Dietary supplements are used by many people to ensure that they get enough daily nutrients — and when you’re living with human immunodeficiency virus (HIV), supplements can play an important role in your therapy. That’s because people with HIV are more likely to develop deficiencies in important micronutrients, and a lack of proper nutrition is known to speed the infection’s progress. Getting the nutrients you need can provide a needed boost to your immune system and support you in your HIV treatment.
But supplements for HIV management come with a caveat: Doctors prefer that people undergoing HIV therapy get most of their nutrients from a healthy diet, not pills, says Margaret Hoffman-Terry, MD, a specialist in infectious diseases and HIV care at the Lehigh Valley Health Network in Allentown, Pennsylvania.
However, because HIV/AIDS can lead to difficulty eating — whether due to decreased appetite or gastrointestinal symptoms of the virus — it is not always possible to get enough nutrients from food. Diarrhea and vomiting, which are common symptoms of HIV as well as side effects of some HIV medications, can also lead to malabsorption, or the inability of the body to absorb needed nutrients from food. Further, some people may opt for quick options like fast food when they get busy, making it tough to get all the nutrients they need from diet alone.
“In our modern life, it can be difficult to find time to cook a good meal all the time,” Dr. Hoffman-Terry notes.
Dietary Supplements in HIV Therapy
In addition to eating as well-balanced a diet as possible, people undergoing HIV therapy can benefit from a daily multivitamin. You can talk to a nutritionist about how to best accomplish this. He or she can look at your diet and make recommendations on what to eat when you’re experiencing HIV symptoms that prevent you from having regular meals. You can also discuss whether dietary supplements could help you meet your nutrition goals, and which ones would be most beneficial for you.
Dietary supplements beyond a daily multivitamin usually are not necessary in HIV therapy. “Although supplements are a big business, they aren’t generally warranted when one looks at the evidence on how helpful they actually are,” says Joseph S. Cervia, MD, a certified HIV practitioner and clinical professor of medicine and pediatrics at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York.
However, dietary supplements can prove useful for those who are deficient in certain nutrients due to malabsorption or gastrointestinal symptoms and lack of appetite. Just be sure to check with your HIV specialist or provider before using them, Dr. Cervia cautions, since supplements and herbal remedies can still cause side effects and interact with other medications you may be taking.
Dietary supplements that can assist in HIV therapy include:
- B-complex vitamins, which help boost the immune system and the nervous system
- Vitamin C, which helps the body fight infection and respond to illness
- Vitamin D, which can help protect aging HIV patients from osteoporosis
- Selenium and zinc, which play important roles in the function of the immune system and are often lacking in people undergoing HIV treatment
- Omega-3 fatty acids, which are found in fish oil dietary supplements and can decrease inflammation and support immunity
- Dehydroepiandrosterone (DHEA), which is a hormone often low in people undergoing HIV therapy and which can help with minor depression
- Probiotic dietary supplements and L-glutamine, which can support gastrointestinal health
- Coenzyme Q10, which is a powerful antioxidant that could increase immune system function
Supplements to Avoid in HIV Therapy
Be cautious about starting any supplements beyond a daily multivitamin on your own, Hoffman-Terry and Cervia note, especially the following three:
St. John’s Wort Some people take this herbal supplement as a treatment for depression, but it can interfere with medications used in HIV therapy. “St. John’s wort is processed by the same system in the liver that handles protease inhibitors and other HIV antivirals,” Hoffman-Terry says. “It will decrease your levels of those drugs.”
Fat-Soluble Vitamins The body excretes excess amounts of most water-soluble vitamins in urine, but fat-soluble vitamins like A, D, E, and K are stored in the body. “This may lead to toxic effects over time,” Cervia says.
Megavitamin Therapy Some people try to treat chronic illnesses by taking high doses of dietary supplements that far exceed recommended daily allowances. Cervia says those undergoing HIV therapy should not do this because huge doses of some vitamins can cause serious risks and side effects. For example, too much fat-soluble vitamin A can cause side effects like jaundice, nausea, and vomiting.
In general, when you’re undergoing HIV therapy, be very cautious regarding any claims made about dietary supplements, particularly if the supplement seems like part of a fad.
“There are a lot of drugs out there that are sold to people as immune strengtheners, but they may not actually help,” Hoffman-Terry says. “Dietary supplements, such as vitamins, are not tested by the FDA or held to any particular standard. If you are curious about whether a supplement might be good for you, ask your doctor before taking it.” He or she may agree that supplementation with certain nutrients is worth a try under medical watch.