Detox conjures up images of painful, sometimes forced, abstinence from hard drugs and alcohol. But for me and thousands of other PWAs, detoxification has played a much broader and more restorative role in improving health. Toxins from many sources can degrade the body's immune function. My pre-AIDS life on the edge--unsafe, bathhouse sex, recreational drugs, junkfood diet and overwork--was a classic example. To minimize the consequences of this compulsive yet satisfying overstimulation, I used strategies ranging from herbs to vitamins to exercise. Eventually, the worst of my toxic behaviors fell by the wayside and, with them, my detox regimen.
But after confronting AIDS for a decade, my failing health forced me to reevaluate my do-little strategy. Last year, I made a serious commitment to detox. It's often a struggle to change lifelong bad habits and stick to new ones. But when I'm successful at this balancing act, the payoff is substantial: I look and feel better, I gain muscle mass (keep wasting at bay), my skin tone improves, and my KS lesions fade.
My need to detox became yet more compelling when I took the plunge into the world of antiretroviral drug cocktails. Fred Bingham, a New York City long-term survivor, says, "PWAs will need detox strategies to sustain years of multiple toxic pharmaceuticals." Whatever you need to detox from, there is a wide range of methods available. You'll have to decide which approaches are doable and safe for you.
A simple place to start is drinking at least 64 ounces (eight cups) of purified water each day, advises San Francisco AIDS specialist Jon Kaiser, MD, author of Immune Power (St. Martin's Press/New York City). Water helps clear the kidneys and liver of toxic buildup. I follow holistic practitioners' advice and drink unchilled water, since cold liquids shock the internal organs. Adequate water intake is crucial for PWAs using the Merck drug Crixivan (indinavir), which can cause kidney stones in up to 5 percent of those on it. "Merck's recommendation of 48 ounces of water per day is totally inadequate," Kaiser asserts. He says all of his patients who drink at least 96 ounces of water a day have so far avoided kidney stones.
Dietary detox methods range from cutting back on refined sugar, caffeine and fried foods to eating more fiber- and nutrient-rich foods such as fresh vegetables, fruits, whole grains and legumes. Many PWAs also use a host of supplements including vitamin C, garlic and herbal colon-cleansing formulas. Chlorophyll, available from products such as blue-green algae and barley grass, helps strengthen cells and regenerate the liver's ability to remove toxins from the blood.
Sweating is a simple detox method: Inducing a temporary and artificial fever speeds up metabolism, opens the pores and pushes toxins through the skin. Steam rooms, dry saunas, Native American sweat lodges, hot baths and exercise can all be used to promote sweating. "Dry or wet--whichever gives you the greatest glow," says Kaiser, who recommends heat therapy at least once or twice a week. But he considers long steam or sauna sessions at high temperatures (above 165 degrees) too stressful. For me, 15-minute sessions are manageable, but I prefer soaking in hot baths at home--with or without a friend--because can control the bacteria.
One controversial detox method promoted by some alternative practitioners--and shunned by others--is fasting. "Malnourished people and those with low immunity definitely should not fast," says Elson Haas, MD, author of The Detox Diet (Celestial Art Publishing/Berkeley). He thinks fasting for many people with full-blown AIDS is potentially catabolic (meaning it breaks down muscle tissue) and may release an overwhelming cascade of toxins. I agree: I have enough problems maintaining my strength and weight. But some healthy HIV positive people can benefit from a gentle, modified fast of three to four days. For example, two daily meals--one fruit, the other steamed vegetables.
Anyone embarking on a detox program will need caution, patience, motivation to change and reliable HIV-specific information. Work with a health practitioner to select methods; use trial-and-error. Drinking water is an easy beginning. Waking up to pee in the middle of the night seems a small price to pay for limiting damage to the only body you have.