Immunol . 97:155-63, 1986; Mihm, S, et al., Pessara et al.. Cellular Immunol. 97:155-63, 1986; Staal, FJ, et al. Lancet 339(8798):909-912, 1992)
Quercetin (Marz, p. 465, 1997)
Thymus and/or spleen extractB and T cell formulas (Marz, p. 465, 1997)
DHEA (dehydroepiandosterone):
- DHEA as monotherapy at fairly high doses of 600 mg twice a day may reduce viral load. (Salvata et al, 1996 Abstract We.B.3385).
- low levels associated with disease progression:
Decreased levels of serum DHEA was found to be a predictor for progression to AIDS in asymptomatic HIV infected men. (Jacobsen et, 1991)
- Another study showed that both DHEA levels and CD4 counts were independent predictors of disease progression in HIV infected men. (Mulder et al 1992).
- A correlational study of CD4 counts and serum cortisol and DHEA-sulfate showed a positive relationship between immune status as measured by CD4 count and DHEA, supporting an hypothesis that DHEA deficiency may worsen immune status in HIV infected patients. (Wisniewski et all 993)
» effects of therapeutic doses:
At 75 mg/day CD4 and CD8 cell counts increased in majority of patients. (Hasheeve et al, 1994)
High doses (750 mg/day) may increase CD4+ count (Dyner et al 1990); using escalating oral doses of DHEA (750 mg/day up to 2,250 mg/day), no sustained increases in CD4 counts nor decreases in serum p24 antigen or beta-2-microglobulin levels were observed, but serum neopterin levels decreased transiently by 23-40%, dose proportionality was not evidenced by serum DHEA nor by DHEA-sulfate. (Dyner et al, 1993)
Suzuki et al (1995) have suggested that low levels of DHEA may cause immunological deficits via deficient IL-2 production in lymphocytes. (Daynes et al, 1990).
- DHEA is a modest selective inhibitor of HIV-1 replication in human lymphocytes and macrophages. (Jacobsen et al, 1994).
- Caution: Caution may be appropriate given that high serum DHEA levels have also been implicated in the pathogenesis of Kaposi's sarcoma in HIV/AIDS. (Christieff et all 995).
footnotes
Abrams B, Duncan D, Hertz-Picciotto I. A prospective study of dietary intake and AIDS in HIV-seropositive homosexual men. J AIDS 1993 6(8):949-958.
Abstract: Abrams prospectively examined the link between baseline dietary intake and development of AIDS over six years in 296 HIV+ men. Higher intakes of micro-nutrients at baseline were associated with higher CD4 counts. Daily multivitamin use was associated with a reduced risk of AIDS and a reduced baseline risk of low CD4 count.
Abdullah TH, et al. Enhancement of natural killer cell activity in AIDS with garlic. Dtsch Zschr Onkol 1989;21:52-53.
Baum MK, et al. Association of vitamin B6 status with parameters of immune function in early HIV-1 infection. J Acquired Immunodeficiency Syndromes 1991;4:1122-1132.
Blehaut H, Saint-Marc T, Touraine J. Double blind trial of Saccharomyces boulardii in AIDS-related diarrhea" International Conference on AIDS/Third STD World Congress, 1992, Abstract #2120, July 19-24b.
Boudes P, et al. Folate, vitamin B12, and HIV infection. Lancet 1990;335:1401-1402.
Butterworth RF, et al. Thiamine deficiency in AIDS. Lancet 1991;338:1086.
Castaldo A, et al. Iron deficiency and intestinal malabsorption in HIV disease. J Pediatr Gastroenterol Nutr 1996;22:359-363.
Cathcart RF III. Vitamin C in the treatment of acquired immune deficiency syndrome (AIDS). Med Hypotheses 1984;14:423-433.
Christieff N, Gharakhanian C, Thobie N, et al. Differences in androgens of HIV positive patients with and without Kaposi's sarcoma. J Clin Pathology 1995; 48(6):513-518.
Abstract: DHEA is frequently prescribed to, and self prescribed by, many HIV+ patients in the U.S. Caution may be appropriate given that high serum DHEA levels have also been implicated in the pathogenesis of Kaposi's sarcoma in HIV/AIDS. DHEA levels were significantly higher, as were testosterone and androstenedione in 34 HIV+ patients with KS vs. 35 HIV+ controls without KS.
