Thursday, January 18, 2007

Another Decade of AIDS (HIV)

In 1995 a protocol for nutritional support of people who were HIV positive was published by a nutrition group headed by Willis H. Reisen, PhD, who received his PhD in biochemistry from the University of Wisconsin in the 1950's and was board certified as a clinical nutritionist in the early 1990's. Dr. Reisen, and his colleague David B. Tardy, self-published their short pamphlet, A Decade of AIDS, after a ten-year period during which they claimed that not a single one of the approximately one hundred HIV-positive people following this protocol had gone from HIV-positive to full-blown AIDS. (Both of these good gentlemen have since passed away at a ripe age.)

I am providing the recommendations of their original protocol in a very short form largely for historical purposes, but also to open people's minds to the possibilities of using nutrition to complement conventional medical care. I'm also providing independent scientific references that I have dug up to document the current science backing up their original protocol, which I present below.

A bit of explanation of the supplemental options was also added by me, along with a few examples of modern formulas providing these nutrients more efficiently than those available on the market some 10-12 years ago.

Please remember that this protocol was designed to be used under a physician's care, and should NOT be used as a substitute for medical care!

HIV nutritional support protocol (to be used only under the medical supervision of a physician):

This protocol has traditionally (since 1985) been used by some clinical nutritionists for the nutritional support of people with HIV for nutritional restoration of the digestive and immune systems. Use this protocol only as directed by your physician.

Nutritional Protocol:

  • Probiotics include acidophilus, bifidus, and other ‘beneficial bacteria’ that are healthy for the human gut. If you are not using an antibiotic prescription drug, simply take a good quality, strong probiotic formula as directed on the label. If you are currently taking an antibiotic prescription drug, supplement with a good quality, strong probiotic formula an hour or two after each dose of antibiotic, then continue taking the probiotics for some weeks after the antibiotic course is over.
  • Take a good hi-potency multiple vitamin to provide basic nutritional supplementation.1, 2, 17-33, 45
  • Take antioxidants to increase detoxification and glutathione production. Cysteine or NAC 3,4, whey protein isolate 34-36, GliSODin ™ 37, 39-44 Silymarin (milk thistle extract) VitaBerry™ or other hi-ORAC antioxidant formula Selenium, preferably selenomethionine, 200-400 mcg/day. 5-8, 39
  • Do a Vitamin C flush, maintaining appropriate levels: 9-11, 38
  • Natural carotenoids 46-48 AIDS-related weight loss and chronic diarrhea ("HIV enteropathy") may respond to a gluten-free diet. 12
  • Progressive resistance training (weight training) and exercise may be used as an alternative or adjunct to steroids. 13,14
  • DHEA may alleviate fatigue and depression (200-500 mg per day for eight weeks). DHEA supplementation had no effect on CD4 cell (helper T-cell) counts or testosterone levels. 15,16

1. Ince S. Vitamin supplements may help delay onset of AIDS. Med Tribune 1993;9:18.
2. Fawzi WW, Msamanga G, Hunter D, et al. Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania. J Acquir Immune Defic Syndr 2000;23:246–54.
3. Roederer M, Staal FJ, Raju PA, et al. Cytokine-stimulated human immunodeficiency virus replication is inhibited by N-acetyl-L-cysteine. Proc Natl Acad Sci 1990;87:4884–8.
4. Herzenberg LA, De Rosa SC, Dubs JG, et al. Glutathione deficiency is associated with impaired survival in HIV disease. Proc Natl Acad Sci 1997;94:1967–72.
5. Baum MK, Shor-Posner G, Lai S, et al. High risk of HIV-related mortality is associated with selenium deficiency. J Acquir Immune Defic Syndr Hum Retrovirol 1997;15:370–4.
6. Olmsted L, Schrauzer GN, Flores-Arce M, Dowd J. Selenium supplementation of symptomatic human immunodeficiency virus infected patients. Biol Trace Elem Res 1989;25:89–96.
7. Chariot P, Perchet H, Monnet I. Dilated cardiomyopathy in HIV-infected patients [letter; comment]. N Engl J Med 1999;340:732 (discussion 733–5).
8. Zazzo JF, Lafont A, Darwiche E, et al. Is non-obstructive myocardiopathy (NOMC) in AIDS selenium-deficiency related? In: Neve J, Favier A, eds. Selenium in biology and medicine. W. DeGruyter & Co.: Berlin New York, 1988, 281–2.
9. Harakeh S, Jariwalla RJ, Pauling L. Suppression of human immunodeficiency virus replication by ascorbate in chronically and acutely infected cells. Proc Natl Acad Sci 1990;87:7245–9.
10. Tang AM, Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244–56.
11. Cathcart RF III. Vitamin C in the treatment of acquired immune deficiency syndrome (AIDS). Med Hypotheses 1984;14:423–33.
12. Nellen H, Flores G, Wacher N. Treatment of human immunodeficiency virus enteropathy with a gluten-free diet. Arch Intern Med 2000;160:244 [letter].
13. Roubenoff R, McDermott A, Weiss L, et al. Short-term progressive resistance training increases strength and lean body mass in adults infected with human immunodeficiency virus. AIDS 1999;13:231–9.
14. Mustafa T, Sy FS, Macera CA, et al. Association between exercise and HIV disease progression in a cohort of homosexual men. Ann Epidemiol 1999;9:127–31.
15. Ferrando SJ, Rabkin JG, Poretsky L. Dehydroepiandrosterone sulfate (DHEAS) and testosterone: relation to HIV illness stage and progression over one year. J Acquir Immune Defic Syndr 1999;22:146–54.
16. Rabkin JG, Ferrando SJ, Wagner GJ, Rabkin R. DHEA treatment for HIV + patients: effects on mood, androgenic and anabolic parameters. Psychoneuroendocrinology 2000;25:53–68.
17. Semba RD, Graham NMH, Caiaffa WT, et al. Increased mortality associated with vitamin A deficiency during human immunodeficiency virus type 1 infection. Arch Intern Med 1993;153:2149–54.
18. Semba RD, Miotti PG, Chiphangwi JD, et al. Maternal vitamin A deficiency and mother-to-child transmission of HIV-1. Lancet 1994;343:1593–7.
19. Coutsoudis A, Pillay K, Spooner E, et al. Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group. AIDS 1999;13:1517–24.
20. Kennedy CM, Coutsoudis A, Kuhn L, et al. Randomized controlled trial assessing the effect of vitamin A supplementation on maternal morbidity during pregnancy and postpartum among HIV-infected women. J Acquir Immune Defic Syndr 2000;24:37–44.
21. Fawzi WW, et al. (2004). A randomized trial of multivitamin supplements and HIV disease progression and mortality. N Engl J Med 351, 23–32
22. Coutsoudis A, Bobat RA, Coovadia HM, et al. The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women. Am J Public Health 1995;85:1076–81.
23. Kanter AS, Spencer DC, Steinberg MH, et al. Supplemental vitamin B and progression to AIDS and death in black South African patients infected with HIV. J Acquir Immune Defic Syndr 1999;21:252–3 [letter].
24. Butterworth RF, Gaudreau C, Vincelette J, et al. Thiamine deficiency in AIDS. Lancet 1991;338:1086.
25. Baum MK, Mantero-Atienza E, Shor-Posner G, et al. Association of vitamin B6 status with parameters of immune function in early HIV-1 infection. J Acquir Immune Defic Syndr 1991;4:1122–32.
26. Tang AM, Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244–56.
27. Boudes P, Zittoun J, Sobel A. Folate, vitamin B12, and HIV infection. Lancet 1990;335:1401–2.
28. Murray MF. Niacin as a potential AIDS preventive factor. Med Hypotheses 1999;53:375–9.
29. Murray MF, Srinivasan A. Nicotinamide inhibits HIV-1 in both acute and chronic in vitro infection. Biochem Biophys Res Commun 1995;210:954–9.
30. Tang AM, Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244–56.
31. Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244–56.
32. Fabris N, Mocchegiani E, Galli M, et al. AIDS, zinc deficiency, and thymic hormone failure. JAMA 1988;259:839–40.
33. Mocchegiani E, Veccia S, Ancarani F, et al. Benefit of oral zinc supplementation as an adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. Int J Immunopharmacol 1995;17:719–27.
34. Micke P, Beeh KM, Buhl R. Effects of long-term supplementation with whey proteins on plasma glutathione levels of HIV-infected patients. Eur J Nutr 2002;41:12–8.
35. Wong KF, Middleton N, Montgomery M, et al. Immunostimulation of murine spleen cells by materials associated with bovine milk protein fractions. J Dairy Sci 1998;81:1825–32.
36. Minehira K, Inoue S, Nonaka M, et al. Effects of dietary protein type on oxidized cholesterol-induced alteration in age-related modulation of lipid metabolism and indices of immune function in rats. Biochim Biophys Acta 2000;1483:141–53.
37. Muth CM, Glenz Y, Klaus M, Radermacher P, Speit G, Leverve X. Sektion. Influence of an orally effective SOD on hyperbaric oxygen-related cell damage. Free Radic Res. 2004 Sep;38(9):927-32. PMID: 15621710
38. Stephensen CB, et al. Vitamins C and E in adolescents and young adults with HIV infection. Am J Clin Nut. Vol. 83, No. 4, 754-759, April 2006
39. Foster HD. How HIV-1 causes AIDS: implications for prevention and treatment. Med Hypotheses. 2004;62(4):549-53. Review. PMID: 15050105
40. The effects of an orally effective SOD (Glisodin) on AIDS West African patients in a randomized double-blinded clinical study.
41. Dugas B (2002) Glisodin®, a nutraceutical product that promotes the oral delivery of superoxide dismutase. Free Radic Biol Med 33: S64
42. Vouldoukis I, Conti M, Kolb JP, et al.(2003) Induction of Th1-dependent immunity by an orally effective melon superoxide dismutase extract. Curr Trends Immunol 5: 141-5
43. Vouldoukis I, Conti M, Krauss P, et al. (2004) Supplementation with gliadin-combined plant superoxide dismutase extract promotes antioxidant defences and protects against oxidative stress. Phytother Res 18 (12): 957-62
44. Vouldoukis I, Lacan D, Kamate C, et al. (2004) Antioxidant and anti-inflammatory properties of a Cucumis melo LC. extract rich in superoxide dismutase activity. J Ethnopharmacol 94 (1): 67-75
45. Jiamton S, et al. (2003). A randomized trial of the impact of multiple micronutrient supplementation on mortality among HIV-infected individuals living in Bangkok. AIDS 17, 2461–2469
46. Austin J. A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome. Eur J Clin Nutr 60: 1266-1276; advance online publication, May 24, 2006; doi:10.1038/sj.ejcn.1602447
47. Baum MK, Shor-Posner G, Lu Y, Rosner B, Sauberlich HE, Fletcher MA et al. (1995). Micronutrients and HIV-1 disease progression. AIDS 9, 1051–1056 48. Stephensen CB (2003). Vitamin A, beta-carotene, and mother-to-child transmission of HIV. Nutr Rev 61, 280–284

Monday, January 15, 2007

Natural Causes is cause for concern about journalism

Natural Causes To those deciding whether this book is worthy of purchasing, I find that many of the author's claims are overblown. Some are demonstrably untrue. Mr. Hurley's inflammatory rhetoric is apparently at odds with official FDA statements, because on its website and in Congressional testimony the agency has repeatedly stated that it has adequate power to regulate dietary supplement safety and quality, which the author denies is true. DSHEA (the Dietary Supplement Health and Education Act) is NOT a deregulation bill. It took a misunderstood food category and elevated its regulation to almost that of pharmaceuticals, allowing the FDA to ban drug and disease claims, control manufacturing quality through mandatory Good Manufacturing Practices (GMP), have veto power over label claims, and make manufacturers bear responsibility for mislabeled, adulterated or unsafe products. What was stopped by DSHEA was inexplicable FDA harassment of supplements, stopped only by outraged federal judges. DSHEA was the compromise bill that gave more power to the FDA while preventing the grossest abuses of its power. Dietary supplement plants are FDA inspected, while also under the sanitation and health laws of local and state governments. Other quality inspectors keep manufacturers honest; for example, GMP, organic and kosher certifiers. A documented paper trail is required for every step in the production of products. The FTC also regulates dietary supplement advertising, including monitoring Internet websites. The dietary supplement industry strongly supported the recent Adverse Event Reporting Act that requires manufacturers to report all serious adverse events to the FDA. Some manufacturers have already been doing this voluntarily, but have received very few, to date. This evidences their commitment to safety. Dietary supplement industry associations have quality programs that require registration and random testing for active ingredients in products, so member companies are of a significantly higher level of quality assurance than other manufacturers. Of course, not all natural products are 100% safe or 100% effective for every person. But, checking poisoning death figures from the American Association of Poison Control Centers, I see that supplements are safer than most other products: there were only 5 accidental deaths linked (reported as possibly due) to dietary supplements over a 3-year period. In the same 3-year reporting period, there were 67 deaths from plain aspirin, 50 from aspirin combinations, 48 from pesticides, 7 from cosmetics, 66 from household cleaners, 171 from plain acetaminophen, and 446 from acetaminophen combinations. The medical journal JAMA reports that there are over 100,000 deaths a year from pharmaceutical drugs that are used as directed, and many more from misperceived drugs. How many dies from the FDA-approved drug Vioxx? How many from mood altering and cholesterol lowering drugs? How many from cardiovascular disease aggravated by synthetic hormone replacement therapy? The tryptophan that caused deaths in the late 1980's was reportedly produced by a pharmaceutical company using a prototype/unproven genetically engineered bacteria for the first time to produce the amino acid, which was then prescribed by a physician. How do dietary supplement companies get all the blame for this? While Mr. Hurley is correct that, normally, food is the best source of nutrients, there are some that are shown to be better absorbed from supplements than food, such as certain B vitamins. Compared with the admitted shortage of essential nutrients in the American diet and the dangers of prescribed and OTC drugs, most people feel better about the relative safety and utility of dietary supplements. Greater than RDA levels of vitamins are NOT toxic. Safe upper levels exist and are often far higher. Medical professionals frequently use mega-doses of Vitamin C, biotin, folic acid, vitamin B-12 and vitamin D with no serious adverse effects. Natural products companies exist because of a strong commitment to natural health, including product safety. Most natural products manufacturers would rather go out of business than harm their customers. Many people believe that natural products are more health promoting than synthetic drugs because the nutrients and gentler therapeutic agents are better tolerated by the body and encourage healing; not merely controlling symptoms like so many toxic drugs. And, yes, dietary supplements are backed by tens of thousands of published research papers showing their safety and efficacy. I read them daily. Perhaps Mr. Hurley just didn't pay enough attention in science class and is too focused on muckraking to notice his many errors. I give this book an "F". Neil E. Levin, CCN, DANLA board certified clinical nutritionist with diplomate in advanced nutritional laboratory assessment

Thursday, January 11, 2007

Neil to be on the radio Jan. 13th

WHERE: KB Radio 1520 AM, Buffalo New York area WHEN: Saturday Morning 9:00 a.m.-10:00 a.m. Eastern time Guest: ME!

Response to NPR report on supplements and colds

Stress, Nutrition and Colds By Neil E. Levin, CCN, DANLA, January 11, 2007 The NPR Morning Edition story airing today called “Low-Stress Life May Be Best Way to Prevent Colds” has some contradictions and inaccuracies. While I can’t defend the “Airborne” formula, which has non-standardized herbs and non-natural ingredients and was developed by a teacher rather than a nutritionist, some of the statements about dietary supplements made in the report are simply inaccurate. One is the purported lack of connection between boosting the immune system and preventing or treating the common cold or flu, reporting the views of one skeptical medical researcher. In fact, there are many hundreds of published clinical studies showing specific mechanisms by which various dietary supplements can improve immune cell function. A review of the published science on zinc in the Journal of Environmental Pathology and Toxicology stated that “[zinc] fulfills an immune function.” The Journal of Applied Microbiology and Biotechnology published a review reporting that, “Garlic has a wide spectrum of actions; not only is it antibacterial, antiviral, antifungal and antiprotozoal, but it also has beneficial effects on the cardiovascular and immune systems.” Alternative Medicine Review recently published a review of the literature on the effects of herbs on the immune system, reporting, “The in vitro and in vivo research demonstrates that the reviewed botanical medicines modulate the secretion of multiple cytokines.” [immune cells] And the journal Autoimmunity bluntly reported on Echinacea’s positive effect on Natural Killer immune cells, indicating that Echinacea may even provide a new treatment for Type 1 Diabetes: “the fact that the herb, Echinacea, is a well demonstrated immunostimulant of NK cells in normal mice/humans,” and concluding that “The results revealed that, in NOD mice, dietary Echinacea…actually stimulated NK cell production in their bone marrow birth site.” Another mistaken claim is that “most people get plenty of that [Vitamin C] in their diet. Yet according to dietary data from the National Health and Nutrition Examination Survey, “We conclude that despite NHANES III data indicating a small increase in the median dietary vitamin C ingestion in the USA, a substantial fraction of the population still ingests vitamin C at or below the Recommended Dietary Allowance.” The RDA is only 60 mg a day. This links to another part of the report that links stress to a two-fold increase in colds. Vitamin C aids adrenal function, with that gland being the most prominent player in stress response. Vitamin C levels in the adrenal gland are reported to be as great as 150 times the general levels in the bloodstream. Of course, if people don’t get enough in the diet and are under stress, that easily explains the vitamin C connection. The report also stated that some formulas contain, “herbs such as Echinacea, which, although very popular, has been shown by the best scientific studies not to work.” Yet recent negative reports have been challenged by the non-profit American Botanical Council (ABC) as not using commercially available preparations and using lower doses less frequently than commonly and previously used in positive studies. Another criticism is that some studies used college students that typically have better immune system functioning than elderly people. ABC Executive Director Mark Blumenthal said in response to one recent study that, “This is not a definitive trial on the efficacy of echinacea, nor should the results be generalized to echinacea preparations widely available. Unfortunately, the conclusion that may be drawn by some media who report this study may state that ‘echinacea is ineffective,’ but this would be an incorrect conclusion based on the design of this study and the evidence in the existing literature.” A meta-analysis of previously published studies on echinacea was published in the journal Clinical Therapeutics, with the conclusion, “Based on the analysis, the likelihood of experiencing a clinical cold was 55% higher with placebo than with Echinacea.” Another published review says that, “Numerous clinical trials have been carried out on echinacea preparations: it appears that the extracts shorten the duration and severity of colds and other upper respiratory infections (URIs) when given as soon as symptoms become evident.” The NPR report also questions the ability of the mineral zinc to reduce colds. Yet a report by the physician-reviewed health education group A.D.A.M. ( states, “Several important studies have revealed that zinc lozenges may reduce the intensity of the symptoms associated with a cold, particularly cough, and the length of time that a cold lingers.” Such misleading statements in a health report may lead people to think that there are no dietary supplements that can correct deficiencies and imbalances which, combined with stress, may lead to impaired immune function. But science shows that the opposite may be true: dietary supplements have a solid role in immunity and health. Neil Levin is a board certified clinical nutritionist who is a product formulator and the nutrition educator for NOW Foods, a manufacturer of dietary supplements. His nutrition blog is available at REFERENCES: Link to original NPR report: Frassinetti S, Bronzetti G, Caltavuturo L, Cini M, Croce CD. The role of zinc in life: a review. J Environ Pathol Toxicol Oncol. 2006;25(3):597-610. Review. PMID: 17073562 Harris JC, Cottrell SL, Plummer S, Lloyd D. Antimicrobial properties of Allium sativum (garlic). Appl Microbiol Biotechnol. 2001 Oct;57(3):282-6. Review. PMID: 11759674 Spelman K, Burns J, Nichols D, Winters N, Ottersberg S, Tenborg M. Modulation of cytokine expression by traditional medicines: a review of herbal immunomodulators. Altern Med Rev. 2006 Jun;11(2):128-50. Review. PMID: 16813462 Schoop R, Klein P, Suter A, Johnston SL. Echinacea in the prevention of induced rhinovirus colds: a meta-analysis. Clin Ther. 2006 Feb;28(2):174-83. Review. PMID: 16678640 Block KI, Mead MN. Immune system effects of echinacea, ginseng, and astragalus: a review. Integr Cancer Ther. 2003 Sep;2(3):247-67. Review. PMID: 15035888 Delorme D, Miller SC. Dietary consumption of Echinacea by mice afflicted with autoimmune (type I) diabetes: effect of consuming the herb on hemopoietic and immune cell dynamics. Autoimmunity. 2005 Sep;38(6):453-61. PMID: 16278152 Herbal Science Group Says Dosage Too Low in New Echinacea Trial Patak P, Willenberg HS, Bornstein SR. Vitamin C is an important cofactor for both adrenal cortex and adrenal medulla. Endocr Res. 2004 Nov;30(4):871-5. Review. PMID: 15666839 Kurugol Z, Akilli M, Bayram N, Koturoglu G. The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Acta Paediatr. 2006 Oct;95(10):1175-81. PMID: 16982486 Hulisz D. Efficacy of zinc against common cold viruses: an overview. J Am Pharm Assoc (Wash DC). 2004 Sep-Oct;44(5):594-603. Review. PMID: 15496046

