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!
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 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.
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!
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 Carter Treatment Director, New York Buyers’ Club
Advances in treatment for HIV, hepatitis C, and other serious illnesses have been made over the last decade, and that’s good news! Many people also utilize nutritional supplements and other forms of integrative medicine to complement standard medical treatments, ameliorate adverse side-effects, and maintain health and well-being. However, many lack information and evidence about those approaches, and have difficulty affording them, since health insurance doesn’t usually provide coverage.
Two decades ago, in the darkest days of the AIDS epidemic, patients and their allies took action: we researched all kinds of possible treatments that might help – some proved helpful, others not. We also formed “buyers’ clubs” to provide information about and distribute experimental drugs, vitamins, and herbs. Thousands of lives were extended and saved. The award-winning film, “Dallas Buyers Club,” tells a story of one of them. Today, only one of these groups survives: We are New York Buyers’ Club.
Making available fully vetted, high-quality nutritional supplements at the lowest possible prices, and
Researching, simplifying, and disseminating the latest on how supplements can be powerful tools to reduce symptoms and drug side effects, and educating people about the most effective ways to use them – information accessible via our website, blog, newsletter, and social media.
NYBC offers online mail orders of more than 200 nutritional supplement products. Over the past decade, thousands worldwide have become Club members and benefited from our purchasing co-op and educational services. Our members especially value our personalized customer service to answer or research anyone’s questions.
New York Buyers’ Club is a vital resource for many people with serious illnesses such as HIV and hepatitis C. We have much potential to serve many more with other diseases such as cancer, diabetes, and heart disease. The evidence mounts daily about the power of nutrients to enhance health and well-being, and reduce the adverse side effects of standard medical treatments.
Your support for NYBC’s 2015 Indiegogo campaign will enable us to:
Compile more of the latest research on using nutrition to support people with chronic illnesses
Publish our SUPPLEMENT newsletter on complementary care more often
Mount a national campaign to promote membership in our purchasing co-op
Continue to improve our use of state-of-the-art digital technologies to put forth clear nutritional info
Engage various disease groups to build partnerships
Expand our efforts to attract major donors for new projects
Develop new efforts to address the crisis in access to affordable hepatitis C medicines
Your contributions are fully tax-deductible. We are the ONLY remaining non-profit buyers’ club in the USA helping people with serious illnesses. Thank you for your support to keep us going and growing!
You may have heard some recent reports on Niacin (one of the B-vitamins) that seemed to suggest it wasn’t of benefit for cardiovascular disease. Actually, the recent studies fueling these reports only looked at certain special forms of niacin taken together with a statin drug. These studies proved a disappointment to the statin drug makers, because the research didn’t show any additional benefit in adding the niacin. (By the way, some researchers have pointed out problems with the special forms of niacin used in these studies.)
Given the confusion in some news reports about Niacin, we at NYBC think it’s important to repeat what researchers stated about Niacin in a March 2014 article in the Journal of Cardiovascular Pharmacology and Therapeutics. This article reviewed the recent Niacin studies, and also reiterated the well-known and well-documented benefits of Niacin for cardiovascular health:
1. In a long-term study called the Coronary Drug Project, “niacin treatment was associated with significant reductions in cardiovascular events and long-term mortality, similar to the reductions seen in the statin monotherapy trials.”
2. “In combination trials, niacin plus a statin or bile acid sequestrant produces additive reductions in coronary heart disease morbidity and mortality and promotes regression of coronary atherosclerosis.”
3. Niacin is the “most powerful agent currently available” for RAISING levels of HDL-C (high-density lipoprotein cholesterol, the so-called “good cholesterol”); and it can also REDUCE levels of triglycerides and LDL-C (low-density lipoprotein cholesterol, the so-called “bad cholesterol”).
Here’s the reference for these three important points about Niacin:
Boden, W E, Sidhu M S, & Toth P P. The therapeutic role of niacin in dyslipidemia management. J Cardiovasc Pharmacol Ther. 2014 Mar;19(2):141-58. doi: 10.1177/1074248413514481.
