New York Buyers’ Club - The Blog

NYBC has been, where and as it can, helping our friends at the Centre in Harare, Zimbabwe as well friends at the Blue Diamond Society in Kathmandu, Nepal.

Recently, Super Nutrition sent us a donation of vitamins that we immediately turned around and sent off to these two organizations. We are grateful that such high quality products are getting some play around the world: healthcare is a RIGHT. And we know a multi is a significant part of managing HIV disease. The clinical data unequivocally support the use of a multi, whether using antiretrovirals or not. (And yes, NYBC disagrees with the notion proposed by some that either ARV or a multi are the only things one needs; neither position is very intelligent!)

In other news, Blue Diamond Society has been working to find housing for people with HIV who have been removed from their clinic by a homophobic and AIDSphobic landlord. An all-too-familiar story around the world.

If you can help NYBC with donations either of vitamins/supplements or cash to help our friends, it would be greatly appreciated! NYBC’s sister organization, FIAR, is accepting any funds earmarked to help out the Nepali situation. More information below:

HIV & AIDS Hospice
Concept note for the purchase of a building
Kathmandu, March 21 (IANS) Twelve men diagnosed with AIDS, four of whom are terminally ill and unable to walk, were thrown out and the AIDS hospice and care centre run for them shut down in Nepal due to the prevailing anti-gay bias, without any human rights group intervening on their behalf. Just as Nepal’s sexual minorities were celebrating the community’s first participation in a national election as contestants, the AIDS hospice run in Kathmandu for homosexuals by Nepal’s pioneer gay rights organisation was closed down Thursday night by the landlord after pressure from the neighbours.

Introduction
Despite significant progress in recent years on policy and awareness, society’s stigma and discrimination towards males who have sex with males and transgender people (MSM/TG) in Nepal remains. This prejudice is compounded when MSM/TG are infected with HIV and Blue Diamond Society’s (BDS) Care & Support programme has been severely challenged in finding accommodation for its HIV & AIDS Hospice. To remove the obstacle of landlord’s prejudice, BDS believes it is necessary to purchase its own premises for Hospice/Care & Support activities.

Background
Government estimates put the number of MSM/TG in Nepal at 130,000 although BDS’ and regional/international experience suggests it is closer to 500,000. Official studies show an HIV prevalence rate of 3-4% indicating an MSM/TG population living with HIV & AIDS in excess of 4,000. Many of these have been rejected by their families and society and it became clear to BDS that they needed care and support from their own community who understood their sexuality/gender, could provide compassionate care and give them access to health services without discrimination. With the support of the Elton John AIDS Foundation (UK) and Sidaction (France), BDS in 2005 opened a hospice centre in Kathmandu. MSM/TG from all over Nepal have made use of this facility and, in two and half years, over 700 MSM/TG living with HIV & AIDS have been supported by staff, many of whom are themselves HIV positive, and been given counselling, care and medical treatment. During the 6 months ended 30 September 2007, despite only having 7 proper beds, a total of 94 MSM/TG were accommodated (on mattresses on the floor when all beds were full) at the Hospice for periods ranging from 1 day to several months. However this work has been severely hampered by being forced to move premises 4 times in 2½ years as landlords, often pressured by neighbours offended by the presence of MSM/TG and HIV+ staff and clients, refuse to extend short-term leases leading to eviction. It has become more difficult to find suitable premises and following the last eviction on 20 March 2008, staff and 12 patients have been forced to find a temporary home in a meeting room at BDS’ office.

Proposed Project
To overcome discrimination by landlords and the disruption of frequent moves, BDS believes it is necessary to purchase its own building for Hospice/Care & Support activities. This building would provide a stable and secure base from which to continue the following existing activities of BDS Care & Support:
Clinical care
Hospice facility (15 beds minimum)
Medical check up and monitoring
HIV testing and counseling
Opportunistic Infection treatment
Co infection treatment
Anti Retroviral Therapy facilitation
Social support
Ambulance service to access hospital services
Training (for self-care and treatment etc) and stress reduction workshops
Palliative care
Food and logistical support

Running costs would continue to be funded by existing donors and/or new ones.

