Micronutrient Article Error

One of the figures in our micronutrient article is wrong–and in fact, it is perhaps the most important one of the paper. The correct figure is attached below and is the one that we originally submitted. The error doesn’t change our findings–these figures have the effect of showing what we found in a graphic. The wrong one tells the story that we found nothing important! The correct one shows how robust our findings actually are.

We are in the process of correcting the error with PLoSOne and will be preparing a more formal response. In the process of re-sizing the figure for editing purposes this past February, an earlier figure was used. This version appears to show no effect from the intervention.

Some might presume that this means we merely cherry-picked the data to find a palatable solution. That would be incorrect as the initial analysis was faulty. Further, the frequentist analysis underscores by comparison our findings of a robust effect.

Our team had, in setting up the analysis, initially used a VERY flat prior probability. This had the effect of squashing the data and distorting such that it no longer reflected the original findings of the studies we were analysing. The reason we can be sure this is the case is that the result did not resemble the original data. I.e., the original data was in fact, for example, Fawzi 0.56 (0.32, 0.98). You can see that clearly in the frequentist analysis (supplementary figure 1).

Upon adjusting to a more accurate scale factor, the result was a strong effect for the impact of a simple multi on the rate of HIV disease progression.

S1 Fig. Forest plot of rate of HIV disease progression, frequentist analysis.

A frequentist analysis yielded a similar 40% reduction in the rate of progression to clinical disease stages (RR 0.60, 95% CI 0.46, 0.78; p = 0.00008) for subjects on MNS, when including supplement arms that included a MNS alone or MNS plus either zinc or selenium.

doi:10.1371/journal.pone.0120113.s001

This underscores also the importance of scrutinizing closely the way data are handled and analyzed. As I have learned over the years in doing this work, a preferred answer may indeed be produced. But in this case, the answer reflects the actual data of the original studies.

George M. Carter

Fig. 2 Bayesian Analysis

Multi Slows Disease Progression

A meta-analysis has been published that reviewed the clinical studies that looked at the use of a multivitamin in people with HIV. There was enough data of people not yet on antiretrovirals and we showed a significant effect on how fast AIDS develops after HIV infection (the progression rate).

CONCLUSIONS: MNS significantly and substantially slows disease progression in HIV+ adults not on ARV, and possibly reduces mortality. Micronutrient supplements are effective in reducing progression with a posterior probability of 97.9%. Considering MNS low cost and lack of adverse effects, MNS should be standard of care for HIV+ adults not yet on ARV.

There was also evidence that it could reduce the risk of dying (mortality). There weren’t enough studies to assess the effect of a multi among those on ARV, though these studies are also discussed.

The first author of the study was NYBC’s George Carter, who was working as part of an NIH grant with colleagues at Mount Sinai in New York.

 

NYBC’s HIV+Aging Series Continues, Now Online!

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Jackie Haught offered personal insights into healing from her 30 years as an acupuncture practitioner.

In recognition of World AIDS Day 2014, New York Buyers’ Club hosted another installment in our ongoing free public seminar series, HIV+AGING. Held Tuesday December 2nd at City University of New York’s Graduate Center in Manhattan, the workshop was a great success and – like any good show – left folks craving more.

This thirst can now be slaked online – on NYBC’s new YouTube page, now featuring excerpts from the December 2 event – with more to come in the future!

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HIV+AGING: What Can Complementary & Alternative Medicine Do for You? featured three outstanding and personable speakers presenting valuable information and insights gleaned from their years of experience in the field of health and HIV.

Panelists included: Dr. Vani Gandhi, Director of Integrative Medicine at Spencer Cox Center for Health at Mount Sinai’s St. Luke’s and Roosevelt Hospitals; Jackie Haught, Founder of Blue Lotus Acupuncture Center in NYC and an acupuncture practitioner for more than 30 years; and NYBC’s own Treatment Director, George Carter, also President of Foundation for Integrative AIDS Research.

Presentations were followed by a hearty and heartfelt Q&A session: attendees not only posed pertinent questions to the panelists, but also opened up with one another about their own personal “CAM” experiences, both positive and frustrating.