SUPPLEMENT: Newsletter of the New York Buyers’ Club is back again and feeling the love – thanks to those who made our recent indiegogo campaign a success! All articles are archived here on our blog, or you can download the printer-ready version.
The movie Dallas Buyers Club scored a couple of splashy wins at the Oscars on March 2: Best Actor for Matthew McConaughey (playing Ron Woodroof, the cantankerous founder of the early AIDS buyers’ club); and Best Supporting Actor for Jared Leto (playing Rayon, a transgender HIV+ woman who becomes Woodroof’s sidekick). Bravura performances indeed, and controversial, too (just read the blogs!).
Meanwhile for us at the New York Buyers’ Club… real life goes on. We think Dallas Buyers Club does an important job in casting its bright Hollywood lights on the work of buyers’ clubs in the fight against HIV/AIDS, beginning in the early days of the pandemic. But here at NYBC –the last HIV/AIDS buyers’ club standing- we would like to present our own award: to YOU! For being an NYBC member, and thereby participating in a long-running community effort to distribute the best available information about managing symptoms and side effects of HIV and HIV meds, while also helping to make beneficial supplements widely accessible through a nonprofit co-op. And a special thanks to the many contributors out there who lent their financial support to NYBC’s recent successful fundraising campaign—you’re our equivalent of the Hollywood producer, without whom the magic can’t happen!
Of course much has changed, and a great deal has changed for the better, since the days depicted in Dallas Buyers Club. Some may even ask why we need a buyers’ club, given that HIV meds have advanced so much in the past 20 years. Unlike Ron Woodroof’s Dallas Buyers Club, NYBC is not importing unapproved drugs or trying novel therapies—that desperate search for any sort of treatment has abated (at least in the wealthier countries). We can look back at the time when New York was home to the PWA Health Group and DAAIR (from which NYBC arose), and there were buyers’ clubs for people with HIV/AIDS in Boston, Houston, San Francisco, Chicago, Atlanta, and Phoenix, among other places. But what need does the New York Buyers’ Club fill today?
Some ask why we need a buyers’ club,
given that HIV medshave advanced so much
in the past 20 years?What need does
the New York Buyers’ Club fill today?
Well, recent research brings into sharper focus what we have understood for quite a while: living long term with HIV is a huge challenge. Antiretroviral (ARV) therapy works to reduce the risk of an AIDS-defining illness to nearly zero, while offering the prospect of a normal life span. But problems abound. First, several non-AIDS-defining conditions become more common. These include several cancers, some stemming from infections like HPV. Then there are the longer term effects of ARV, which can threaten quality of life and increase mortality risk, including challenges to the cardiovascular system, nerves, cognitive function, liver, kidneys, and bones.
These side effects are being understood today by some old mechanisms that are getting new attention. At NYBC’s community event on HIV and Aging, held last March, our speaker Steve Karpiak, Ph.D. emphasized the inflammatory processes that continue throughout HIV infection and the cascade of damage that persistent inflammation causes, even as ARV therapy holds the virus in check. And just last October, we were interested to read a comprehensive review on the health effects of chronic inflammation during HIV infection. According to this overview, many markers of inflammation remain high during HIV infection, and those inflammatory problems are linked to elevated risk of cardiovascular, liver, kidney, bone, and neurologic diseases. But none of this is really news to us: addressing the chronic inflammation that accompanies HIV has been central to our work at NYBC—and between those of us at NYBC and those who go back to DAAIR days, we’ve been addressing this model of the disease for over 20 years!
Probiotics may help in countering
the damaging inflammatory processes that are found in HIV infection,
even when the virus is held in check by meds.
The recent review of inflammation effects during HIV did suggest that probiotics, for example, may hold promise for countering inflammatory processes that are concentrated in the gut. Indeed, probiotics have been a staple in the NYBC catalog from the start, even when we were simply recommending them to support gastrointestinal health and improve absorption of nutrients. Now we’re looking forward to new research on supplements, which in this case may help us understand the additional benefits of probiotics as anti-inflammatories. Meanwhile, NYBC continues to search out the latest news about a wide array of topics, from hepatitis C coinfection, to alternative treatments for sleep and mood disorders, to the value of a daily multivitamin + selenium for people with HIV.