Estimated Budget (US dollars)
Buying the building (depends on the location) 100,000 – 150,000
Furnishing and equipment 50,000
Setting up cost 5,000

Total US$ 155,000 - 205,000

We would be more than happy to submit full proposal in necessary once we have a positive indication from you.

Sunil Babu Pant
Director
Blue Diamond Society

Blue Diamond Society is Nepal’s leading community based organisation representing sexual and gender minorities. It seeks to convince Nepali society to respect the human rights of its community members and to empower them to advocate for these rights and deliver HIV & AIDS programmes for themselves.
www.bds.org.np
bluediamondsociety@yahoo.com

Here’s the latest news on Vytorin and Zetia, two drugs that are widely prescribed as cholesterol-lowering agents.

We repeat some of the suggestions we made when the failings of these two drugs were first revealed: consider such alternatives as statins plus niacin*; or a supplement based on plant sterols and other components, Cardio Edge from Douglas Labs.

* See NYBC entries for Niacin 100mg (recommended as initial dose to minimize “flushing”) and Niacin Timed-Release / Niatab 500mg, the full-strength dose.
 —- 
Journal Issues Warning on Two Cholesterol Drugs
New YorK Times
By ALEX BERENSON
Published: March 30, 2008

CHICAGO — Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia, may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday.

The journal’s conclusion came as doctors at a major cardiology conference in Chicago saw for the first time the full results of a two-year clinical trial that showed that the drugs failed to slow, and might have even sped up, the growth of fatty plaques in the arteries. Growth of those plaques is closely correlated with heart attacks and strokes.
…

We accessed the full story at www.nytimes.com on 3/30/2008.

Astragalus is traditional botanical that has drawn new research attention in recent years, especially for its usefulness in increasing the effectiveness of some cancer treatments while diminishing side effects. As background on this herb, we present the excerpt below from the NYBC entry on Astragalus (See complete entry for more information and cautions.)
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Astragalus is considered a strong immune booster and an energy herb and may help to restore depleted red blood cell formation in bone marrow. Some evidence indicates that it stimulates the body’s natural interferon production, helps adrenal function, is a diuretic for edema and inflamed kidneys and helps cancer patients withstand the side effects of chemotherapy.
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Some recent research on astragalus as an adjunct in cancer treatment
The Memorial Sloan Kettering Cancer Center Integrative Medicine website reports on two major reviews, from 2005 and 2006, which examined published evidence about the use of astragalus as an adjunct therapy in certain cancer treatment settings:

–McCulloch M, et al. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: Meta-analysis of randomized trials. J clin Oncol 2006;24(3):419-430.
This analysis sought to determine whether Chinese herbal medicine containing Astragalus increases the effectiveness of platinum-based chemotherapy for advanced non-small-cell-lung cancer.

–Taixiang W, et al. Chinese medical herbs for chemotherapy side effects in colorectal cancer patients (Review). The Cochrane Database Syst Rev 2005; (1):CD004540.
Four clinical trials were included in this review to assess the effectiveness of Astragalus (Huangqi) compounds on the quality of life, side effects of chemotherapy, and on adverse effects in colorectal cancer patients.

See also the University of Maryland Medical Center’s Complementary Medicine website entry on Astragalus for this overview:

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Astragalus (Astragalus membranaceus) has been used in Traditional Chinese Medicine for thousands of years, often in combination with other herbs, to strengthen the body against disease. It contains antioxidants, which protect cells against damage caused by free radicals, byproducts of cellular energy. Astragalus is used to protect and support the immune system, for preventing colds and upper respiratory infections, to lower blood pressure, to treat diabetes, and to protect the liver.

Recent research in China indicates that astragalus may offer antioxidant benefits to people with severe forms of heart disease, relieving symptoms and improving heart function. At low to moderate doses, astragalus has few side effects, although it does interact with a number of other herbs and prescription medications.

We’re re-printing below an excerpt from a piece Lark Lands wrote several years ago, because it still has much solid advice for people with HIV/AIDS. A medical journalist and longtime AIDS treatment educator and advocate, Lark was a pioneer in focusing attention on an integrated, “holistic” approach to HIV disease. She served as science editor for POZ magazine, and has also been a contributor to Canadian AIDS Treatment Information Exchange (CATIE) publications.