We are already planning the next event and welcome collaborators!

Tune in to New York Buyers Club’s new YouTube channel for excerpts from our latest HIV+AGING event and more.

New @ NYBC – February 2015

supplement-header-2014These New Products and More
Available Through NYBC’s Newly-Redesigned Website & Co-Op Store

mega-pc-35-lecithin-1200mgMega PC-35 Lecithin – (Jarrow Formulas, 120 x 1200 mg; $9.75) Each softgel contains 1200 mg lecithin with choline 57 mg (from 35% PC lecithin) and 420 mg of phosphatidylcholine derived from soy. Phosphatidylcholine is a compound containing different types of fatty acids, glycerin, phosphorus and choline (a nitrogen-containing base). This may be an excellent product for people with hepatitis B or C, according to one well-designed study using 3 grams per day. Other benefits may be for mood enhancement for those with neurological disorders, to enhance cardiovascular health (in the context of a better diet), and possibly preventing or treating gallstones.

betaine-plus-pepsin-100-capsFor digestive health, NYBC is now carrying Twinlab’Betaine HCL Caps (100 caps $9.50). Each capsule contains betaine (as betaine hydrochloride) – 648 mg plus pepsin, 130 mg.

The addition of pepsin is thought to significantly improve the ability of the betaine to help the stomach lower the pH, that is, make the stomach more acid. That first amount of hydrochloric acid that your food hits arriving in the stomach is a crucial part of digestion. Betaine is typically used for people with a condition of low stomach acidity known as hypochlorhydria. This may actually be the problem even though one has reflux. It is a fairly common finding, for example, among people living with HIV, among a range of other conditions. Supplementing with betaine can help to improve digestion IF this is the case. Getting properly diagnosed before trying this is critically important. A 2013 study among healthy adults who had chemically-induced reduction in gastric acid (e.g., through proton-pump inhibitors) saw a reduction in stomach pH when given betaine supplements.

Uridine-5-monophosphate, 60 capsules for $22.20 from Jarrow. Each capsule contains 250 mg Uridine-5’-monophosphate disodium salt. Uridine is one of the nucleotides that is used by the RNA molecule. It is found in abundance incorporated in the phospholipid membranes of neural (especially brain) tissue. Data are limited but suggestive of benefits for memory and liver function. This is not dissimilar to an intervention utilized to help minimize mitochondrial toxicity associated with some antiretroviral drugs. One study suggested this could reduce damage to AZT or d4t (stavudine or Zerit)-related mitochondria, however, markers of inflammation were worsened. So this one should probably be used in the context of an anti-inflammatory protocol such as including carnitine, NAC, alpha lipoic, curcumin, omega-3 fatty acids and the like, which are a good idea anyway to keep TNF, IL-6 and hsCRP in check.

Astaxanthinastaxanthin-12-mg-30 12 mg – 30 softgels $16.25 from Jarrow Formulas. Astaxanthin is one of the many varieties of carotenoids (beta-carotene being one of the longest known and best characterized). Studies are somewhat mixed on the benefits of this agent to offset oxidative stress induced by exercise, with some benefit seen among soccer players and none for cyclists. One study using a mix of carotenoids showed an enhancement of visual acuity. Other small studies suggest benefits for increasing HDL, skin tone, and reflux frequency.


Garlic & Allicin  Sadly, NYBC no longer carries Dr. Zhang’s popular Allicin supplement,garlicell and arlipure however we have found these two excellent substitutes that indicate the amount of allicin and other components on the label. GarliPure from Natrol (120 “odor controlled” caps for $17). Each capsule contains 750 mcg of allicin along with 7.5 mg gamma glutamyl-cysteine, 5 mg allicin, 4 mg sulfur and 800 mcg of thiosulfinates, and GarliCell.
Source Naturals’ GarliCell features “no after-odor.” Each $14 bottle has 90 tablets; each tablet contains 6 mg (6000 mcg) of allicin along with 4.2 mg sulfur and 6 mg of thiosulfinates. Allicin is thought to possess the greatest activity of garlic’s various components. Early studies showed some pretty robust effects on cryptosporidiosis. Aside from anti-infective activity, there may be some benefit for maintaining a healthy blood lipid profile.