In conclusion (music coming up now, so we must hurry), see Dallas Buyers Club, both for the Oscar-winning performances, and for its slice of history about HIV/AIDS buyers’ clubs. But please remember to think of the New York Buyers’ Club as well, and what it’s doing for you today!
Enid Vazquez. “Houston Buyers Club: Desperate Days Beyond Dallas.” Positively Aware, Jan-Feb 2014.
An excellent review of Dallas Buyers Club, with much background on the HIV/AIDS buyers’ club movement
Deeks, Steven G et al. “Systemic Effects of Inflammation on Health during Chronic HIV Infection.” Immunity, October 17, 2013
At the end of 2013, there was much buzz about new studies showing that curing insomnia in people with depression might double the chance of a complete recovery from depression. The studies, financed by the National Institute of Mental Health, were welcomed as the most significant advance in treating depression since the introduction of the “selective serotonin re-uptake inhibitor” (SSRI), Prozac, twenty-five years ago. In effect, the new research findings turn conventional wisdom on its head, since they suggest that insomnia can be a main cause of depression, rather than just a symptom or a side effect, as previously assumed. If you can successfully treat a depressed person’s insomnia, according to the new view, you eliminate one of the main factors causing the depressed state.
New research findings turn conventional wisdom on its head suggesting that insomnia can be a main cause of depression rather than just a symptom or a side effect as previously assumed
As we followed reports on this breakthrough research on insomnia and depression, we were especially encouraged to read comments like the one from Washington DC psychiatrist James Gordon, who has advocated an integrative approach to treating depression. Here’s his letter to The New York Times:
I welcome a new report’s finding that cognitive behavioral therapy is improving the outcome for depressed people with significant insomnia (“Sleep Therapy Seen as an Aid for Depression,” front page, Nov. 19).
It reminds us that changes in attitude and perspective, and a therapeutic relationship, can right biological imbalances — like disordered sleep — and significantly enhance the lives of troubled people. The study also puts the therapeutic role of antidepressant medication in perspective: the depressed participants who received behavioral therapy did equally well whether or not they were taking the drugs.
I hope that these results will encourage the National Institute of Mental Health, researchers, clinicians and all of us to expand our horizons.
There are a number of other nonpharmacological therapies, including meditation, physical exercise, dietary change and nutritional supplementation, acupuncture and group support, that show promise for improving clinical depression and enhancing brain function.
At NYBC we have long believed that non-prescription therapies, such as supplements, are valuable alternatives for treating mood disorders and sleep disorders When the Centers for Disease Control surveyed use of antidepressant drugs in 2008, it found that one in 10 Americans was taking an antidepressant, and many had taken these drugs for years. Over a period of ten years, antidepressant use in the U.S. had shot up by 400%! So the question arises: how much of this spectacular increase represented real gains in treatment, and how much was over-prescribing? As Dr. Gordon mentions in his letter above, in some cases behavioral therapy for depression has worked just as well whether people were taking antidepressants or not—hardly a strong argument for the value of the prescription drugs.
A well-publicized 2008 report in the New England Journal of Medicine found that pharmaceutical companies had consistently reported only the most favorable trial outcomes for their popular antidepressants
A well-publicized 2008 report in the New England Journal of Medicine found that pharmaceutical companies had consistently reported only the most favorable trial outcomes for their popular antidepressants, passing over evidence that suggested a more limited effectiveness. Furthermore, as with many drugs, especially those used over a long period, antidepressants have side effects. Higher bone fracture risk and multiple cardiovascular risks have been identified; sexual side effects are common with antidepressants in both men and women; and withdrawal symptoms for those tapering off antidepressants include a long list of problems, such as panic attacks, insomnia, poor concentration and impaired memory.