The title of this piece is “The 7 Deadly Sins for those wishing to live long and well with HIV.” This excerpt has to do with nutrient needs (but see also the other sections, including those on gastrointestinal health and maintaining muscle mass.)
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Sin #2: Ignoring the nutrient needs that both the disease and the medicines create.

Some information about Women’s Blend from Super Nutrition, which also produces the Super Blend and Opti-Pack multivitamins.

Here are some excerpts from the Super Nutrition description of this multi:

This is a food-based multivitamin, enriched with organic green foods and herbs.

–Includes a robust B-Complex formula to increase energy throughout the day
–Immune supporting, anti-aging antioxidants
–Bone support - 1,000 mg Calcium, 600 mg Magnesium, 1,000 IU Vitamin D, 3 mg Boron and 1,000 mg Vitamin C
–Heart Healthy - 1,000 mcg Folic Acid, 200 mg Vitamin B6, 200 mcg Vitamin B12 plus 400 IU Vitamin E
–Enriched with 600 mcg Biotin & 100 mg GLA
–Special female herbal blend with Pau d’Arco, Peony, organic Nettles and Rosemary
100 mg 5:1 Vitex extract*
–Special flower petal blend, featuring Red Rosebuds
–200 mg Vitamin B6 to help reduce PMS*
–6 tablets per day

*Here’s some additional information, supplied by Michael Mooney at Super Nutrition in response to our request:

> Vitex for PMS.  A placebo-controlled study showed that 20 mg of Vitex extract reduced PMS 28> percent better than placebo. Women’s Blend has 100 mg of 5:1 extract.

Andrew Weill reports on studies suggesting that Rosavin, made from Rhodiola rosea, may be helpful in sustaining mood.

http://www.drweil.com/drw/u/WBL02081/Herb-Reduces-Depression-May-Extend-Life.html

Rhodiola rosea is not a widely known botanical remedy, but perhaps it should be. Several recent studies have revealed that the herbal extract of this yellow-flowered, Arctic mountain plant may have multiple health benefits. A study published in the Nordic Journal of Psychiatry, reporting on people with mild-to-moderate depression, showed that patients who took a Rhodiola extract known as SHR-5 (sold under the trade name Arctic Root) reported fewer symptoms than those who took a placebo. And a study by researchers at the University of California at Irvine revealed that fruit flies that ate a diet rich with Rhodiola lived an average of 10 percent longer than those that ate three other herbs known for their life-extension properties.

As usual, these modern findings come long after indigenous people have already determined the plant’s value. Russians and Scandinavians have used it for centuries to combat stress and depression.

See also NYBC entry on Rosavin, a Rhodiola rosea extract produced by Ameriden.

As human beings, we face these types of deep hurts in the course of a life. Facing our own death or the death of a loved one is profound.

One woman’s experience is reflected in this video. She is a neuroscientist, driven to study the brain in part from the experience of living with a relative with schizophrenia. It is about 18 minutes long–and VERY much worth it.

http://www.microclesia.com/?p=320

Learning to live with these agonies is as much the art of living. How do we respond to challenges? Do we judge ourselves to harshly when things don’t work out the way we would like? Can we find a less judgmental, more open space in which to accept both the joys and struggles of life? Can we learn to forgive others and ourselves for harms inflicted? In the buddhist tradition, meditation is thought of as a practice. And living day-to-day, moment-to-moment as challenges arise represents the opportunity to navigate the way we respond to and engage with life with increasing skill and openness.

Another remarkable individual is Stephen Levine. He has written a number of books, including the seminal work, Who Dies, published originally in 1982. His wisdom is deep and he provides great guidance without judgment. One meditation from that book that illustrates some of his viewpoints is below. Check it out–and by all means, get a copy of the book! It is skillful and compassionate.

Self Forgiveness Meditation

Reflect for a moment on that quality we call forgiveness. Bring into your mind, actually into your heart, the image of someone for whom you have much resentment. Take a moment to feel that person right there at the centre of your chest in the heart centre.