New Strengths + Sizes…

NYBC is now carrying a few new strengths and sizes of customer favorites. Our ever-popular “house brand” of CoQ10, Jarrow’s CoQ10 Q-Absorb, now is available in a very economical 120 x 100 mg softgel size for only $29. For those seeking a higher dose, we now also have CoQ10 400 mg (60 softgels) from Protocol for Life at $44.50.

curcumin-phytosome-jarrow-500-mg-60cNYBC has also picked up Jarrow Formulas‘ new Curcumin Phytosome (each cap 500 mg curcumin phytosome-phosphatidylcholine complex with 18-22% curcuminoids), a formulation that may further improve the absorption of curcumin. In the Ayurvedic tradition, recipes often include honey or black pepper, today known to enhance the body’s ability to absorb this increasingly important and well-researched anti-inflammatory agent.

Also new at NYBC…

calcium-blend-iron-free-easy-swallow-180A very moderately priced B100 (B Complex) from Twinlab for $11.75 that contains  100 mg of eachof the B-vitamins (and 100 mcg of B12). Each bottle, 100 capsules… Borage (Jarrow Formulas; 120 sg for $16.25) Provides one gram of polyunsaturated fatty acids from the Borago officinalis plant, including 240 mg of gamma linolenic acid (GLA/omega-3) and other fatty acids. This is a good source of GLA, especially in combination with flaxseed oil … New variation on SuperNutrition‘s Calcium Blend, an iron-free, easy-swallow formulation, same price ($14.25) and strength – just smaller (and more!) tablets.

In The News: CoQ10 Proves Its Worth Again

Heart To Heart: News & Tips For A Healthy Heart

New research on the supplement CoQ10, recently published in American and European medical journals, shows that it increases survival rates and decreases hospitalizations for people being treated for heart failure. CoQ10 (also called Coenzyme Q10, among other names) is a powerful antioxidant and acts as an essential factor in the heart’s energy production. In the past, clinical studies have provided evidence of its value as an adjunct treatment for angina, congestive heart failure, arrhythmia, and hypertension (high blood pressure). In addition, researchers have found that statin drugs deplete CoQ10, and so it has been suggested that people taking these cholesterol-lowering drugs should also use CoQ10 to support healthy heart function.

CoQ10 (also called Coenzyme Q10 and ubiquinone, among other names) is a powerful antioxidant and acts as an essential factor in the heart’s energy production. A naturally occurring and powerful antioxidant nutrient, it retards free radical formation in biological systems, and resembles vitamin E and vitamin K in chemical structure. Biochemically, it functions much like vitamin E in that it participates in antioxidant and free radical reactions. 

NOW AVAILABLE FROM NYBC’S ONLINE CO-OP:
Jarrow Formulas’ Q-Absorb, available in two strengths, utilizes a “completely natural proliposome lipid soluble delivery system clinically shown in humans to increase Co-Q10 levels up to 400% – three to four times better absorbed than chewable Co-Q10 tablets.” Price: $21- $29.

Douglas Labs’ Cardio Edge* employs plant sterols (phytosterols) from soy, Sytrinol (a proprietary extract of polymethoxylated flavones and tocotrienols from citrus and palm fruits), and pomegranate extract. Their Ultra Coenzyme Q10 ($121.60) has 60 chewable tablets with 200 mg CoQ10 combined with 500 mg lecithin.

* Note: Prices on Douglas Labs’ products are considerably lower for NYBC members!

The study lasted for two years and compared heart failure patients taking 100mg CoQ10 three times per day with patients who were not taking the supplement. By the end of the two-year period, the CoQ10 group showed a significantly lower rate of hospitalization for heart failure, significantly better functional capacity, and a significantly lower rate of death from cardiovascular disease.

NYBC has stocked CoQ10 since our founding, and has recently expanded its offerings. We’re happy that we’ve been able to provide this important supplement at discounted prices to our members over the years, and we’re happier still to see this new research strengthening the case for a supplement that already had a considerable amount of evidence demonstrating its benefit for heart health.

Here are some additional NYBC suggestions for cardiovascular health. All are based on our reading of the always-evolving research on nutrition and nutritional supplements:

Eating fatty fish (such as wild salmon) once or twice a week is an excellent approach to maintaining cardiovascular health; however, regular supplementation with fish oil can also provide the omega-3 fatty acids (called DHA and EPA) that have been closely linked to cardiovascular benefit. Note that supplements, when properly purified, avoid the problem of mercury contamination, a concern for those who eat sea food regularly.

Niacin, a B vitamin, is still one of the best agents for supporting cardiovascular health. In a long-term study, it was associated with lower risk of cardiovascular disease and death related to cardiovascular disease. (Don’t be misled by some recent reports about Niacin’s lack of effect, which only appeared in a study using a particular form of the supplement together with a statin drug.) The main drawback of Niacin is that it may cause flushing and itching, which make it difficult or impossible for some to take. Starting with a low dose of about 100 mg and working up to about 1,000 mg per day may minimize this reaction.

Other helpful agents include carnitine (which may lower triglycerides), pantethine (a B vitamin) and phytosterols, such as those in Douglas Labs’ CardioEdge.

Acetylcarnitine Gets Credit

Don’t let the icky generic packaging fool you! All NYBC products and vendors are carefully vetted and hand-picked. The manufacturer here, Montiff, produces our “house brand,” N-Acetyl-L-Carnitine (90 capsules; 500 mg ea acetyl-L-carnitine), as well as our proprietary ThiolNAC (which we unfortunately just ran out of stock of).

 

Longtime NYBC Favorite for Neuropathy Gets Its Due

A 2013 review by neurology experts found confirmation of the benefits of acetylcarnitine (also called N-acetyl-L-carnitine) supplementation for diabetes-related neuropathy (=nerve pain and damage), for HIV and antiretroviral therapy-related neuropathies, for neuropathy caused as a side effect of chemotherapy, and for neuropathy caused by compression (like sciatica). According to the review, acetylcarnitine “represents a consistent therapeutic option for peripheral neuropathies.”

Furthermore, recent research on acetylcarnitine has provided new insights into how the supplement works to diminish the pain of neuropathy and promote the regrowth of damaged nerve tissue.  That’s why the authors of the review conclude that the recently expanded knowledge about acetylcarnitine’s mechanism of action can open up “new pathways in the study of peripheral nerve disease management.”

We’re glad to see confirmation of earlier findings about the value of this supplement for conditions like the peripheral neuropathy experienced by people with HIV—NYBC has been recommending it for that purpose for many years.

We hope that this review will lead to even wider recognition in the medical community of the value of acetylcarnitine as a therapy for neuropathy.  It’s time this supplement got its due!

 

Want to know more about amazing acetylcarnitine?
This blog has 26 related articles about acetylcarnitine!

Over 50 And Poz? Join The Club!

Insights on HIV+Aging From Our Resident Expert

Bette Davis was famous for her quip that “Old age ain’t no place for sissies.” Well, many of us, sissies or not, are getting there anyway, and Bette had no idea what kind of challenges would arise with HIV added to the mix.

NYBC is for anyone, with any chronic condition, who wants to maintain health. As a gay man living with hepatitis C, it has helped me enormously to keep my liver in good shape, bloodwork normal, and viral load extremely low. But we formed in the era of HIV. Members of NYBC’s Board of Directors and many in our membership are living with HIV and that remains a priority. Those who survived that era, and a new generation, are now all in mid-life or later, and rightfully full of questions.

The good news is that more and more people with HIV are living into old age. But, as our 2013 HIV+Aging event with ACRIA’s Dr. Stephen Karpiak underscored, there are many challenges that may arise. Some of these are familiar to older folks, but may appear earlier or more aggressively for those who are HIV+.

