February 28, 2012
MAC-Pack and Opti MAC-PACK: Alternatives to K-PAX at HALF THE PRICE
K-PAX®, the popular multi-supplement pack, was developed following Dr. Jon Kaiser’s 2006 study that found an increase in CD4 count among HIV+ individuals using a mix of a potent multivitamin and antioxidants.* Eventually, Medicaid or ADAP formularies of many states included K-PAX®– a validation by the healthcare system welcomed by those of us who have long maintained that supplements can help to address chronic illness. Unfortunately, many people do not have access to these programs and for them, cost can be an issue. Even worse, some states, such as New York, are cutting budgets and eliminating items like K-PAX® from their formularies.
That’s why NYBC continues to offer the MAC Pack (for Multivitamin Antioxidant Combination), a low-cost alternative to the “Double-Strength” K-PAX® formula, based on products already available through our nonprofit co-op. (Unlike K-PAX®, the parts of the MAC Pack are delivered in their original bottles, so “some assembly is required”–one reason we also stock small ziplock baggies, which are great for travel, too!)
Note that the NYBC MAC Pack is based on the formula that was originally studied and published in the journal AIDS, while the current version of K-PAX®, on the other hand, has considerably less of certain micronutrients, such as vitamins B6 and B12. Nevertheless, the NYBC MAC Pack still costs HALF THE PRICE of the retail “Double Strength” K-PAX® formula. (That’s $62/month for the MAC Pack, versus $139/month for K-PAX® Double Strength.)
Subsequently, NYBC added to its MAC Pack offering by introducing the Opti-MAC Pack. This version of the MAC-Pack relies on SuperNutrition’s OptiPack (iron free), which has higher amounts of B vitamins than Added Protection, and so represents a further economy in number of bottles (no P5P or B12 needed!) and in cost (about $56/month).
For more information on NYBC’s MAC Pack or Opti-MAC Pack, or to place an order, visit us at www.newyorkbuyersclub.org, or call us at 1-800-650-4983. A comparison chart of the exact ingredients is available on our website. All the components of the MAC-Pack or Opti-MAC Pack can be ordered individually as well.
* Micronutrient Supplementation Increases CD4 Count in HIV-infected Individuals on Highly Active Antiretroviral Therapy: A Prospective, Double-Blinded, Placebo-Controlled Trial. Kaiser JK, et al. JAIDS 2006;42[5]: 523-528.
August 17, 2011
NYBC’s MAC-Pack on the “Ask The Experts” forum, thebody.com
We were glad to see a recent Q&A on the “Ask the Experts” forum of thebody.com, which is one of the leading online sources of information for people with HIV. The question concerned NYBC’s MAC-Pack, our low-cost, close equivalent to K-PAX, a multivitamin/antioxidant combination which has been shown in research to raise CD4 counts, and which is available thru some — but not all–formularies in some — but not all — states.
For more information, see NYBC’s entry
MAC-Pack
Here’s the exchange:
QUESTION: macpac
Jul 5, 2011
are you familiar with the co. NYBC and their MACPAC-combination multivitamin & antioxidant program sells for 65 dollars and they compare to KPAC for 1/2 the cost..don’t want to throw money away on useless vitamins or vitamins that are sub-par or not testedANSWER: Response from Mr. Vergel
Supplement quality is always an important issue. One available resource is www.consumerlab.com although they are a for-profit company. It would be preferable if there were a government agency that routinely tested supplements and published the results!
It will always be a bit of a crapshoot, but the good news is the majority of supplements tested by them either pass and those that do fail often do for relatively minor reasons (though some do spectacularly).
According to Jared Becker and George Carter from the New York Buyers Club, the brands used in NYBC’s MAC Pack come from companies as reputable as K-PAX and with longer histories. NYBC has assessed Jarrow, Douglas Labs and Montiff, the providers used to make the Mac Pack. A few years ago, NYBC sent Montiff’s acetylcarnitine for testing and it came back fine. NYBC also uses consumerlab’s reports to verify quality of our big suppliers like Jarrow and Douglas.Nelson Vergel
Entry posted at: http://www.thebody.com/Forums/AIDS/Nutrition/Q216051.html?ic=700101
January 7, 2011
Raltegrivir (Isentress) and Antacids/Minerals
A recent discussion on the excellent PozHealth listserve has alerted us to a potential problem with the relatively new HIV medication, raltegravir (brand name, Isentress). This drug inhibits an enzyme used by HIV called integrase.
As with many medications, it needs to be absorbed properly by the body after being taken. Some drugs can interact with this, blunting its benefit in lowering viral load to undetectable. In particular, antacids (that often come in the form of calcium carbonate) appear to reduce the drug’s efficacy when they are taken at the same time.