And in your heart say to that person, ‘I forgive you for anything you may have done in the past, either intentionally or unintentionally, through your thoughts, words or actions that caused me pain. I forgive you’.

Slowly allow that person to settle into you heart.

Don’t judge yourself for how difficult it is.

No force, just opening slowly to them at your own pace.

Say to them, ‘I forgive you. I forgive you for the pain you caused me in the past, intentionally or unintentionally, through your thoughts, your deeds, your words. I forgive you’.

Gently, gently open to them. If it hurts, let it hurt. Gradually open to that person. That resentment, that incredible anger, even if it burns, ever so gently though. Forgiveness.

‘I forgive you’.

Let your heart open to them.

It is so painful to hold someone out of your heart.

‘I forgive you’.

Let your heart open just a bit more to them. Just a moment of opening, of forgiveness, letting go of resentment.

Allow them to be forgiven.

Now opening more to forgiveness, bring into your heart the image of someone from whom you wish to ask forgiveness.

Speak to them in your heart. ‘I ask your forgiveness for anything I may have done in the past that caused you pain, either by my thoughts or my actions or my words. Even for those things I didn’t intend to cause you pain, I ask for your forgiveness’.

‘For all those words that were said out of forgetfulness or fear. Out of my closedness, out of my confusion. I ask for forgiveness’.

Don’t allow any resentment you hold for yourself to block your reception of that forgiveness. Let your heart soften to it. Allow yourself to be forgiven.

Let yourself be freed.

Let that unworthiness come up, that anger at yourself – let it all fall away.

Let it all go.

Open to the possibility of forgiveness.

‘I ask your forgiveness for whatever I may have done in the past that caused you pain. By the way I acted or spoke or thought, I ask your forgiveness’.

It is so painful to hold yourself out of your heart. Bring yourself into your heart. Say ‘ I forgive you’, to yourself. Don’t reject yourself.

Using your own first name, in your heart say, ‘I forgive you’. Open to that. Let it be. Make room in your heart for yourself.

‘I forgive you’.

All those resentments, let them fall away.

Open to the self-forgiveness. Let yourself have some space.

Let go of that bitterness, that hardness, that judgement of yourself.

Say ‘I forgive you’ to you.

Let some glimmering of loving kindness be directed toward yourself. Allow your heart to open to you. Let that light, that care for yourself, grow.

Self-forgiveness.

Watch how thoughts of unworthiness and fears of being self indulgent try to block the possibility of once and for all letting go of that hardening.

See the freedom in self-forgiveness. How can you hold that pain even a moment longer?

Feel that place of love and enter into it. Allow yourself the compassion, the care, of self-forgiveness. Let yourself float gently in the open heart of understanding, of forgiveness, and peace.

Feel how hard it is for us to love ourselves. Feel the pain on the hearts of all those caught in confusion. Forgive them, forgive yourself, let go gently of the pain that hides the immensity of your love.

Below is an excerpt from the Canadian AIDS Treatment Information Exchange (CATIE) information sheet on the use of CoQ 10 by people with HIV/AIDS. This excerpt focuses particularly on changes in lipid profiles that may accompany HIV medications, and the strategy for addressing these potentially damaging changes:

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One common side effect of highly active antiretroviral therapy (HAART) is increased levels of fatty substances or lipids in the blood. Examples of the lipid changes that can occur in HAART users include the following:increased levels of triglycerides
increased levels of cholesterol
increased levels of LDL (bad cholesterol)
decreased levels of HDL (high-density lipoprotein – good cholesterol)

See also NYBC’s entries on Coq10 100mg and CoQ10 30mg . The NYBC information includes reference to a 2007 study in the American Journal of Cardiology on COQ 10 and the relief of myopathic symptoms in patients treated with statins. Please also note cautions on using CoQ 10 with the blood-thinning agent coumadin.