Much can be done to address these issues, especially by preventing them from arising in the first place. Prevention and mitigation strategies can start when you note risk factors in bloodwork or changes in your physical or mental and emotional condition. At our HIV+Aging event on December 2, NYBC presented comprehensive and holistic methods and means you may use to make life more livable. The information from the presentations available online and through printed summaries.

As always, the first step is you. How are you? How is your weight? Energy? Sexual energy (libido)? Muscle strength and tone? Thinking? Feeling and emotional state? Is there any pain? How is your bloodwork? 

Of course, it is becoming abundantly clear how vital diet and exercise are at the outset. There’s no one simple answer here, and that fact can be a big barrier or challenge for many people. Find help if you need it – but this can also be a place of great self-empowerment. Not just in the things you try to avoid (processed foods, soda, etc.), but in the things you choose to eat. And the good news is that there are many delicious and healthier choices.

A good rule of thumb is just to eat more fruits and vegetables, preferably fresh (or frozen, rather than canned). Fruits such as apples and berries are incredibly high in good phyto-nutrients, as are green and leafy vegetables such as kale and broccoli, and red, orange and yellow fruits and vegetables such as beets, carrots, and winter squash. These veggies are also a great source of the all-important fiber you need for good digestive function! You might think that watery fruits and veggies, such as watermelon, cucumber, and celery, are lower in nutrients, but on the contrary – they are among the most nutritious. Be sure to include legumes in your diet: beans of all kinds are among the healthiest foods you can eat.

Exercise is also something each of us needs to work on. Walking whenever possible, for example. Cycling, swimming or just doing exercises at home can make a very big difference not just for energy and lean tissue, but all the way down to the cellular level, helping your cells’ powerhouses, the mitochondria.

More and more research is pointing to an underlying common problem: inflammation. This is tested for in a variety of ways, mostly by bloodwork. Even when you are on a good regimen of antiretrovirals (ARV) that suppresses the viral load below detectability, the virus is still there and active. It is causing the body to respond in ways that continue to send out inflammatory signals.

These inflammatory processes have been associated with liver and kidney problems, gut trouble (where most of the HIV virus resides), digestive problems, neurological disease (from neuropathy to cognitive impairment), sugar control (diabetes), hormonal problems (low testosterone), and heart and cardiovascular risks.

Indeed, the cardiovascular risks that people with HIV face are heightened and significant. This is where bloodwork plays a key role. Get complete copies. and work with your doctor to understand it. Is your cholesterol high? What is your LDL (“bad cholesterol”) level? Is your “good cholesterol” (HDL) high enough? What is your vitamin D level? There are some other tests your doctor may consider that can help you understand how your blood moves, such as d-dimer and CRP (or hsCRP).

There’s a wide array of dietary supplements that may help you to address underlying inflammation, and data for some of these agents has been accumulating over the years and show good benefit. The very first is the use of a good, potent multivitamin/mineral formula to provide the essential building blocks your body needs. Even for people who are not on ARV, this simple intervention has been shown to significantly reduce the rate of disease progression to AIDS.

Other elements of a core anti-inflammation protocol include: fish oils (for blood fats and also, perhaps surprisingly, depression), niacin (for LDL and HDL), alpha lipoic acid and N-acetylcysteine (NAC) for inflammation, and acetylcarnitine for neuropathy.

More and more data are coming out on how important the “good” bacteria in our guts are and the value of using probiotics (like acidophilius or bifidus) in helping to heal the lining of the gut. Low Vitamin D levels in HIV have been linked to a wide range of problems, including more rapidly thinning bones. Having not just the D3 and calcium, but a good formula to help bone function, along with resistance exercise, can help keep your skeleton strong.

There’s much more than we can cover here. Crafting a regimen and approach that works for you, allowing that to evolve and develop over time will help to assure that you are, and remain, in the best health possible… so that you can get on with your life! And we hope that our summary of the key nutrients and agents that show benefit will help you on your way.

We are happy to discuss any questions you have to help you in making treatment choices. Consultations are free. Email us questions via the form below, or schedule a time to speak on the phone by leaving a message at (800) 650-4983.

george-m-carter

George Carter
Treatment Director, New York Buyers’ Club