We be JAMA! Report: Multivitamin + selenium slows progression of early-stage HIV

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.

supplement-header-2014
This article from the Spring 2014 edition of SUPPLEMENT: Newsletter of the New York Buyers’ Club, available for download at http://www.NewYorkBuyersClub.org

 

References:

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[5]: 523-528.

 

Top Ten Reasons to Support the New York Buyers’ Club

As we reach the finish of the New York Buyers’ Club fundraiser, we thought it was time to circulate the “Top Ten Reasons” to support NYBC–in case there are those of you out there who aren’t familiar with the unique contributions this nonprofit co-op and information exchange makes to the lives of people with HIV and/or Hepatitis C.

Learn more and make your donation at

http://www.indiegogo.com/projects/empower-people-with-hiv-hep-c-to-thrive

TOP TEN REASONS TO SUPPORT THE NEW YORK BUYERS’ CLUB

1. ThiolNAC. NYBC is the only source for this formula combining two widely recommended and well-researched antioxidants, alpha lipoic acid and NAC (N-acetylcysteine). ThiolNAC is especially useful for people with HIV and those with liver disease. NYBC’s combination formula reduces both cost and pill count.

2. NYBC stocks a unique lineup of high quality, specially formulated multivitamins, including Added Protection and Ultra Preventive Beta from Douglas Labs, and the Super Immune Multivitamin and Opti-Energy Easy Swallow from SuperNutrition, Member pricing for these multis is very low—in fact, Douglas asked us to hide the Member price from the general public!

3. NYBC’s MAC Pack and Opti-MAC Pack provide a mix of antioxidants and micronutrients very similar to those in K-PAX®, but at half the price. (Included in many formularies, K-PAX®, is based on Dr. Jon Kaiser’s 2006 journal article that reported an increase in CD4 count for people with HIV taking the nutrient combination.)

4. NYBC stocks a wide selection of Traditional Chinese Medicine supplements, from suppliers like Health Concerns, Pacific Biologic, and Zhang. (NOTE: Zhang products are available only if you log into the NYBC website as a Member.)

5. PharmaNAC®. This effervescent, extremely stable form of NAC (N-acetylcysteine) supports respiratory and immune function. In particular, it holds promise for people with cystic fibrosis, according to recent clinical trials conducted at Stanford. NYBC has stocked an effervescent form of NAC since 2004, based on its well-supported usefulness for chronic conditions.

6. NYBC specializes in probiotics like Florastor® and Jarro-Dophilus EPS. Probiotics support gastrointestinal health, a foundation for general health. And, a recent review in the Journal of the American Medical Association found probiotics effective for preventing and treating antibiotic-related diarrhea, a common side effect.

7. NYBC monitors and presents to its Members the latest research on supplements to support cardiovascular health, including fish oil, CoQ10, plant sterols, and Vitamin D.

8. NYBC annual membership is a tremendous bargain at $5 (low-income, unemployed), $10 (middle-income), or $25 (higher income). Do you know of any other organization that offers annual memberships as low as $5, yet gives you such significant savings?

9. The NYBC Blog alphabetically indexes more than 400 informative posts, providing the latest research news about supplements in an easy-to-read online format.

10. Yes, you can talk to a live person at NYBC! Our Treatment Director, George Carter, has two decades of experience with supplement research, especially for people with HIV and/or liver disease. Reach him at our toll-free number 800-650-4983.

NYBC Fundraising Campaign Almost There – Please Donate Today to Take Us Over the Top!


The New York Buyers’ Club, your community-minded nutritional supplements co-op, provides access to low-cost, high-quality supplements especially selected for people with HIV, Hepatitis C and other chronic conditions. NYBC also reports on the best and most useful scientific information on using supplements to stay healthy–see, for example, our previous post on a ground-breaking November 2013 study in the Journal of the American Medical Association, which points to an important role for multivitamins and selenium as a means to slow progression of HIV.


Please help us continue our important work—donate today:


DONATE TO NEW YORK BUYERS’ CLUB


(NYBC is a 501c3 nonprofit organization recognized by the IRS, so your contributions are tax-deductible!)