One contributor to the list noted that he now takes the drugs separately from any antacids as WELL as his K-PAX. This is prudent. We strongly urge you to separate any multi or other minerals that may inhibit the benefit of this medication by taking them about 4 hours apart.
This is also based on some research, as discussed on the HIV Insite website. They note: “: ”It appears that polyvalent cations (such as magnesium, calcium, and iron) bind integrase inhibitors and interfere with their activity against integrase. A pharmacokinetic study showed that administration of antacids containing divalent cations at the same time as elvitegravir (an investigational integrase inhibitor) lowered serum elvitegravir concentration by more than 40%. This effect was minimal if antacids were taken 4 hours apart from the integrase inhibitor.(5) The interaction of raltegravir and antacids has not been studied; pending further investigation, antacid medications and other agents with polyvalent cations should be used cautiously with (and taken separately from) raltegravir.”
(If you would like to join the POZHealth group, send a blank email to PozHealth-subscribe@yahoogroups.com and you will get an email with instructions to follow. It is a terrific group!)
December 15, 2010
Opti-MAC Pack
The Opti MAC Pack is NYBC’s simplest and least expensive alternative to the K-PAX multivitamin/antioxidant combination, which was the subject of Dr Jon Kaiser’s groundbreaking study showing the value of these supplements for people with HIV.
Instead of the Added Protection multivitamin, it uses SuperNutrition’s Opti-Pack, which includes about 1000 mcg of B12 and 250 mg of B6 as pyridoxine, thus providing a good replacement for the extra pills offered in NYBC’s regular MAC (Multivitamin Antioxidant Combination) Pack. As we’ve said before, though the regular MAC Pack and the Opti-MAC Pack are not precise, 100% matches of the K-PAX, they do, we feel, provide a close equivalent, and at a much lower cost (less than half the price!) Note that some may wish to add more Vitamin C to the regimen, but note also that NYBC’s Opti-MAC Pack and regular MAC Pack both have the advantage of providing more acetylcarnitine than K-PAX–not a bad idea, in our estimation, especially if you’re experiencing neuropathy. And the NYBC combination products are available iron-free, which is a good idea for those dealing with liver disease or impairment as well as HIV.
Read more about the general ideas behind the MAC Pack and Opti-MAC Pack at
April 6, 2010
K-PAX Canadian Trial
K-PAX, the comprehensive multivitamin/antioxidant formula for immune support, is now the subject of a randomized clinical trial in Canada. The sponsors of the Canadian trial are the Canadian HIV Trials Network and the Ontario HIV Treatment Network (OHTN). This is a high-quality scientific study, that is, it’s a double-blind, placebo-controlled randomized clinical trial–the same kind of investigation required by the FDA before approval of drugs.
The Canadian K-PAX trial is enrolling antiviral-naive HIV-infected patients, and seeks to test whether K-PAX can provide useful support for the CD4 counts of HIV(+) individuals who have not yet begun taking anti-retroviral medications. (Patients starting the study will have CD4 counts between 350 – 800.) Half the group will be randomly chosen to receive K-PAX, while the other half will receive a low-dosage type multivitamin like those sold over the counter in drugstores.
We welcome this follow-up study on the K-PAX formula. The first study, which led to wide release of the K-PAX formula, was published in 2006 and did show a significant increase in CD4 counts among those taking it, whereas other participants had no increase or even some decline. We should also mention that our predecessor organization, DAAIR, was suggesting multivitamin/antioxidant protocols for people with HIV/AIDS back in the 1990s, even before anti-retroviral therapy became generally available.
In 2006, meanwhile, NYBC developed a close equivalent of the K-PAX formula using components from its product list. This allowed the purchasing co-op to offer its MAC-Pack (Multivitamin-Antioxidant-Combination Pack) for approximately half the price of the K-PAX, a useful alternative especially for those living in localities where K-PAX was not covered by ADAP or other insurance. See www.newyorkbuyersclub.org for more details.
November 2, 2009
Micronutrients for people with HIV: a low-cost equivalent to K-Pax
K-PAX®, the popular multi-supplement pack, was developed following Dr. Jon Kaiser’s micronutrient study that found an increase in CD4 count among HIV+ individuals using a mix of a potent multivitamin and antioxidants.* At this point, the Medicaid or ADAP formularies of many states include K-PAX®–a validation by the healthcare system welcomed by those of us who have long maintained that supplements can help to address chronic illness. Unfortunately, many people do not have access to these programs and for them, cost can be an issue. (The retail price of the “Double-Strength” K-PAX® formula is about $130/month, quite a sum for those on a budget who face extra healthcare costs.)
That’s why NYBC designed MAC Pack (for Multivitamin Antioxidant Combination), an alternative to the “Double-Strength” K-PAX® formula, based on products already available through our nonprofit co-op. Unlike K-PAX®, the parts of the MAC Pack are delivered in their original bottles, so “some assembly is required” (one reason we also stock small ziplock baggies–great for travel, too!) While NYBC’s MAC Pack is not a precise, 100% match of the K-PAX® formula, it provides a similarly comprehensive vitamin, mineral and antioxidant regimen—and at a much lower cost (about $62/month).
