When it was recently suggested that I go see a naturopath a couple months ago, I shrugged it off. I’ve gone this route before and It’s been helpful and I’ve learned a lot from those visits. But in the end I’d slide back into my old ways and some of the underlying issues didn’t seem to get dealt with  - such as my lack of energy.

When I picked up this nasty bug from Italy and had to take Flagyl, a drug with warnings that it is possibly carcinogenic, at it’s maximum dosage, it felt like chemotherapy.

In the end it didn’t work and it was suggested that I go back on it again. Even after taking it, a week was needed to recover from it. There was simply no way. This was when I decided to make an appointment with someone who came highly recommended to me.

I made the appointment. The first one lasted for about an hour and a half. It sounds like a lot, but the time passed very quickly. What I liked about this particular naturopath is that he has extensive experience working with addictions and knows a lot about the 12 step programs, a lot of the issues that go with it, as well as HIV.

What we spoke about turned out to be part info-sharing, part guidance, and part counselling. looking at what’s going on in all aspects of my life, not just the physical health.

This was the first time I had this experience. When I go to my regular doctor it’s about the meds, and sometimes we talk about other stuff. The focus is really on medication and monitoring.

Because of this experience I thought I’d journal a bit about it as I go through this process. This goes without saying, yet needs it anyway: Do not follow any supplements that I do unless you check it out with a qualified naturopath or your physician. There are many potential interactions that can happen. There you go; you were warned.

One of my major issues is depression, and worse, seasonal depression. The first thing we discussed was Vitamin D. I had been taking it, but only a couple thousand milligrams a day, and cheap drug store brands. We switched that to 5000 a day via liquid drops.

Now maybe it’s placebo effect or my imagination but I started to feel a “brightness” that I haven’t felt for a long time. I was told it would take from a week to 10 days to feel a difference. If need be, I can increase it even more, but this was our starting point.

I also spoke about my tendency to isolate with my TV, and lack of structure in my life which in turns leads to anxiety as I feel like I don’t have a handle on a myriad of things I’ve taken on, but not this website.

I have started to create a small foundation of structure for the day. No matter what time I get up, I have my coffee in the living room and read the paper on my laptop. I have my breakfast, shower and take the dog out. I am now ready for work.

Before I’d wake up, grab a coffee and sit and start working. There were no boundaries to what was work time, me time, housecleaning time, relaxing time. With the exception of my weekly Shabbat (beginning Friday evening to Saturday evening) every day was almost the same as the other.

The other piece I’ve added is going to my 12-step meetings everyday, with Fridays off, and sometimes Thursday. I have my conversion class on Thursday night (another imposed structure).

Bit by bit it is coming together.

I thought I’d share what my homework is for the next two weeks. Again, this is tailored to my needs, however if you deal with some generic issues such as lack of structure etc, some of these points may apply to you.

1) Probiotic-  HMF Intensive 1 cap per day take at least 2 hours away from antibiotic.  Before bed would be best, will give the most benefit but this mean taking your antibiotic with your meals.

2)  VItamin D.  5 drops on your hand and lick it off, once a day-doesn't matter when

3) Diet diary, fill out and return to me weekly.

4) work on a daily/weekly structure for your time

5) follow up with the GP who is giving you the antibiotic for blood test-specifically CBC and Liver function tests, also get a copy of any test within the last 6 months

6) consider B12 shots

7) continue with meetings, get up off your chair every hour,

8) drink water - goal is 2 liters a day

9) Be gentle with yourself during this process- you don't have to be perfect- just make some progress.

Point number one, refined sugar is by and large the worst additive for the immune cells. Refined sugar is immunosuppressive.  No mincing words about it.

To boost your immune system, it is important to try to stay on diet ideally free of foods with refined sugars such as corn syrup and fructose, hydrogenated oils, trans fats, unnecessary additives and preservatives.   Your glutathione level is fastest depleted by toxins, sugar and chemicals ingested into the body.   Glutathione’s deficiency has been linked to many “age related diseases such as muscle weakness and fatigue, mitochondrial dysfunction, Alzheimer’s and Parkinson’s, cancer, inflammatory illness” (Dr. Mercola).  HIV infection accelerates the aging process and also linked to the inflammatory process in the body due to HIV replication, immune activation, cell death, etc.

The beauty of glutathione is that it works on an intracellular level. It helps protect the mitochrondria (the energy factory) in the cell.  Many of the side effects of HIV medication are due to mitochrondial toxicity.  Glutathione helps boosts the activity of other antioxidants such as vitamin C, E, alpha lipoic acid and CoQ10 and the fruits and vegetables consumed.  As a side note, Coenzyme Q₁₀ is found in the heart muscle.  However, anti-cholesterol drugs or statin drugs deplete Coenzyme Q₁₀ in body, you might want to consider supplements.