Thursday, January 04, 2007

Neil on TV today!

Neil was featured in an interview about asthma on the 700 Club today. It should be broadcast this evening on ABC FAMILY cable network (10 PM Central time). The interview runs from about 7 to 11 minutes into the hour-long program.

Clone Wars!

I sent this letter to the editor to several newspapers yesterday: Dear Editor, The U.S. Food and Drug Administration (FDA) recently announced approval of meat and dairy products from cloned animals, despite widespread concern among scientists and food safety advocates.Recent polls show that, though most Americans do not want food from cloned animals, cloned milk and meat may soon be sold without labels. But there is much more to the debate than just the nutrient profile of cloned meat and milk, which the FDA seems to have focused on to the exclusion of other issues. Some scientists argue that clones may be inherently unhealthy, with potentially harmful consequences for foods derived from clones. Altered gene expression is common in clones and the process typically results in defective aborted fetuses and birth defects. The first cloned mammal was the sheep "Dolly". Just six years old when euthanized (expected to live until eleven), Dolly suffered from arthritis and lung disease usually found in much older animals. The lead scientist responsible for "creating"Dolly warned that even small imbalances in a clone's hormone, protein or fat levels could compromise the safety of its milk or meat, and some farmers do inject synthetic growth hormones in dairy cows. The FDA has ignored valid scientific and ethical concerns to fast-track a decision for the benefit of biotech companies, without significant public input. Please let our representatives in Washington know that food from cloned animals should be banned. At least label cloned food so we may freely choose whether to eat or avoid it. Neil E. Levin Clinical Nutritionist

Wednesday, January 03, 2007

Neil on the radio

Available for the next few days only: I am in the second half hour of this one-hour radio show segment from Healthy Talk Radio with Deborah Ray, broadcast 1/2/07 Topic: black cohosh study