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HIV, Chronic Inflamation and The Role Of Vitamins/Supplements

Vitamins

HIV, Chronic Inflamation and The Role Of Vitamins/Supplements

Vitamins and supplements can play an important role in the health of people with HIV. Shortly after it was established, ACON set up a Vitamin Service with a commitment to maintain and improve the health of people with HIV by providing high quality vitamins at the lowest possible prices. And this commitment continues to this day.

• The changing face of HIV

The changing face of the epidemic requires ACON to keep up with new developments in treatment, care and supplementation. This is the key role of the ACON Vitamins and Supplements Advisory Group. This group comprises an HIV doctor, naturopaths and dietitians and the ACON Treatments and Client Support Officer.

The lives of people with HIV have been transformed dramatically in recent years. Improvements in treatments and care and a better understanding of HIV have resulted in people living longer than ever before, and with fewer of the health issues associated with the early days of HIV. In fact a person diagnosed with HIV today in Australia who is on medication and maintains a healthy lifestyle can expect to live close to a normal lifespan.

However the longer these people live, the more health issues researchers and doctors are discovering. Some of the most significant health issues that are currently being experienced by people living longer with HIV are chronic inflammation and the health of the gut. Both of these can be improved by many approaches, including supplementation.

• Practitioner Quality

The range of products from the ACON Vitamin and Supplement Service are ‘Practitioner Quality’. This means that the products are superior in quality to supermarket and pharmacy brands in their manufacture, content and quality. They are also better able to be absorbed by the body and therefore said to have superior ‘bioavailability’. In supplementation the term bioavailability literally means how well or efficiently a supplement is able to be absorbed, utilised and/or retained by the human body.

If a drug is injected into the body intravenously it has a bioavailability of 100%. If something, like a supplement, is taken orally it begins to be broken down from the time it enters our mouths and continues to be broken down as it passes through the body. Superior manufacturing procedures using superior ingredients and testing standards mean that the products chosen by the ACON Vitamin and Supplement Service have superior demonstrated bioavailability than supermarket products, and therefore will work better.

For this reason you will need to consult with a qualified practitioner and ask them to write you a letter or fill in an ACON Vitamin ‘script’. Practitioners can include your HIV doctor, GP, dietitian, naturopath, or herbalist. A letter or a signed ‘script’ is a requirement of the Therapeutic Goods Act (TGA) to ensure accurate information is provided and correct products are recommended. For this reason a new letter or script is required every six months.

Most practitioners have copies of the ACON ‘scripts’, but if they don't, one can be posted or emailed to you, or you can download one from the ACON website. The scripts are also available from the Positive Living Centre (PLC) and ACON Commonwealth Street Head Office reception staff.

• Supplements as protection against HIV related Inflammation

Despite advances in treatment and care, even if your blood results tell you that HIV is undetectable in your blood, the virus can still hide in other parts of the body. In HIV medicine these are called reservoirs and can include the lymph glands, bone marrow and nervous tissue. This ongoing ‘dormant’ infection stimulates the immune system to constantly send out ‘cytokines’. Cytokines are cells that cause inflammation as the immune systems response to infection.

When you have a flu, it is not the flu itself that makes you feel ‘stuffy’ and ‘blocked up’, rather it is the cytokines that the immune system sends out to fight the infection. You will also notice this immune response if you scratch or scrape yourself. The area will become ‘inflamed’ or swollen, and turn red. This is a result of the immune system sending out cytokines to fight the infection.

Chronic Inflammation

• Immune Activation
When your immune system comes into contact with an infection, ‘memory’ cells are made and stored so you have an automatic defence against if you come into contact with that infection again. This is how we develop immunity, and is also why you usually only get things like Chicken Pox or Hepatitis A only once.

Because of the unique nature of HIV, when you develop memory cells to HIV the virus becomes ‘part’ of your immune system. This is why it has so far proven difficult for scientists and doctors to fully rid HIV from the human body. In continuously sending out HIV memory cells, the immune system is unknowingly reproducing new HIV. Having HIV ‘embedded’ in your immune system puts it in a continuous state of Immune Activation. Immune activation typically only lasts for the duration of an infection, or the duration of the flu, for example.