A few small differences between NYBC’s MAC Pack and K-PAX® should be noted:
1) Acetyl L-Carnitine: The MAC Pack actually contains more acetylcarnitine than the double-strength K-PAX®—not a bad idea, especially if you believe, as we do, that acetylcarnitine may be one of the key elements in the multivitamin-antioxidant combination. (Two a day is sufficient if you want to match the K-PAX® formula, but three or more can help if you’re dealing with neuropathy.)
2) Vitamins: The multivitamins contained in the MAC Pack have somewhat different formulas than those in K-PAX®. Taking an extra Vitamin C tab along with the regular multi would make up for one difference. And some might wish to take a bit more calcium and vitamin D3, since bone health remains a concern for people with HIV, and there is also growing recognition of the need for higher doses of D3.
3) Iron: K-PAX® only comes with iron, but for those with liver trouble, this might NOT be a good idea. With the multivitamin Added Protection, you can choose whether to take iron or not (it is available both with iron and without). Also: Ultra Preventive Beta, another Douglas Labs multi, offers a variety of food-based nutrients in addition to a standard multivitamin formula, for $3 more per month.
Note: In 2009, NYBC added to its MAC Pack offerings by introducing the Opti-MAC Pack. This version of the MAC-Pack relies on SuperNutrition’s OptiPack (iron free), which has higher amounts of B vitamins than Added Protection or Ultra Preventive Beta, and so represents a further economy in number of bottles and in cost (about $56/month). Even with these savings, it’s still a close equivalent of the K-PAX®!
For more information on NYBC’s MAC Pack or Opti-MAC Pack, or to place an order, please visit www.newyorkbuyersclub.org, or call 1-800-650-4983. (You can also order the components of the MAC-Pack or Opti-MAC Pack individually.)
REFERENCE:
* Micronutrient Supplementation Increases CD4 Count in HIV-infected Individuals on Highly Active Antiretroviral Therapy: A Prospective, Double-Blinded, Placebo-Controlled Trial. Kaiser JK, Campa AM, Ondercin JP, et al. JAIDS 2006;42[5]: 523-528.
December 12, 2008
Multivitamin Antioxidant Combination (MAC-Pack): a K-Pax alternative available in no-iron formula for those with liver impairment
In 2007, NYBC began offering an alternative to the K-Pax multivitamin-antioxidant supplement, which was added to some ADAP and Medicaid formularies following publication in 2006 of Dr. Jon Kaiser’s study that found CD4 increases in people with HIV taking a micronutrient combination supplement. A first reason for the NYBC alternative, called the MAC-Pack, was price: for those without access to ADAP or Medicaid programs, the double strength K-Pax cost of about $140/month was rather high, and NYBC as a nonprofit co-op was able to present a close equivalent for only $62/month.
But another rationale for introducing the MAC-Pack was its flexibility. In fact, because MAC-Pack uses the AMNI/Douglas multivitamins Added Protection as its core, it can be configured as a formula with or without iron. Having the option of an iron-free MAC-Pack is important especially to people with elevated liver enzymes, liver impairment, or hepatitis co-infection. Taking iron supplements is generally not recommended for this group, since processing the iron puts an extra strain on liver function.
Also note that the MAC-Pack provides somewhat more acetylcarnitine than the K-Pax, which may not be a bad idea, especially if you believe, as we do, that acetylcarnitine is probably a key element in the multivitamin-antioxidant combination. (Two tabs/day is sufficient if you’re just interested in matching the K-Pax formula, but three/day may be better especially for those dealing with neuropathy.)
For more information, see the NYBC entry:
December 11, 2008
Acetylcarnitine for peripheral neuropathy, and as a component of a multivitamin/antioxidant combination
The UK-based information website www.aidsmap.com provides this succinct summary of evidence for use of acetylcarnitine (also “L-acetylcarnitine” or “acetyl-l-carnitine”) for HIV-associated antiretroviral toxic peripheral neuropathy:
A deficiency in L-acetyl carnitine may also play a role in neuropathy related to HIV treatment[4]. Taking L-acetyl carnitine supplements may reverse the nerve damage caused by HIV treatment, accompanied by an improvement of pain in most patients[5]. Similar studies have also shown improvements in pain with L-acetyl carnitine treatment, with one showing sustained benefit after more than four years[6][7][8]. Although the mechanism of L-acetyl carnitine’s action is unknown, it may counteract neuropathy by acting as an anti-oxidant, preventing the damage to mitochondria. Preliminary evidence suggests that carnitine may also be effective in treating other symptoms of mitochondrial toxicity, including elevated lactic acid levels[9].