Turning to the alternatives, we describe below supplements that NYBC has highlighted over the years for sleep and mood disorders. Note cautions about their use, but also note that some of these products may actually carry added benefits, rather than unwanted side effects.
1. Melatonin is a hormone occurring naturally in the body, but some people who have trouble sleeping have low melatonin levels. Melatonin has been used for jet lag, for adjusting sleep-wake cycles for people doing shift work on varying schedules, and for insomnia, including insomnia due to high blood pressure medications called beta-blockers. It is also used as a sleep aid when discontinuing benzodiazepines (Klonopin, Xanax, etc.) and to reduce side effects when quitting smoking.
2. Fish Oil. Epidemiologists have noted that populations that eat fish regularly have low rates of depression. And research has found that omega-3 fatty acids in fish oil supplements can be of benefit in treating depression and bipolar disorder. Fish oil can also be taken with other anti-depressants as an adjunct therapy. Doses found effective in treating depression are quite high, 3 to 9 grams per day, so be aware of potential problems related to the supplement’s blood-thinning properties. Added benefit: fish oil can help manage cholesterol, and supports cardiovascular health.
3. Deficiencies in the B Vitamins, especially B12 and folate, can result in neurologic symptoms — for example, numbness, tingling and loss of dexterity — and the deterioration of mental function, which causes symptoms such as memory loss, confusion, disorientation, depression, irrational anger and paranoia. A number of studies have shown that vitamin B12 is deficient in a large percentage of people with HIV, and the deficiency can begin early in the disease. Supplementing with a B complex protects against deficiency and supports cognitive health and mental function.
4. Vitamin D deficiency has also been linked to depressed states. Lack of the “sunshine vitamin” may be especially associated with Seasonal Affective Disorder (SAD), the “winter blues.” Vitamin D also supports bone health, and may protect against colds and flus.
5. Theanine, an amino acid found in green tea, acts as a relaxing agent by increasing levels of certain neurotransmitters (=brain chemicals that shape your mood), including serotonin, dopamine, and GABA (gamma amino butyric acid). Human studies have been limited to date, but one small study showed that theanine decreases stress responses such as elevated heart rate. Another investigation compared theanine’s calming effect to that of a standard anti-anxiety prescription drug, and found that theanine performed somewhat better. Note that NYBC stocks Theanine Serene (Source Naturals), a combination supplement that includes theanine and GABA.
6. Probiotics. Very recent research has looked into the communication between the digestive system and the brain, with a goal of understanding how gut health may influence chronic conditions, including mood disorders like depression and anxiety. For example, it has been shown that certain probiotics promote production of the calming, anti-stress neurotransmitter GABA in the body, pointing to a direct influence of probiotics on mood. Other potential links between the gastrointestinal system’s microorganisms and brain function are currently being explored.
7. L-Tryptophan and 5-HTP (5-hydroxy L-tryptophan). These closely related supplements are converted in the body to serotonin and to melatonin. (Take L-tryptophan with carbohydrates to make it effective.) Their use as antidepressants has been studied, and they have also been found to aid sleep and suppress appetite. (To minimize appetite suppression, take the supplement an hour before bedtime.) Although L-Tryptophan and 5-HTP are close relatives, people may respond somewhat differently to them, so it may be worthwhile to try the other if the first doesn’t produce an effect An added benefit: 5-HTP may also decrease symptoms of fibromyalgia and migraine headaches.
8. In research funded by the National Institute of Mental Health, DHEA (dehydroepiandrosterone) was found to be an effective therapy for mild-to-moderate or severe midlife depression, on par with some prescription drugs. Moreover, the research showed that taking DHEA promoted both a significant lifting of depressive symptoms and an improvement in sexual functioning. Note that dosing recommendations vary for men versus women, and DHEA is not recommended for those diagnosed with prostate conditions or cancer.
9. SAMe (S-adenosyl-l-methionine) is produced naturally in the body from the amino acid methionine. Supplementing with SAMe increases concentrations of the neurotransmitters serotonin and dopamine. Several studies show SAMe having an antidepressant effect comparable to that of some prescription drugs. SAMe should be avoided in people with bipolar disorder, and should be used cautiously with other antidepressants, because the combination may push serotonin levels too high. Taking a B-complex vitamin while using SAMe can counter build-up of homocysteine, which has been linked to heart disease SAMe may also support joint health and liver function. Caution: the National Center for Complementary and Alternative Medicine has posted a warning that SAMe may increase likelihood of pneumocystis infection in immune-compromised people. Note: see also Trimethylglycine (TMG), which includes the raw materials that the body uses to manufacture SAMe. TMG is much less expensive than SAMe.
10. St. John’s Wort is a widely used herb with clinically demonstrated (multiple, well-controlled studies, mostly in Europe) anti-depressant effects for mild to moderate depression – generally without the side effects of prescription antidepressants. High doses of the herb may cause a sensitivity to light (phototoxicity), so avoid direct sunlight or sunbathing while using. Do not take St. John’s Wort with 5-HTP, serotonin re-uptake inhibitors (like Prozac), or with protease inhibitors, as it may affect beneficial liver enzymes. St. John’s Wort may also have activity against Epstein-Barr and herpes infections.
11. Finally, we’ll mention another combination supplement that NYBC has stocked: GABA Soothe (Jarrow). The GABA in this supplement is the neurotransmitter that promotes calmness coupled with mental focus. Also included is theanine (see above for a description of its anti-anxiety effects) and an extract of ashwagandha, an herb which has long been used in the Ayurvedic tradition of India to reduce fatigue and tension associated with stress.
Turner, E et al. Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy. New England Journal of Medicine, 2008; 358:252-260 January 17, 2008 doi: 10.1056/NEJMsa065779
Logan, A.. Omega-3 fatty acids and major depression: A primer for the mental health professional. Lipids Health Dis. 2004; 3: 25; doi: 10.1186/1476-511X-3-25
Sudden cardiac death secondary to antidepressant and antipsychotic drugs, Expert Opinion on Drug Safety, March 2008; 7(2):1081-194
Alramadhan E et al. Dietary and botanical anxiolytics Med Sci Monit. 2012 Apr;18(4):RA40-8.
Rogers PJ, Smith JE, Heatherley SV, Pleydell-Pearce CW. Time for tea: mood, blood pressure and cognitive performance effects of caffeine and theanine administered alone and together. Psychopharmacology (Berl) 2008;195(4):569–77.
Kimura, K et al. L-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2007 Jan;74(1):39-45.
Carpenter, D J. St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Rev. 2011 Mar;16(1):17-39.
Foster, J A et al. Gut-brain axis: how the microbiome influences anxiety and depression Trends in Neuroscience. 2013 May;36(5):305-12. doi: 10.1016/j.tins.2013.01.005.
Rao, A V & Bested, A. A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome. Gut Pathog. 2009; 1: 6 doi: 10.1186/1757-4749-1-6
We’re tempted to file this story under the heading of “news that we already knew,” but it’s still good to get a stamp of approval in the form of publication in Journal of the American Medical Association (JAMA), one of the top medical journals in the U.S., if not the world.
At NYBC and at our predecessor DAAIR we have long recognized the development of vitamin and mineral deficiencies in HIV, and have long recommended multivitamin/mineral supplements to counter those health-threatening deficiencies. We have also followed for years the work of Marianna Baum, lead author of the JAMA study, who has focused attention on the mineral selenium, which may have an important role in preventing replication of HIV. So, while this story doesn’t come as a complete surprise, it’s great to have further support for some long-held practices.
The combination of a daily multivitamin
plus the mineral selenium proved to be an effective regimen,
cutting by about half the risk of reaching the point
where ARV therapy would be recommended
Baum’s study was conducted in Botswana, where nearly one in four adults is infected with HIV. The trial followed about 900 newly infected adults who were not yet taking any HIV medications. These participants were divided into groups that randomly received different combinations of vitamins, the mineral selenium, or a placebo. Over the study’s two-year period, the combination of a daily multivitamin plus the mineral selenium proved to be the effective regimen, cuting by about half the risk of reaching the point where ARV therapy would be recommended in Botswana (CD4 count of 200-250).