• Chronic Inflammatory Response

Ongoing ‘Immune Activation’ stimulates the immune system to continuously send out inflammatory cytokines. Extended periods of exposure to cytokines (a chronic inflammatory response) can affect the health and function of the heart, blood vessels, digestive system and other parts of the body. Many people with HIV report skin rashes, itchy scalp, fatigue and digestive issues. These and other symptoms can be attributed to the chronic inflammatory response. These symptoms can also be caused by other health issues such as allergies.

Doctors and researchers are noticing now that people living with HIV are living much longer, they are more likely to develop heart disease and other health issues much earlier than the general population. Please follow this link to further information and references. If you add in other lifestyle factors such as drinking, smoking, unhealthy diet and lack of exercise the risks of developing premature health issues can be much higher. The chronic inflammatory response also contributes to premature ageing of your physical appearance.

• Exercise and Diet
Your doctor is constantly monitoring your blood results to monitor for complications that might be related to inflammation. If you have any results that might indicate health issues related to inflammation your doctor will have important information and advice for you. Suggestions might include the possibility of changing treatment or prescribing another medication to treat the related health issue. Your doctor can also advise about lifestyle issues and might even suggest a referral to an HIV dietitian or to increase your exercise.

HIV dietitians are expert in relation to how diet can both improve health and prevent health issues. Daily exercise is also important for your heart, weight, bones, brain and even improves mood and energy. Consider buying a pedometer and clocking up 8,000 to 10,000 steps per day. It’s not as hard as it sounds – you may be surprised how much you are already walking! You should discuss any plans to change your exercise routine with your doctor before starting.

• Stress Management
Stress can also contribute to inflammation and related health issues. Psychological stress can be described as a state of mental or emotional strain or tension, and can be commonly experienced by people living with HIV. When you are stressed your body releases hormones to prepare you for a ‘flight or fight’ response. If people feel stressed most of the time, these hormones can be continuously released. This process can further contribute to inflammation related health issues.

There are many approaches to stress management. You might like to talk to a counsellor about a specific issue that is worrying you, or you may want to try yoga or meditation. You can ask your doctor or other health care worker for advice, or even contact ACON who provide a range of services and referrals. Daily exercise is also an excellent way to combat stress.

You should also tell your doctor if you are feeling stressed, as these symptoms can be a sign of other health issues like anxiety or depression, which doctors working in HIV are often very experienced with. If you want to discuss mental health issues you should book a longer appointment at the beginning of the day if possible. This will give you and your doctor enough time to talk about what’s happening to you.

Other causes of inflammation not entirely related to HIV include allergies, asthma, hayfever and other health issues. You should ask your treating team if you should undergo allergy and other testing to ascertain if you need to have any of these issues addressed.

Vitamins and Supplements

• Omega 3 Fatty Acids and inflammation.
Omega-3 fatty acids (Omega-3’s) are ‘essential fatty acids’, meaning our bodies can’t ‘make’ them so we get them from our diet. Omega-3 is a type of polyunsaturated fat that is commonly referred to as “good fats”, because unlike saturated fats (or “bad fats”), they do not increase cholesterol levels in the blood.

There are three types of Omega-3 fatty acids:

ALA    alpha-linolenic acid
EPA    eicosapentanoic acid
DHA    docosahexanoic acid

The best way to get Omega-3’s is from our diet and some of the best sources of Omega-3’s from our diet include flaxseed oil, canola oil (including margarines derived from canola oil), walnuts, wheat germ, linseed, soybeans, seaweed and dark green leafy vegetables.

Good sources of EPA and DHA are found in oily cold water fish such as salmon, mackerel, sardines, herring, halibut, and to a lesser extent, tuna. Fish get their Omega-3 fatty acids from the algae they eat and so there may be a difference in the amount of Omega-3’s found in wild fish versus farmed fish. Eggs are also a good source of Omega-3 and, while lean red meat does contain some Omega-3 fats, it is not a rich source.