Nutrients for Health:  Many antioxidants like beta-carotene, selenium and vitamins A, C and E are present in healthy living foods.  First and foremost, it must be real food.  Real food is defined as wholesome food that is minimally processed, does not have tons of sugar, dubious chemicals you cannot pronounce and foods that actually rot (not full of chemicals and preservatives that it last a lifetime in a landfill).   Avoid, reduce and/or eliminate pop/soda (full of sugar) and processed meats (full of nitrates) gradually from your grocery list.   If this sounds overwhelming to you- take baby steps to your goal.

Omega 3 is excellent to maintain cardiovascular and mental health and has anti-inflammatory effects. Curcumin from tumeric also has anti-inflammatory effects and is believe to be useful in minimizing dementia.  Omega 3 supplements have been found to have equally beneficially effects as Prozac for depression

An ideal healthy diet is high in complex carbohydrates vs. simple carbohydrates.  Complex carbohydrates are whole grains (bread) & whole grain cereals (not whole wheat), vegetables and fruits. The cereal must have 3 to 5 grams of fibre and preferably not more than 8 grams of sugar.  Simple carbohydrates are sugars, fresh or dried fruits, honey, jam or syrups.  Add fats such as good fats from nuts, seeds, avocado, olive oil (omega 9) and fish(omega 3 from deep sea cold water fish such as mackerel, sardines, salmon, anchovies). 

Nuts and seeds are high in various essential fatty acids. Do not eat salted and toasted nuts and seeds if you want seek therapeutic benefits. Toasted nuts may taste better, but the heat has destroyed most of the healthy essential fats.  Add soluble fibre and insoluble fibre to your diet.  Avoid buying anything that contains more than five ingredients should be frequently obeyed.

Nutrition is needed by cells, tissues, organs to metabolize and absorb food, anti-HIV drugs and support various processes in the body.  You need the following foods to sustain health within. They are:

l  Amino acids: L-cysteine and L-methionine (sources: eggs, fish, steak)

l  Antioxidants: GSH (glutathione) high rate of oxidation on a cellular level ( food sources see below)

l  Mitochondria protectors: B complex, vitamin C, E, Alpha lipoic acid, NAC

l  Body can make own antioxidants using selenium, manganese, zinc which  works with cysteine in NAC (Brazil nuts are high in selenium)

Shopping for supplements:  Buy it when on sale or in bulk.  A bottle of any supplement has 60 to 90 pills or capsules.  It can be taken every other day if you want more value for your money.

Other foods high in glutathione are whey protein (ion exchange formulation and cold –pressed), and these fruits and vegetables have highest glutathione per serving: spinach, potatoes, asparagus, avocado, squash, okra, cauliflower, broccoli, walnuts, garlic and tomatoes.  The yellow spice turmeric contains curcumin which may be useful to increase glutathione levels.

Some easy ways to boost the intake of antioxidant for overall health are as follows.  Summer is an excellent time to consume as many berries as possible for their high antioxidant content.  It is also advisable to consider freezing blueberries, black berries, raspberries and strawberries.  Exercise helps increase glutathione levels naturally.

Do not taker B-12 close to bed time unless you are planning an exciting evening.  However take calcium/magnesium closer to bedtime, as it is relaxes the muscles.

Oxygen radical absorbance capacity (ORAC). ORAC is a scoring system of foods based on antioxidant capacity of foods. The top 10 fruits and vegetables on the ORAC list –from highest to lowest are  as follows. Prunes followed by raisins, blueberries, blackberries, cranberries, strawberries, pomegranates, raspberries, plums, oranges.  Vegetables; kale, spinach (raw), brussels sprout, alfalfa sprouts, broccoli, red bell pepper, onion, corn and eggplant.   These may not be your favorite picks but it is what nature blessed the foods with.   A simple rule – shop for a grocery list of fresh foods that look colorful and you can be eating lots of high ORAC foods.

To good health and make conscious decisions when eating foods and buying foods. Treat your body kindly by putting real foods into your body. You will reap the benefits of your diet.

Ref:

NAC Info Sheet, http://www.thebody.com/content/art4754.html

Dr. Mercola, Ori Hofmekler .This ONE Antioxidant Keeps All Other Antioxidants Performing at Peak Levels.  www.mercola.com

To build health from within, it is important to understand inflammation and oxidation.Inflammation is believed to be one of the main causes of aging and organ disease in PHAs.

In the early 80’s there was on going research in gut associated lymphoid tissue (GALT).Researchers knew in early HIV infection, the immune cells in the intestinal system are infected and the early symptoms of HIV seroconversion are gastrointestinal (GI) related diarrhoea, wasting, indigestion, and weight loss. However, when the triple combination anti-HIV drugs came about in 1996, research in GALT was abandoned until recently in 2006 it resurfaced (http://www.prn.org/index.php/progression/article/hiv_1_gastrointestinal_galt_267). In the last five years, researchers have found that ARV has revived some of the immune cells in the intestinal system but not all of it.Plus there are many variables; number of CD4+ cells at time of ART initiation, CD8, percentage of CD4+ ,other co-infections, and overall health.

HIV infection in the GI tract can affects absorption of foods and nutrients in the intestines. “To maximize the efficiency of digestive function, the GI tract has evolved such that it has the largest surface area among all organs. In fact, the 400 m2 surface area of the GI tract is about 200 times larger than the surface area of the entire skin.”(Mehandru.S, 2007). We know HIV also affects the production of B12 in the intestine hence many PHAs are B12 deficient. B12 is important for energy and red blood production. Furthermore HIV infection affects the bone and heart muscles. A health regimen has to integrate the many components of health. As such taking antiretrovirals therapy (ARV) is one part of the plan but not all of it.

Thirty years later, HIV is known to cause many cellular inflammations, from an increase in cytokines, chemokines, interleukins, an imbalance in the two arms of the immune system; the cellular and humoral arm to mention a few. As all of us know our body best, but how do we control inflammation within and keep our health at an optimal level. There is much more one can do to boost cellular health, minimize oxidative stress while living with HIV infection. We are going to take a look at what goes on in the cells and understand inflammation, oxidation and the role of the mitochondria.

The immune system and inflammation: Living with HIV infection means the immune system is constantly activated or stimulated and does not get the vacation it needs. While a person may have a high CD4+ count, the CD8 may also be high which means the immune system is constantly fighting off the infection. In an ideal immune system, it has high CD4+ and low CD8 count. A low viral load or undetectable viral load does not mean HIV is not in the tissues, cells, blood or organs. All it means is HIV cannot be detected by the current diagnostic test.  Over the cause of HIV infection, we are now certain of the increase in inflammation over a long term in living with HIV. The cause of this increase is not completely understood.

When the body is fighting an infection, “or repairs injured tissues, fluids and cells get transported to the site of injury. As the body heals, the cells can swell, get warm, and become sore. One theory is that as HIV chronically infects the body, cells and tissues are destroyed and then heal, activating the immune system. That leads to an over stimulated immune system that can become burned out or weakened. So, even though a lab result may show a high CD4 count, the amount of inflammation in the body may be causing damage on a cellular level. And that can lead to heart, liver, kidney disease, and greater levels of bone loss."For more on HIV and inflammation, http://www.thebody.com/content/art57904.html?ic=700100.

What is oxidation?

Oxidation is a process of breaking food down into energy and involves a chemical reaction. Food breakdown is one of the many oxidative processes in our bodies. During this process, molecules called free radicals are produced. Free radicals are a normal part of the oxidation process. They can damage the membranes of the cells in much the same way that rust damages the body of a car.

During HIV infection, many researchers have observed an increase in free radicals (extra unpaired oxygen molecules, oxygen has two molecules as in O2, in its stable form). ARV and HIV infection both seem to cause an increase in free radical production in the body and this is currently believed to be linked with inflammation.What can you take to minimize oxidation? Increase the intake of anti-oxidants either with foods and/or supplements, and improve your breathing capacity.

Mitochondria, is located in the cells and is the energy production centre of the cell. They are tiny thread like organelles in living cells-they squirm, lengthen, and change shape almost continuously. Enzymes dissolved in the fluid within the mitochondria, carry out reactions in which oxygen is used to break down food. As foods are broken down, energy is released. Some of the fatigue reported in HIV infection, is related to mitochrondria toxicity. Mitochrondria is found in almost all organs, tissue, nerves, and bones muscles in the body. While ARV are important to control viral replication ,it also can damage mitochondria DNA and cells, and cause wide range of side effects including fat loss, peripeheral neuropathy, and high lactate levels amongst a host of symptoms.

The free radical production causes mitochrondia toxicity and cell death (apoptosis). Some research has associated free radical with side effects such as neuropathy, acid lactosis, pancreatitis (Dr. Jon Kaiser, 2003). Inflammation is an ongoing process as long as HIV exists in the body. The inflammation is directly linked with illness associated with aging such as bone loss, cardiovascular disease and decrease in cognitive functions.

What we do know is one potent antioxidant can decrease the impact of free radicals. It is called glutathione, and it is very effective as minimizing the oxidative process at an intracellular level in the cells. Our body in its inherent wisdom produces glutathione in the walls of our cells. Some foods can also minimize inflammation in the body. These will be discussed in Part 3.Translate

I have been recently presenting workshops on HIV and nutrition. What I have come to understand and acknowledge over the 15 years of speaking on nutrition, many poz persons have not fully integrated nutrition as part of their health regimen.

Unfortunately, many staff and volunteers at ASOs/NGOs in Canada or across then world, who work in treatment or outreach with PHAS have minimal knowledge of impact of nutrition on immune system.   As the Vienna Conference is over,

with not a single word, abstract or presentation on nutrition-no big surprise! In 2006 International AIDS Conference there were 2 sessions on nutrition and 3 poster presentations on nutrition and complementary medicine. In 2008 International AIDS Conference, there were a total of 2 abstracts on nutrition and complementary medicine and one presentation on food shortage.

Antiretrovirals (ARV) are crucial to our health, but 70 percent of the immune system is in the gastrointestinal system. Hence the key to maintain optimal immune functions and overall health lies in what foods we ingest. I was reading a recent article in The Body called An Introduction to Dietary Supplements for People Living With HIV/AIDS. You can read it at, http://www.thebody.com/content/art56659.html?getPage=3

Over all, it is a good read and it listed Alpha-Lipoic –Acid, Calcium and Vit D 3, Carnitine, Coenzyme Q10 (CoQ10), Zinc and B 12. However, the article has missed a few gems notably Omega 3 oils and NAC (N-acetyl cysteine). Another comprehensive resource on nutrition is the Practical Guide to Nutrition for PHAS, Get a free copy at www.catie.ca.

As a strong advocate of nutrition for PHAS, there is research documenting the role of micronutrients for good health and minimizing many of the side effects of HIV drugs. Micronutrient depletion starts at the onset of HIV infection, hence it is wise to supplement early vs. when health needs are chronic. In a nut shell, healthy nutrition consists of providing the cells, tissues, and organs of the body with adequate micro-nutrients to function at optimal level. Medications also need nutrition to break it down, be processed, absorbed and metabolized by cells and tissue. And all solid and liquid foods are processed by the liver. New HIV drugs may come onto the market, but all drugs have their slew of side effects.

During HIV infection, many researchers have observed an increase in free radicals (extra unpaired oxygen molecules). The cause of this increase is not completely understood. Free radicals are produced mostly during metabolism and exposure to toxins and cause much damage in the cell. A decrease in antioxidants in general and glutathione in particular, has also been observed. All antioxidants are crucial in eliminating free radicals from your body. To control the oxidation process, our body produces an antioxidant called glutathione in the walls of our cells. Glutathione as a strong antioxidant has a crucial role to combat free radical damage in the cells. An easy source of glutathione is NAC. In all the years, I have presented on nutrition and micro supplements, many PHAS still have never heard of glutathione or NAC

N-acetyl cysteine was first used by PHAS when there was no anti-HIV medication available. In the dark days, PHAS who survived the epidemic, took NAC found it helped to keep their CD4+ at a decent level and prevented opportunistic infections. NAC is converted to glutathione in the body and glutathione is the single most important antioxidant the cells need. It is found inside every single cell in your body. "Glutathione is a vital protein that cells need to function. Many studies have documented low glutathione in people with HIV. Dr. Luc Montagnier's work with CD4 cells from PWAs suggests that even cells without HIV can grow weak and die, but with added GSH can regain their vigor. This is where NAC comes in. NAC is broken down by the body into cysteine. Researchers have also noted that low levels of cysteine in PWAs. The body uses cysteine to replace glutathione" (The Body).

While it is important to eat healthy, since 70 percent of the immune cells live in the gastrointestinal tract. HIV is most abundant where the immune cells are, most of HIV lives in the gastrointestinal cells. We do not know if anti-HIV medications are successful in minimizing HIV replication in the gastrointestinal cells. If you are interested to know more of the gastrointestinal system and HIV, look up GALT online. GALT stands for 'gut associated lymphoid tissue'.
As such digestion is compromised for many PHAS inspite of healthy eating. Only 2 percent of HIV is found in your blood. We also know that HIV infection causes inflammation and on a cellular level accelerates the aging process.