Baum’s findings are especially relevant for early-stage HIV infection, where the multivitamin + selenium combination proved its value in cutting risk of progression, and actually decreased the likelihood that participants would reach the point where antiretroviral meds would be recommended. Other research, such as Dr. Jon Kaiser’s study of a multivitamin + antioxidants, has been directed at those who are using antiretroviral meds, and may have developed some symptoms or side effects such as peripheral neuropathy. Kaiser’s finding that the multivitamin + antioxidants combination could increase CD4 counts led to the development of K-PAX, and also motivated NYBC to offer its MAC Pack, a close equivalent of K-PAX, assembled from hand-picked products from NYBC’s catalog.
Taken together, the Baum and Kaiser studies suggest to us the value of long-term supplementation strategies that can slow progression of HIV, oppose the known, damaging deficiencies that are likely to develop with HIV, and help stabilize and even improve health for people with HIV, whether they are taking antiretroviral meds or not.
If you’d like to get started with NYBC’s MAC-Pack, or if you’d like to find a multivitamin + selenium combination, please visit our website. You can also call our toll-free number at (800) 650-4983 for further information and advice about supplement strategies for HIV.
Baum, M. et al. Effect of Micronutrient Supplementation on Disease Progression in Asymptomatic, Antiretroviral-Naive, HIV-Infected Adults in Botswana: : A Randomized Clinical Trial. JAMA. 2013;310(20):2154-2163. doi:10.1001/jama.2013.280923.
Kaiser, J. 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: 523-528.
A vast review of studies on Vitamin D has concluded that people with low levels of the vitamin had a 35 percent increased risk of death from heart disease, a 14 percent higher risk of death from cancer, and a greater risk of death from all causes as well.
The authors of this review, who came from a wide range of European and US universities, also looked at the usefulness of supplements, and found that there was no benefit from taking Vitamin D2. However, when they studied middle-aged and older adults who took Vitamin D3, they found an 11% reduction in risk of death from all causes. They also estimated that up to two-thirds of the people in Europe and the US are deficient in Vitamin D, and they calculated that about 13% of all deaths in the US, and about 9% of all deaths in Europe, are linked to low Vitamin D levels.
NYBC’s comment: This review suggests that it is crucial to supplement with Vitamin D3—-which is the type of Vitamin D stocked by NYBC. Older forms of supplementation, such as Vitamin D2-fortified milk, may not have benefit, according to this research. Secondly, though some have argued that low Vitamin D may simply be a side effect of disease processes that can’t be reversed by supplementing, we believe that this study also offers evidence that, especially when people are known to be deficient in Vitamin D (as is often the case in older populations, or among HIV+ people), supplementing with D3 has the potential to reduce disease risks, and indeed may reduce the overall risk of mortality.
See NYBC’s catalog for more detailed recommendations on Vitamin D3 supplementation:
Chowdhury, R et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ April 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g1903
A preliminary study that will be presented at the American Academy of Neurology meeting in April-May 2014 suggests that being deficient in Vitamin C raises your risk for a stroke. The lead researcher of the study, Dr. Stéphane Vannier, M.D., of Pontchaillou University Hospital in France, said that the research pointed to Vitamin C deficiency as a risk factor for the often deadly hemorrhagic type of stroke, just like high blood pressure or being overweight. He also called for further research to identify exactly how Vitamin C levels affect stroke risk (for instance, as an influence on blood pressure).
This study finds still another negative consequence of Vitamin C deficiency, since low Vitamin C levels have also been linked to anemia, a lower capacity to fight infection, lower wound healing capacity, gingivitis, and joint pain. Vitamin C is found in many fruits and vegetables, including oranges and peppers, and can also be obtained through supplementation.