Coodley G, Nelson HD, Loveless MO, Folk C. ß-carotene in HIV infection. J. AIDS 1991, 6: 272-276.
Abstract: HIV+ patients (n=21) were randomly assigned to receive either B-carotene (180 mg/day) or placebo for 4 weeks and then crossed over to receive the alternate treatment for 4 weeks. B-carotene resulted in a statistically significant increase in total WBC, % change in CD4 (rise of 17%), and % change in CD4/CD8 ratio.
Coodley GO, et al. Beta-carotene in HIV infection. J Acquired Immune Deficiency Syndromes 1993;6:272-276.
Coodley GO, et al. Beta-carotene in HIV infection: an extended evaluation. AIDS 1996;10:967-973.
Daynes R, Dudley DJ, Araneo BA. Regulation of marine lymphokine production in vivo II. DHEA is a natural enhancer of interleukin 2 synthesis by helper T cells. Eur J Immunol 1990; 20: 793-802.
Abstract: The effects of oral administration of DHEA in 13 HIV+ patients with baseline CD4 counts of 250-600 cells/mm3 was evaluated in phase I study (Dyner et al 1990). Five patients treated with the highest of three doses (750 mg/day) had CD4+ cell increases at 8 weeks from a mean of 373/µl pre-treatment to 463/µl after 8 weeks. In another open label, uncontrolled study in 12 HIV+ patients, DHEA therapy (75 mg/day) increased CD4 and CD8 cell counts in the majority of patients (Hasheeve et al, 1994). A subsequent study (Dyner et al, 1993) evaluated escalating oral doses of DHEA (750 mg/day up to 2,250 mg/day) for 16 weeks in 31 HIV+ patients with baseline CD4 counts between 250 and 600 cells/ul. Dose proportionality was not evidenced by serum DHEA nor by DHEA-sulfate. No sustained increases in CD4 counts nor decreases in serum p24 antigen or beta-2-microglobulin levels were observed. However, serum neopterin levels decreased transiently by 23-40% at 8 weeks. Suzuki et al (1995) have suggested that low levels of DHEA may cause immunological deficits via deficient IL-2 production in lymphocytes. Abnormal levels of DHEA were associated with low levels of serum IL-2. Direct murine lymphocyte exposure to DHEA at low concentrations (l0-10 - l0-7 M) enhanced secretion of IL-2 following immunological challenge.
Dworkin BM. Selenium deficiency in HIV infection and the acquired immunodeficiency syndrome (AIDS). Chem Biol Interact 1994;91:181-186.
Fabris N, et al. AIDS, zinc deficiency, and thymic hormone failure. JAMA 1988;259:839-840.
Fidelus RK, et al. Enhancement of intra cellular glutathione promotes lymphocyte & L activation by mitogen. Cellular Immunol . 97:155-63, 1986.
Abstract: It was found that NAC increased the ratio of CD4 to CD8 and the changes were based upon dose.
Folkers K, et al. Biochemical deficiencies of coenzyme Q10 in HIV-infection and exploratory treatment. Biochem Biophys Res Commun 1988;153:888-896.
Gogu SR, et al. Increased therapeutic efficacy of zidovudine in combination with vitamin E. Biochem Biophys Res Commun 1989;165:401-407.
Harakeh S, Jariwalla RI, Pauling L. Suppression of human immunodeficiency virus replication by ascorbate in chronically and acutely infected cells. Proc Natl. Acad. Sci., USA 1990; 87: 7245-7249.
Abstract: Despite the fact that vitamin C is commonly taken in high doses by HIV+ individuals, no controlled studies have been done to date in humans. Some in vitro work suggests that ascorbate can suppress HIV replication in both chronically and acutely infected T-lymphocytes.
Hattori I, Ikematsu S, Koito A, et al. Preliminary evidence for inhibitory effect of glycyrrhizin on HIV replication in patients with AIDS. Antivir Res 1989;11:255-262.
Hoerr R, Bostwick E, Standish L. Hyperimmune bovine colostrum in the treatment of AIDS-related cryptosporidial diarrhea, unpublished data.