(You can retrieve the references by going to the original web page,
at http://www.aidsmap.com/cms1235526.asp)
For more information, see the NYBC entry:
Also note that acetylcarnitine is a principal component of NYBC’s MAC-Pack (a low-cost alternative to the K-PAX):
November 10, 2008
The MAC-Pack: a K-PAX alternative from NYBC
The New York Buyers’ Club continues to offer its MAC Pack, or Multivitamin-Antioxidant Combination pack, which is a close equivalent to the double-strength K-PAX but at about half the cost. (K-Pax is usually listed at $139; NYBC’s MAC Pack sells for $62.)
K-PAX, a multi-supplement pack, was developed following a study by Dr. Jon Kaiser that found an increase in CD4 count among HIV+ individuals using this mix of a potent multivitamin and antioxidants.
At this point, the Medicaid or ADAP formularies of many states include the K-PAX formula. Unfortunately, some people may not have access to these programs and for them cost can be an issue. That is why NYBC designed the alternative MAC-Pack, which is based on products and prices currently available through its nonprofit purchasing coop.
The MAC-Pack includes:
Acetylcarnitine: 3/day, one month supply = $15.50 (one bottle; 500mg/90)
ThiolNAC (NAC + alpha lipoic acid): 3/day, one month supply = $14.00 (one bottle; 500mg/200mg/90)
Vitamin B6 (pyridoxal-5-phosphate/P5P): 3/day, one month supply = $10.00 (one bottle; 50mg/100)
Vitamin B12 (methylcobalamin): 2/day, one month supply = $3.75 (one bottle; 1000mg/100)
Added Protection (without iron): OR Added Protection (with iron): 6/day, one month supply = $19.25
All of these components of the MAC-Pack are also available as individual items; click on links for more information.
Notes:
1) The NYBC package actually has MORE acetylcarnitine than the double-strength K-PAX. Not a bad idea, especially if you believe, as we do, that acetylcarnitine is probably one of the key elements in the multivitamin-antioxidant combination. (Two a day is probably sufficient if you are just interested in matching the K-PAX formula, but three or more can help if you are dealing with neuropathy.)
2) The multivitamins available through NYBC have somewhat different formulas than the K-PAX (see product labels available on the NYBC website for details). Taking an extra vitamin C tab along with the regular multi would make up for one significant difference. And some might wish to take a bit more calcium and vitamin D3 than Added Protection offers, as bone loss remains a concern among people with HIV.
3) K-PAX only comes with iron; for those with liver issues, this is probably NOT a good idea. With the multivitamin Added Protection, you can choose whether to take iron or not. (Please specify when ordering.)
March 11, 2008
Can supplements reduce cancer risk? – Price and pill count drop for NYBC’s low-cost K-pax alternative, the MAC Pack – A healthy response to a recent and sobering New York Times article, “AIDS Patients Face Downside of Living Longer”
These and other stories can be found in the latest issue of the New York Buyers’ Club newsletter, THE SUPPLEMENT, now available online at
http://www.newyorkbuyersclub.org/supplement/index.html
On this page, you can also browse through SUPPLEMENT issues from the past three years, which contain stories on topics ranging from the latest thinking on supplements and cholesterol control, to US practitioners of Traditional Chinese Medicine and their formulas for liver health.
You can also visit www.newyorkbuyersclub.org for NYBC’s full set of information resources.
February 29, 2008
PharmaNAC (effervescent n-acteylcysteine) and MAC-Pack (K-Pax alternative)
A few words about PharmaNAC, an effervescent NAC (n-acetylcysteine) that the New York Buyers’ Club has been supplying in the past year. This form of NAC has proven especially useful to people with respiratory conditions like chronic bronchitis. And we were interested to read recently of a person with cystic fibrosis reporting on her use of PharmaNAC.
NAC in various forms has been researched and used more widely in Europe than in the US, although some influential work on this supplement for people with HIV was conducted at Stanford back in the 1990s, and helped lead, for example, to the inclusion of NAC in K-Pax, a multivitamin antioxidant combination that showed significant enough benefit to be added to state government-financed formularies for people with HIV.
NYBC originally imported a German effervescent NAC called ACC Akut (Hexal), but we were delighted when a North American supplier began to offer the very similar PharmaNAC, which we have stocked for the past year. (PharmaNAC is actually a higher dose of NAC per tab–900mg–than ACC Akut’s 600mg, though we have been able to keep the price about the same due to lower shipping costs.)
NYBC’s mission as a nonprofit buyers’ co-op also motivated us to devise a low-cost alternative to K-Pax for those who don’t have access to subsidized versions of this product. The NYBC MAC-Pack provides a close equivalent to K-Pax, but the cost has been brought down to less than half that of K-Pax.
Note: it’s also possible to order non-effervescent NAC and ThiolNAC separately:
