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 Carter
Treatment Director, New York Buyers’ Club
New York Buyers' Club - The Blog 
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