06.27.08
Jon Kaiser presentation: a nutritional supplement combination therapy to lower cholesterol
We had the opportunity to hear Dr. Jon Kaiser speak in New York last night, in one of his regular information sessions for people wanting to know about holistic/integrative approaches to treating HIV. (It was a double bill, since he had invited his colleague Dr. Ricky Hsu to open the evening with a review of HIV pharmaceuticals, including those just approved.)
While Dr. Kaiser ranged over several topics, including his long-standing interest in micronutrient support for people with HIV and the benefits it can provide, we took the most notes on his approach to reducing cholesterol with nutritional supplements. The need for cholesterol reduction strategies is widespread among people with HIV, since cardiovascular disease is a major concern, especially among those who have been on treatment for a number of years. Yes, as Dr. Kaiser stressed, there are obvious things to start with in order to reduce cardiovascular disease risk: you’ve got to quit smoking, and if you have high blood pressure, you have to work out the (relatively simple) treatment to control it.
But many people with HIV are prescribed statin drugs like Lipitor to reduce cholesterol, and unfortunately the statins come with a handful of potential side effects. So, Dr. Kaiser has recently been offering some of his patients the alternative of a nutritional supplement combination therapy. It consists of low-dose Niacin (to minimize flushing), fish oil (helpful in lowering triglycerides), plant sterols (available now in spreads, by the way), and pantethine. Although he’s only followed a few cases to date, he’s quite encouraged by results, and believes that many people with HIV could achieve good results (comparable to those offered by statins) with this kind of combination therapy.
Of course all of these components have been widely studied for cholesterol control before (you’ll find more information on them on the NYBC website at www.newyorkbuyerslcub.org). But it’s another very valuable contribution from Jon Kaiser the integrative health specialist to refine a combination of supplements to serve the particular purpose of reducing cholesterol and cardiovascular risk for people with HIV. We’ll watch for further updates from him on the clinical experience with this combination therapy.
06.03.08
Acetylcarnitine and Alzheimer’s Disease
The Journal of Neuroscience Research featured an article in 2006 on acetylcarnitine and Alzheimer’s Disease (AD)
that outlined the possible mechanism of this supplement in counteracting the effect of AD. Essentially, acetylcarnitine antioxidant workings may be able to prevent, or helpt to prevent, the deformations of brain structure associated with the development of Alzheimer’s. The authors of this NIH-funded research conclude that acetylcarnitine “may be useful as a possible therapeutic strategy for patients with AD.”
For more on this supplement, including its applications for neuropathy, see the NYBC entry Acetylcarnitine.
06.02.08
Do Abacavir and ddI (Didanosine) Contribute to Risk of Heart Attack?
This was the topic of a presentation at the 15th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston in February 2008. Researchers from a large European database that collects information on over 200 HIV clinics unexpectedly found that recent use of abacavir (in the past six months), and to a lesser extent ddI, was linked to an increased risk of heart attacks.
Although the overall level of heart attack was low (1.6%) in the group of more than 33,000 HIV+ individuals studied, it was nonetheless double the rate that would otherwise be expected.
These findings, which continue to be investigated, are focusing for now on the particular risk that taking abacavir (or ddI) might present for those who already have some risk factor for cardiovascular disease, such as being diabetic, being a smoker, having high blood pressure, or having higher than normal lipids (cholesterol and triglycerides). Also under discussion is whether screening for hypersensitivity to abacavir (shown by about 8% of people), which is a simple blood test, could steer those most susceptible to this increased heart attack risk away from abacavir.
It’s also clear that many HIV positive people taking abacavir could take steps to minimize their risk for cardiovascular disease by:
1. quitting smoking
2. lowering high lipid levels
3. lowering high blood pressure
4. getting treatment for diabetes
5. changing diet
6. starting an exercise program
(See entries on this blog for some suggestions regarding #s 2, 3, and 4.)
We’ve presented the above information based especially on the Canadian AIDS Treatment Information Exchange treatment update on this topic, which includes a bibliography for further reading. The complete CATIE update can be read at:
