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December 4, 2000
A Holistic Approach to HIV
Complementary treatments help with immune rebuilding
By David Batterson

Skipper Chong Warson

hese days, patients with human immunodeficiency virus (HIV) have better treatment options than ever before, and average life spans are increasing dramatically. Most physicians who specialize in treating AIDS urge patients to stick to the highly active antiretroviral treatment (HAART) regimen. This triple therapy is often called the "AIDS cocktail." It commonly consists of two drugs with a tongue twister name, nucleoside reverse transcriptase inhibitor (NRTI), and one highly active protease inhibitor.

But these new drugs are often accompanied by severe side effects, and after a time, patients' immune systems can deteriorate regardless of their use. Some physicians, including David Hardy, M.D., of Pacific Oaks Medical Group, in California, see the current triple therapy "eventually failing due to toxicity, intolerance, and resistance." So what's the solution?

Immune-system rebuilding, says Jon Kaiser, M.D., a San Francisco-based physician who treats HIV through a holistic approach along with the usual prescribed medicines. Currently an integrative medicine consultant who specializes in the combination of natural treatments and state-of-the-art drug therapy, Dr. Kaiser points to studies of this methodology documented in his book Healing HIV -- How To Rebuild Your Immune System (HealthFirst Press, 1999).

To keep HIV under control, it's vital to maintain a healthy outlook and avoid stress, says Dr. Kaiser. He explains that the body's natural ability to heal is affected by diet and stress levels, as well as "the health of your intestinal system, level of hormones, and your psychological and emotional health."

According to Dr. Kaiser, specific problems that make HIV worse are herpes infections, intestinal parasites, low protein intake, inadequate antioxidant vitamins, hormonal imbalances, and substance abuse.

Intestinal parasites

Because the presence of intestinal parasites can wreak havoc on an HIV-ravaged immune system, Dr. Kaiser recommends that all HIV patients be tested for them, even if they don't have diarrhea or blood in the stool. Fatigue can be a common symptom of intestinal parasites, but most often there are no symptoms at all.


Through HIV seminars based on his immune-building approach, Dr. Kaiser gets his HIV-positive patients thinking beyond their next "cocktail" to improving their overall health and well-being.


Kaiser recalls a patient who could not tolerate protease inhibitors, but once an intestinal parasite problem was diagnosed and treated, the patient continued with antiviral drugs without stomach or intestinal upsets. Dr. Kaiser's standard treatments for parasite elimination include paromomycin (Humatin), iodoquinole (Yodoxin), and a natural treatment with psyllium seed husks or black walnut tincture. These should be taken only under medical supervision.

Miscellaneous gastrointestinal problems associated with HIV therapy often include constipation and intestinal gas. Chris Feagan, a registered nurse who works with HIV patients, advises that for constipation it's "best to avoid laxatives if you can." Laxatives can be harsh and often exacerbate side effects. Fegan suggests natural remedies like ginger root, peppermint or chamomile tea, allspice, fennel, and Swedish bitters. For gas, which can be embarrassing as well as painful, Fegan recommends walking, yoga, and over-the-counter antiflatulents.

For other natural remedies, Fegan recommends the Professional's Handbook of Complementary & Alternative Medicine, by Charles W. Fetrow, Pharm.D., and Juan R. Avila, Pharm.D. (Springhouse Publishing, 1999).

Protein intake

For HIV patients, diet is extremely important both in alleviating side effects and in maintaining the immune system. One food group that patients sometimes ignore is protein, which Dr. Kaiser says helps your body fight illness; too little protein can cause fatigue. When one of his patients adopted a macrobiotic diet -- eliminating all meat -- his CD4 count (an indicator of immune function) dropped "quite a bit," Dr. Kaiser recalls. When the patient started eating meat again, his CD4 count increased.

When an HIV-positive individual is under stress, Dr. Kaiser recommends 0.6 grams of protein per pound of body weight. For example, a 170-pound person should consume 100 grams of protein daily. In addition to meat, the doctor suggests beans, tofu, cottage cheese, sunflower seeds, and nuts such as peanuts and cashews.

Hormone levels

An optimal hormone balance is also crucial, says Dr. Kaiser. One hormone level he tests for is DHEA, because it's a "common deficiency with HIV patients." DHEA -- an over-the-counter supplement -- helps with appetite, mood, and energy level," says Dr. Kaiser. Another common deficiency is testosterone, which affects mood, energy, and libido. The doctor recommends a patch, Testaderm TTS, which delivers testosterone more evenly than shots do. Dr. Kaiser also recommends nandrolone (Deca-durabolin), oxandrolone (Oxandrin), and growth hormones, which help build muscle when combined with a good exercise regimen. These anabolic hormones "can possibly deal with side effects like 'protease hump' and similar body changes," he says.


Vitamins and minerals are other useful weapons in the fight against HIV. Dr. Kaiser maintains that vitamin deficiencies decrease tolerance to antivirals and cause side effects to worsen. Besides high-potency multiple vitamins and minerals, he recommends taking 1,000 milligrams of vitamin C and 400 IU of vitamin E daily to help detoxify the system. Vitamin B6 (100 milligrams) is useful to deal with peripheral neuropathy, or tingling and pain that often occurs in the feet of HIV patients, he says.

For HIV-related anemia and fatigue, Dr. Gillermo Santos, M.D., of Betances Health Unit in New York City, recommends vitamin therapy through nutrition. Dr. Santos tells HIV patients to fight fatigue with iron-rich foods, such as beets and dark-green leafy vegetables like spinach and kale. He also suggests taking B-complex supplements.

Dr. Kaiser recommends some additional supplements: coenzyme Q-10 (30 milligrams), N-acetyl cysteine (500 milligrams), and acidophilus. Acidophilus is important for a healthy intestinal system, he says, because some medications eliminate "good bacteria" in the digestive system.

A new attitude

Whether Dr. Kaiser's holistic approach works for all his HIV patients or not, it does succeed in inspiring them. Through HIV seminars based on his immune-building approach, Dr. Kaiser gets his HIV-positive patients thinking beyond their next "cocktail" to improving their overall health and well-being. Tom Sullivan, who attended Dr. Kaiser's seminar in San Diego last year, uses the information he gained as a system of checks and balances regarding his treatment progress. "I'm here to basically reconfirm my HIV treatment program that I'm on," he said at that time. "The last time I saw Dr. Kaiser, he did a really good job of making me feel comfortable with the way my [current] doctor is treating me."

Dr. Kaiser is confident that holistic treatment has a positive effect on his patients' well-being. "Many of my patients actually say to me that they are almost thankful that HIV came into their lives," says Dr. Kaiser, "because they are a healthier, happier people due to all the changes they've made."

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