Abstract: Hoerr and Bostwick at Galagen, the Research division of Land 0 Lakes, has developed a treatment for AIDS-related cryptosporidial diarrhea. Colostrum from cows immunized against cyptosporidium is lyophilized and given orally in 10 gram doses reconstituted in water four times a day. Bastyr University and the University Health Clinic (Standish as clinical investigator) have been two of the national clinical sites evaluating the efficacy of hyperimmune bovine colostrum (Sporidin-G™) in cryptosporidial diarrhea. In six patients treated for 20-40 days, four had resolution of diarrhea and elimination of detectable cryptosporidium oocysts in follow-up stool samples.
Humphrey JH, Quinn T, Fine D, et al. Short-term effects of large-dose vitamin A supplementation on viral load and immune response in HIV-infected women. J Acquired Immune Deficiency Syndromes Human Retrovirol 1999;20:44-51.
Ikegami N, et al. Prophylactic effect of long-term oral administration of glycyrrhizin on AIDS development of asymptomatic patients. Int Conf AIDS 1993;9. (Abstract)
Ince S. Vitamin supplements may help delay onset of AIDS. Med Tribune 1993; November 9:18.
Ito M, Sato A, Hirabayashi K, et al. Mechanism of inhibitory effect of glycyrrhizin on replication of human immunodeficiency virus (HIV). Antivir Res 1988;10:289-298.
Jacobsen M, Fusaro R, Galmarini M, Lange W. Decreased serum dehydroepiandosterone is associated with an increased progression of HIV virus infection in men with CD4 cell counts 200-499. J Infectious Dis 1991; 164: 864-868.
Abstract: DHEA is a modest selective inhibitor of HIV-1 replication in human lymphocytes and macrophages. The antiviral mechanism does not appear to be mediated through reverse transcriptase inhibition since DHEA did not inhibit HIV-1 RT enzymatic activity when tested up to 100 uM. Acute infection of normal human lymphocytes was also inhibited by DHEA at 10-1OOuM (Schinazi et al 1994). In another in vitro experiment, 50% inhibition of macrophage HIV p24 expression occurred at concentrations of 3-30 ug/ml.
Marz R. Medical Nutrition From Marz. Second edition. Omni-Press, Portland, OR, 1997.
Mihm S, Ennen J, Pessara U, Kurth R, Droge W. Inhibition of HIV-1 replication and NF-kappa B activity by cysteine and cysteine derivatives. AIDS. 1991 May;5(5):497-503.
Abstract: HIV-1 proviral DNA contains two binding sites for the transcription factor NF-kappa B. HIV-1-infected individuals have, on average, abnormally high levels of tumour necrosis factor alpha (TNF alpha) and abnormally low plasma cysteine levels. We therefore investigated the effects of cysteine and related thiols on HIV-1 replication and NF-kappa B expression. The experiments in this report show that cysteine or N-acetylcysteine (NAC) raise the intracellular glutathione (GSH) level and inhibit HIV-1 replication in persistently infected Molt-4 and U937 cells. However, inhibition of HIV-1 replication appears not to be directly correlated with GSH levels. Cysteine and NAC also inhibit NF-kappa B activity as determined by electrophoretic mobility shift assays and chloramphenicol acetyl-transferase (CAT) gene expression under control of NF-kappa B binding sites in uninfected cells. This suggests that the cysteine deficiency in HIV-1-infected individuals may cause an over-expression of NF-kappa B-dependent genes and enhance HIV-1 replication. NAC may be considered for the treatment of HIV-1-infected individuals.
Mocchegiani E, et al. Benefit of oral zinc supplementation as an adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. Int J Immunopharmacol 1995;17:719-727.
Mulder JP, Frissen P Krijnen, et al. DHEA as predictor for progression to AIDS in asymptomatic HIV-infected men. J Infectious Dis 1992; 165: 413-418.
Abstract: Both DHEA levels and CD4 counts were independent predictors of disease progression in HIV infected men (Mulder et al 1992). A correlational study of CD4 counts and serum cortisol and DHEA-sulfate showed a positive relationship between immune status as measured by CD4 count and DHEA, supporting an hypothesis that DHEA deficiency may worsen immune status in HIV infected patients.
Nanba H. Immunostimulant activity in-vivo and anti-HIV activity in vitro of 3 branched b-1-6-glucans extracted from maitake mushrooms (Grifola frondosa). VIII International Conference on AIDS, 1992. (Abstract)
Robinson MK, et al. Glutathione deficiency and HIV infection. Lancet 1992;339:1603-1604.