The people at the AIDS Treatment Data Network (ATDN) have developed a series of “Simple Fact Sheets” about treatment and management of HIV. Their fact sheet on “Nutritional Management of Lipodystrophy,” written by an HIV nutritionist at Cabrini Medical Center in New York, covers diet (the right mix of carbohydrates, protein, fruits and vegetables, the right kinds of fats), exercise, and supplements, beginning with a good multivitamin, preferably one that includes a good set of antioxidants. There’s also a description of some supplements that may be useful in reducing lipodystrophy: L-carnitine, NAC, chromium, alpha lipoic acid, B-complex vitamins (niacin may be key among the B vitamins, but the recommendation is to always supplement using a B-complex, since the different B vitamins support one another’s action), and omega-3 fatty acids (fish oil and/or flaxseed).

 To read the entire fact sheet, go to

http://www.atdn.org/simple/nutrlip.html

We’ve spoken recently about the study of HIV and aging produced by ACRIA, a non-profit, community-based AIDS medical research and treatment education organization.

A main finding of the 2006 study is the prevalence of depression among older adults with HIV. In its survey of about 1000 older HIV+ adults, ACRIA researchers found that they experienced depression at a rate almost 13 times as higher than the general population. And for people with HIV, the consequences of depression are associated with many physical issues, far beyond just “feeling down”:

“By suppressing the immune system, depression may render people more vulnerable to infectious diseases. Stress and depression have harmful effects on cellular immunity, including those aspects of the immune system affected by HIV. Body cell mass depletion is associated with significant increases in fatigue, global distress and depressive symptomatology, and reduced life satisfaction. Elevated symptoms of depression are associated with a faster progression to AIDS and a higher risk of mortality. Depressive symptoms, especially in the presence of severe stress, are related to decreases in CD4 cell count and declines in several lymphocytes.”

These study findings and other related research motivated NYBC to assemble up-to-date information on dietary supplements and depression. See, for an overview, this information sheet:

Printable version of the info sheet, including a chart for quick comparison of these supplements as used to address depression

More information on the individual supplements is also available on the NYBC website, at  www.newyorkbuyersclub.org, as well as on this Blog, under “Depression.”

Acetyl-l-carnitine (often shortened to acetylcarnitine) and L-Carnitine (aka carnitine) are among the most heavily investigated of dietary supplements for their applications to HIV/AIDS. In particular, acetylcarnitine has been studied for more than a decade for HIV-associated neuropathy, especially by Michael Youle in the UK (see other entries under “acetylcarnitine, this Blog). Acetylcarnitine is also a key component in the K-Pax (and NYBC’s low-cost K-pax equivalent, the MAC Pack). Meanwhile, carnitine is also much used by people with HIV, and the prescription form, Carnitor, is made available through some state-funded formularies.

For a very good overview on acetycarnitine and carnitine research and application to HIV/AIDS, see

Acetyl-l-carnitine and L-carnitine: Canadian AIDS Treatment Information Exchange Fact Sheet

A brief excerpt:

Why do PHAs use this supplement?
Carnitine has many potential uses, including the following:

1. helping to heal damaged nerves—peripheral neuropathy (PN)
2. helping to decrease levels of lactic acid in the blood
3. reducing higher-than-normal levels of cholesterol and/or triglycerides
4. helping to maintain muscle growth

1. To manage peripheral neuropathy (nerve damage causing tingling, numbness or burning in the hands, feet and legs)
Levels of carnitine in the blood are sometimes lower in PHAs with peripheral neuropathy, particularly under the following conditions:

• damage from viral infections such as HIV and CMV (cytomegalovirus)
• the use of “d” drugs such as d4T, ddI and ddC
• the use of some anti-cancer drugs and antibiotics
• alcohol abuse
• diabetes

What the medications in the above list have in common is that they can damage the energy-producing parts of nerve cells—the mitochondria. Injured mitochondria cannot supply sufficient energy and nerves begin to malfunction and can die. Nerves in the feet, legs and hands, particularly in the skin covering those body parts, appear to be especially susceptible to PN. Some researchers have noticed that PHAs with PN can develop abnormal sweating, suggesting that nerves in sweat glands can also be affected.

One formulation of carnitine, acetyl-L-carnitine (ALCAR), may play a role in the management of PN. This compound helps mitochondria function and also appears to enhance the effect of a chemical that helps nerves grow—nerve growth factor.