You can also visit the NYBC website and online catalog at

http://www.newyorkbuyersclub.org/

New study in Journal of the American Medical Association shows that a multivitamin + selenium slows progression of HIV

The Journal of the American Medical Association has published a new study showing that a multivitamin and selenium combination supplement significantly reduced immune decline and morbidity in people with HIV who were treatment naïve (=not on antiretroviral/ARV therapy). This was a two year study with individuals who had CD4 counts above the recommended threshold for beginning ARV treatment. Over the two-year period, the combination of a daily multivitamin plus the mineral selenium cut by about half the risk of reaching the point where ARV therapy would be recommended (CD4 count of 200-250).

This study shows the importance of daily multivitamin + selenium supplementation for HIV+ people who are recently infected and/or have relatively high CD4 counts. It also provides further confirmation of the value of multivitamin, multimineral supplement strategies like the one included in the NYBC MAC-Pack.

On the Importance of B Vitamins

We’ve adapted this piece from the NYBC Info Sheet on Vitamin B12.

We can now update the Info Sheet with recent reports on the importance of the B vitamins for cognitive health, a specific concern for people with HIV, but also a general concern for people as they age: https://nybc.wordpress.com/2011/03/31/supplements-for-the-brain-and-nerves/

NYBC members often supplement with B-right B complex and/or with Methylcobalamin, a form of B12 that is better absorbed by the body than other forms of B12.

B-12 may play a very critical role in preventing HIV disease progression: a large Johns Hopkins University study found that people with HIV who are deficient in B-12 have a two-fold increased risk of progression to AIDS. In this study, those who were B-12 deficient progressed to AIDS four years faster than those who were not. The exact mechanism by which adequate B-12 in the body may slow progression is not known, but the finding is not surprising, given all the roles B-12 is known to play in healthy human function.

B12 and another B vitamin, folic acid, are critical to prevent or eliminate the often-overwhelming fatigue that so often accompanies HIV disease, as well as to help prevent some forms of neuropathy and brain and spinal cord changes. Maintaining adequate B12 levels also supports the bone marrow’s production of blood cells (crucial to prevent white and red blood cell decreases), and helps protect the heart.

There are countless anecdotal reports from people with HIV that using B-12 supplementation has dramatically improved their lives by its ability to reverse fatigue, often restoring normal energy to people who had previously been so exhausted that their daily functioning had been greatly affected. Many people have also reported significant improvements in memory and mental functioning, improvements that have made a huge difference in daily life. The possibility that B-12 supplementation might also help prevent or reverse the spinal cord changes that can have such devastating effects on some people is also very encouraging.

B-12 and folic acid should always be given together. Doses of B-12 (1000 mcg given daily via pills, or one to several times weekly via prescribable nasal gel or injections) and folic acid (800 mcg daily via pills) may be useful for restoring energy, treating neuropathy, protecting the heart, increasing overall feelings of well being, and boosting mental function (especially when combined with thiamin, niacin, and folic acid, since all four of these B vitamins are needed for normal neurological function) even when tests don’t indicate obvious deficiencies.

Deficiencies of B-12 can result in deterioration of mental function and neurologic damage that will yield such symptoms as memory loss, decreased reflexes, weakness, fatigue, disorientation, impaired pain perception, tinnitus (chronic ringing in the ears), neuropathy, burning tongue, and various psychiatric disorders. B-12 deficiency can also cause canker sores in the mouth, impaired bone marrow function, loss of appetite, and loss of weight, as well as impaired antibody responses to vaccines.

Folic acid deficiency can also cause fatigue and weakness, along with irritability, cramps, anemia, nausea, loss of appetite, diarrhea, hair loss, mouth and tongue pain, and neurological problems. In addition, folic acid deficiency is believed to play a role in the development of numerous and varied types of human cancers.

A combination of B-12 and folic acid deficiency can allow increases in blood levels of homocysteine, a chemical that can damage artery walls and contribute to heart disease.

One of the known causes of B12 deficiency is chronic viral illness with resulting poor gastrointestinal absorption. AZT use may contribute to deficiencies of both B-12 and folic acid. Many other drugs may worsen folate status in the body including TMP/SMX (Bactrim, Septra), pyrimethamine, and methotrexate (all three of which are folate antagonists), as well as phenytoin (Dilantin), various barbiturates, and alcohol (all of which block folate absorption). B-12 deficiency can also worsen folate levels in the body because B-12 is required to change folate into its active form.

