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



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.

NAC (N-acetylcysteine) – Clinical Summary from Sloan Kettering Memorial Cancer Center’s Integrative Medicine website

NAC (N-acetylcysteine) has been much studied as a dietary supplement, and is more widely used in Europe than in the US, especially for conditions such as chronic bronchitis or as an antidote to acetaminophen poisoning. Its usefulness for people with HIV has been investigated (sometimes contentiously) by many reseachers in the past two decades. One way to bring the discussion up to date, while also giving the broadest overview of NAC’s applications and potential applications, is to refer to the entry found on the Sloan Kettering Memorial Cancer Center’s Integrative Medicine website–an online resource well worth consulting. (Note: references for this summary are found on the SKMCC website, which is reviewed frequently–this clinical summary, accessed 1/31/2008, was updated within the last two months.)

Clinical Summary

Endogenous antioxidant and precursor to intracellular glutathione. N-acetylcysteine (NAC) is used to prevent exacerbations of chronic bronchitis, treat drug-induced hepatotoxicity, and prevent and treat conditions of oxidative stress and reduced glutathione levels, such as HIV/AIDS, cancer, and toxicity from chemo- or radiotherapy. NAC increases plasma levels of cysteine and glutathione and has antioxidant, nucleophilic, mucolytic, and possibly chemopreventative properties. Animal models suggest anti-carcinogenic, antimetastatic, and antiangiogenic activities. Oral bioavailability is low. Studies in smokers and patients with history of adenomatous colonic polyps show an inhibition of cancer biomarker development, although NAC did not inhibit formation of secondary head and neck or lung tumors in a EUROSCAN trial. 400-1200 mg/day NAC reduces the number of acute exacerbations in patients with chronic bronchopulmonary disease, but little clinical effect on lung function is seen in patients with cystic fibrosis. NAC raises GSH and cysteine levels in HIV+ patients, but shows no effect in Lou Gehrig’s disease. Human studies evaluating the role of NAC in the prevention of chemo- or radiotherapy induced toxicities are inconclusive. Gastrointestinal side effects are most often reported.

And here’s a study, limited in its goals, but with an interesting specific finding about using NAC at the start of antiretroviral treatment in HIV:
The effect of N-acetylcysteine supplementation upon viral load, CD4, CD8, total lymphocyte count and hematocrit in individuals undergoing antiretroviral treatment
Spada C, Treitinger A, Reis M, et al. Clin Chem Lab Med 2002;40:452-455.
Individuals infected with the human immunodeficiency virus (HIV-1) present with decreased CD4, a progressive increase in viral load, compromised cell immune defense, and hematologic alterations. The aim of this study was to assess the serum viral load, CD4, CD8, lymphocyte count and hematocrit at the beginning of antiretroviral therapy in individuals who were supplemented with N-acetylcysteine (NAC). Twenty volunteers participated in this double-blind, placebo-controlled 180-day study. Ten participants received 600 mg of NAC per day (NAC group) and the other ten serving as a control group received placebo. The above mentioned parameters were determined before treatment, and after 60, 120 and 180 days. In NAC-treated patients hematocrit remained stable and an increase in CD4 cell count took place earlier than that in the control group.

NYBC Offers a Low-Cost Alternative to K-PAX

 K-PAX, a multi-supplement pack, was developed following Dr. Jon Kaiser’s study that found an increase in CD4 count among HIV+ individuals using this mix of a potent multivitamin and antioxidants. (Dr. Kaiser was hardly new to the field of nutritional supplementation for people with HIV/AIDS—see his book Healing HIV: How To Rebuild Your Immune System, which was based on many years of clinical experience with hundreds of patients and still, in our judgment, has many valuable insights about everything from assessing and managing gastrointestinal problems, to exercise and diet for people with HIV.)  

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 become an issue. For example, the price for the double strength K-PAX formula is about $140 per month, not an insignificant amount for anyone on a budget and dealing with the usual extra healthcare-related costs. That’s why NYBC has designed an alternative to the double-strength K-PAX formula, based on products and prices currently available through our nonprofit purchasing coop. Here’s our suggestion, which is not a precise, 100% match of the K-PAX, but does, we feel, provide a close equivalent–and at a much lower cost:

Acetylcarnitine – 3/day – one month supply = $15.50 (one bottle; 500mg/90)
Lipoic  – one/day – one month supply = $7.50 half a bottle; 300mg/60)
NAC – 3/day – one month supply = $11.25 (one bottle; 500mg/90)
Vit B6 (pyridoxal-5’-phosphate/P5P) – 3/day – one month supply = $7.85 (one bottle; 50mg/100)
Vit B12 (methylcobalamin) – 2/day – one month supply = $3.75 (actually, les than half a bottle; 1000mg/100)
Added Protection (or Ultra Preventive Beta) – 6/day – one month supply = $14.00 ($17.00 for UPB) (one bottle; 180)

Total monthly cost of the NYBC multivitamin-antioxidant package is $59.85. (The intial cost, since you use only half a bottle to make a monthly supply of some items, is $71.10.) This is HALF THE PRICE of the double-strength K-PAX.  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’re just interested in matching the K-PAX formula, but three or more can help if you’re 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 trouble, this might NOT be a good idea. With the multivitamin Added Protection, you can choose whether to take iron or not. And Ultra Preventive Beta, another Douglas Labs multi, offers in addition to a standard multivitamin formula a variety of food-based nutrients, for an additional $3 per month. 
If you’d like more information on NYBC’s low-cost alternative to K-PAX, or if you’d like help in ordering the alternative package, please email us at contact@newyorkbuyersclub.org and we’d be glad to assist.