Many foods now have Omega-3’s added, or are ‘fortified’. Some fortified foods include milk, margarine, bread, breakfast bars, yoghurt and juices. You can ask your dietitian or check the labels of products to find out which foods are fortified with Omega-3’s.

The principal dietary source of Omega-3’s is alpha-linolenic acid (ALA). In a healthy person this is converted or changed into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These are the only forms of Omega-3’s that the body is able to use.

This conversion depends on chemical processes in the body that are very sensitive to interference caused by a variety of lifestyle factors including:

• Diets high in sugar or alcohol
• Diets high in ‘bad fats’ from processed and take-away foods
• Smoking
• Pollution
• Stress
• Ageing
• Viral infections, including HIV and Hepatitis
• Diabetes and other health issues
• HIV treatments and other medications

This can result in many people living with HIV not getting enough Omega- 3’s from their diet and missing out on the health benefits, especially the anti-inflammatory properties. Many researchers, doctors, dietitians and other health experts are recommending that people with HIV take Omega-3 supplements.

“DHA is known for its benefits for supporting cardiovascular health and normal function of the brain. Specifically, DHA plays a role in lowering triglycerides (fat molecules found in the blood) and has a ‘cardio protective function’ (protects the health of the heart) that may help maintain optimal cardiovascular health.”

MetaPure EPA/DHA Capsules

Following a great deal of research and discussion with the ACON Vitamins and Supplements Advisory Group, the ACON Vitamin Service has chosen MetaPure EPA/DHA Capsules as our stock item of Omega-3’s.

Some of the reasons for this choice include:

• The capsule form is superior to liquid form, as soon as you open a bottle of liquid fish oil it starts to oxidise or ‘go off’, and lose its beneficial properties;
• Higher concentration of ingredients than comparison products, allowing many people to take only 1 capsule once a day as opposed to 9 capsules required in other products. Some people may be required to take more for specific health issues;
• The higher concentration and fewer required capsules results in greater savings for our clients. The company that supplies this product has given us an extra discount for this product;
• Ingredients are sourced naturally;
• A higher standard of manufacture than required by industry standards resulting in a more pure product with fewer contaminants such as mercury;
• No fishy taste; and
• Many others. Please see the product guide included in this magazine for more information.

Important

This information has been taken from the manufacturer’s product information, and as such is approved by the Therapeutic Goods Administration (TGA). The TGA carries out a range of assessment and monitoring activities to ensure therapeutic goods available in Australia, including this product, are of an acceptable standard (do what they claim to do) with the aim of ensuring that the Australian community has access, within a reasonable time, to therapeutic advances (improvements in healthcare).

The manufacturing and purification technology used to produce the Metagenics range of concentrated Omega-3 fatty acid formulae results in a final product that exceeds industry standards. This ensures superior purity from common contaminants including Mercury and other heavy metals (all fish contain heavy metals, including Mercury). Australia has strict standards that require manufacturers to ensure that Mercury must be present below a certain level. This product ensures an even lower level of Mercury than Australian Standards.

The PLC

The PLC sometimes has volunteer practitioners who you can consult for free. The PLC can also recommend complementary therapists who are experienced in working with people with HIV. The ACON Treatments and Client Support Officer is also able to provide information for general health related enquiries. If you would like to engage with one of these people at the PLC you will need to register as a PLC client (quick, easy and confidential) and make an appointment.

The Positive Living Centre at located at 703 Bourke Street in Surry Hills. It is open for drop in visits from Tuesday to Friday from 10:00am to 4:00pm. The centre is open on Mondays by appointment only and some evenings during which therapies and courses are conducted.

If you or someone you know works in the area of supplementation and would like to volunteer at the PLC, or you have any questions relating to its services please call (02) 9699 8756, Freecall 1800 063 060 or email plc@acon.org.au. If you would like to come into the PLC please call first so we can make sure someone is available to meet you.