Vitamin D, HIV, diabetes

A poster at the recent Conference on Retroviruses and Opportunistic Infections reported that Vitamin D supplementation decreases risk of diabetes and possibly cardiovascular complications for people with HIV. The study looked at data from 1574 patients over about 2 and half years. 61% of the patients were “undetectable” for HIV RNA, and at the start of the study, 14% showed evidence of “metabolic syndrome,” which generally points toward development of diabetes.

The study authors found that those patients who supplemented with 1000IU of Vitamin D per day had a substantially lower risk of developing full-blown Type 2 diabetes, which carries with it a higher risk of heart and blood vessel disease. However, they also found that this level of supplementation was not sufficient to completely make up for Vitamin D deficiencies in a significant number of the patients, and so they suggest that a higher dose could prove even more helpful for those with very low starting levels of the vitamin.

Reference: Guaraldi, G, et al. Vitamin D3 Supplementation Decreases The Risk of Diabetes Mellitus Among Patients with HIV Infection. CROI, 2011.

This study adds further evidence to NYBC’s conviction that Vitamin D supplementation, generally at 1000IU – 2000IU/daily (or, in case of substantial deficiency, even higher) is HIGHLY RECOMMENDED FOR PEOPLE WITH HIV. The expense is so low, the side effects basically nonexistent, and the health benefits so convincing that it doesn’t make sense for people with HIV not to supplement with this vitamin!

You can read more about current studies on the health benefits of Vitamin D on this blog.

A simple blood test for Vitamin D is available to check levels–ask your doctor.

Note that NYBC stocks:

Vitamin D – 1000IU

Vitamin D – 2500IU

Vitamin D- 5000IU

These Vitamin D formulations provide a convenient way to take the “sunshine vitamin” at the levels suggested by many recent studies.

Vitamin D deficiency in people with HIV/AIDS

The website aidsmap.com has featured a piece on Vitamin D deficiency among people with HIV in its top stories from this year’s annual Conference on Retroviruses and Opportunistic Infections (CROI, San Francisco, Feb. 2010), one of the main yearly meetings for scientific research on HIV/AIDS. Here’s an excerpt from the report, authored by Derek Thaczuk and published 2/19/2010:

Vitamin D deficiency extremely common among HIV-positive patients in diverse regions
[…]
New analyses have found widespread vitamin D insufficiency among American, Italian and Swiss cohorts of HIV-positive patients. [Note: also reported at CROI was a study looking at health outcomes in Tanzanian women with low vitamin D levels.] These data were presented in a poster session and related discussion at the 17th Conference on Retroviruses and Opportunistic Infections (CROI).

Vitamin D deficiency was consistently less frequent in Caucasians than in other races. Otherwise, the studies were not entirely consistent as to other risk factors, such as duration or type of antiretroviral treatment.

At the CROI discussion session on Wednesday, moderator Peter Reiss from the University of Amsterdam began by noting that vitamin D deficiency can result in bone density loss, cardiovascular disease, diabetes and insulin resistance, kidney disease, and other metabolic conditions commonly seen in patients with HIV.
[…]
Conclusions

These studies add to a growing body of evidence that insufficient or deficient vitamin D levels are extremely prevalent among persons with HIV. While prevalence figures (and the cutoff values used to define them) vary, these studies reported insufficiency rates of 54% to 72%; figures which are generally consistent with other reports. Studies in women linked vitamin D deficiency with risk of bacterial vaginosis, thrush, and other health problems.

The single factor invariably associated with insufficiency or deficiency was non-Caucasian race. Otherwise, reported risk factors were not entirely consistent, although several studies identified NNRTI and/or efavirenz use.

Investigators agreed that vitamin D deficiency is prevalent among HIV-positive individuals, has harmful effects on health, and is easily addressable through supplementation. Remaining research questions include the link between deficiency and clinical health outcomes, the impact of supplementation, the best doses for supplementation, and closer comparisons of deficiency rates in people with HIV and in the general population, where deficiency is also common.

Read the full story at

http://www.aidsmap.com/en/news/A17781D3-3857-455D-B13B-D7628DF427C7.asp