Roederer M, et al. Cytokine-stimulated human immunodeficiency virus replication is inhibited by N-acetyl-L-cysteine. Proc Natl Acad Sci 1990;87:4884-4888.
Salvata, et al. XI International Conference on AIDS July 1996. Abstract We.B.3385.
Abstract: Reported at the XIth International AIDS Conference in 1996, a small open-label trial with 20 HIV+ people, DHEA as monotherapy at fairly high doses of 600 mg twice a day was shown to reduce viral load by 0.6 log unit in HIV patients with baseline CD4 counts of 50-300.
Sappey C, et al. Vitamin, trace element and peroxide status in HIV seropositive patients: asymptomatic patients present a severe beta-carotene deficiency. Clin Chim Acta 1994;230:35-42.
Schrauzer GN, Sacher J. Selenium in the maintenance and therapy of HIV-infected patients. Chem Biol Interact 1994;91:199-205.
Semba RD, Graham NMH, Cajaffa WT, Margolick JB, Clement L, Vlahov D. Increased mortality associated with vitamin A deficiency during human immunodeficiency virus type 1 infection. Arch Intern Med 1993;153:2149-2154.
Abstract: Vitamin A deficiency was associated with lower CD4 levels among both HIV seropositive and seronegative intravenous drugs users (n=179). In HIV+ subjects, vitamin A deficiency was associated with increased mortality.
Semba RD, Miotti PG, Chiphangwi JD, et al. Maternal vitamin A deficiency and mother-to-child transmission of HIV-1. Lancet 1994; 343:1593-1597.
Abstract: In 300 HIV+ mothers in Africa, the rate of transmission was much greater in women who had very low vitamin A levels; rates ranged from 32% in the women with the lowest vitamin A levels down to 7% in women with the highest levels.
Smith, Graham, Flynn, Greenberg, Sowell, Ing, Vlahov, XI International Conference on AIDS July 1996. Abstract #We.B.182.
Abstract: At the 1996 XIth International AIDS Conference the HIV Epidemiology Research Study (HERS) reported on correlates of nutritional status in their cohort of 626 women (426 HIV seropositive, 199 HIV seronegative). Among seropositives, higher levels of ferritin and lower levels of B12, zinc and selenium were associated with lower CD4 counts. Multiple vitamin use was reported by 47% of HIV positive women and 31% of HIV negative women. Multiple vitamin use was associated with reduced rates of vitamin deficiency, but not mineral deficiency.
Staal FJ, et al.. Glutathione deficiency and HIV infection. Lancet 339(8798):909-912, 1992.
Standish L, et al. Alternative Medicine in HIV/AIDS: Current State of the Science and Justification for Research. Bastyr University AIDS Research Center, Seattle, Washington, October 1996.
Standish L, Guiltinan J, McMahon E, Lindstrom C. One year open trial of naturopathic treatment of HIV infection class IV-A men. J Naturopathic Med 1992;3:42-64.
Tang A., Graham NMH, et al. Dietary micronutrient intake and risk of progression to AIDS in HIV-1 infected homosexual men. Am. J. Epidem, 138 (11): 937.
Abstract: An epidemiological study of 281 HIV+ men provided evidence that certain dose ranges of dietary micro-nutrient intake of vitamins B1, B2, B6, C and niacin were associated with slowed disease progression, whereas high doses of zinc and vitamin A were associated with faster progression to AIDS.
Wisniewski TL, Hilton C, Morse E, Svec F. The relationship of serum DHEA-S and cortisol levels to measures of immune function in HIV-related illness. Am J Med Sciences 1993; 305(2): 79-83.
Abstract: A correlational study of CD4 counts and serum cortisol and DHEA-sulfate showed a positive relationship between immune status as measured by CD4 count and DHEA, supporting an hypothesis that DHEA deficiency may worsen immune status in HIV infected patients.
Yamada Y, Nanba H, Kuroda H. Antitumor effect of orally administered extracts from fruit body of Grifola frondosa (maitake). Chemotherapy 1990;38:790-796.
Zhang QC. Preliminary report on the use of Momordica charantia extract by HIV patients. J Naturopath Med 1992;3:65-69.
Note: Many thanks and best wishes to Leanna J. Standish, ND, Ph.D. and Bastyr University AIDS Research Center for gathering these citations, producing abstracts, and conducting valuable research.