Researchers in England conducted an extensive study of ALCAR in PHAs with peripheral neuropathy. Their findings revealed that most PHAs showed some degree of recovery from nerve damage after taking ALCAR 1.5 grams twice daily for up to 2¾ years.
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See also the NYBC entry on acetylcarnitine. Like its predecessor DAAIR, NYBC has this key supplement manufactured by pharmaceutical-grade producer Montiff; this allows for considerable cost savings for co-op buyers compared to commercially available products.

NYBC stocks two supplements that provide an array of nutritious green foods and select botanicals (such as gingko biloba) combined with probiotics. ProGreens has the wider spectrum of greens, botanicals and probiotics, while Green Defense is the purchasing co-op’s basic greens + select botanicals + probiotics product. As you’d expect, they vary in price as well, with Green Defense being about half the price of Pro Greens. Both are one-month supplies, so we are talking about a daily expense of a little more than a dollar (for Pro Greens), or about 50 cents per day (for Green Defense).

ProGreens (NutriCology). This contains greens together with a wide spectrum of probiotics to support gastrointestinal health.  Used as directed, this is a 30-day supply.

Each serving (approximately 8.8 grams) contains:
Organic Wheat grass powder 350 mg
Organic Barley grass powder 350 mg
Organic Alfalfa grass powder 350 mg
Organic Oat grass powder 350 mg
Organic Spirulina 1,000 mg
Chlorella (cracked-cell) 350 mg
Dunaliella salina 40 mg
Dulse powder 30 mg
Licorice root powder 100 mg
Eleuthero Root Extract 130 mg
Pfaffia paniculata (Suma root powder) 60 mg
Astragalus root extract 60 mg
Echinacea purpurea leaf and stem extract 60 mg
Ginger root powder 5 mg
Soy Lecithin (99% oil-free) 2,000 mg
Wheat sprout powder (gluten-free) 350 mg
Acerola berry juice powder 200 mg
Beet juice powder 200 mg
Spinach powder (1.5% octacosanol) 150 mg
Royal jelly (5% 10-HDA) 150 mg
Bee pollen 150 mg
Flax Seed powder 500 mg
Apple pectin and fiber 500 mg

Total count non-dairy probiotic cultures: 5.0 billion
Lactobacillus group (L.rhamnosus A, L.rhamnosus B,
L.acidophilus, L.casei, L.bulgaricus) 3.5 billion
Bifidobacterium group (B.longum, B.breve) 1 billion
Streptococcus thermophilus 500 million
Fructooligosaccharides (FOS) 500 mg
Milk Thistle extract (80% silymarin) 60 mg
Ginkgo biloba leaf extract 20 mg
Green tea extract (60% catechins) 20 mg
Grape pip extract (92% proanthocyanidins) 20 mg
Bilberry extract (25% anthocyanidins) 20 mg
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Green Defense (Jarrow). This is a mix of greens with a probiotic to support gastrointestinal health as well. Used as directed, it’s a 30-day supply.

Each single (6 g) scoop provides:
Grasses and Algaes - 980 mg
The following are organic:
Barley Grass Juice
Quinoa Grass
Spirulina
Oat Grass Juice
Wheat Grass Juice
[The remainder are not organic]
Vegetables - 1,430 mg
Spinach Juice Powder
Broccoli Juice Powder
Tomato Powder
Beet Powder
Botanicals - 320 mg
Tiger cane extract (Resveratrol source)
Quercetin
Milk Thistle Extract
Citrus Bioflavonoids
Green Tea Extract
Grape Seed Extract
Ginkgo biloba
Ginger Root
Fibers - 2,760 mg
FOS (Fructooligosaccharide)
Rice Bran Powder
Apple Fiber Powder
Probiotic Metabolites - 60 mg
Metabolin (Propionibacterium shermani)

Pro Greens and Green Defense can be added to juice or water. Drink immediately; best taken on an empty stomach. More than one scoop per day may be used if desired. Pregnant or lactating women considering taking more than one serving per day should consult their healthcare practitioner prior to use.