Ask POZ : I'm on HIV treatment, but I'm also considering supplements. Any concerns?

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May 1, 2014

I'm on HIV treatment, but I'm also considering supplements. Any concerns?

Stuart Federman
Stuart Federman
Stuart D. Federman, PharmD, AAHIVP
Gateway Apothecary
Saint Louis, MO

There are no current supplements that can cure or reduce viral load that we are aware about. There are certain supplements that you should just avoid because there are drug interactions, as well as a lack of evidence that the supplement is as effective as other medications for certain health conditions.

Most supplements do not go through the rigorous process of getting an approval from the Food and Drug Administration, which medications have to prove that they are effective. Before starting any herbal product you should talk to your HIV-specialized doctor or pharmacist who can help steer you in the right direction.

St. Johns Wort is a supplement that is used naturally for depression. There is limited data in Europe, where it shows some effectiveness. However, it also is metabolized in the same spot where the antiretrovirals are broken down, which will cause the dose of the antiretroviral to be lowered and therefore can cause the medication not to work.

Most supplements have not been fully studied in people with HIV, so we do not know what type of interaction that this can cause. Also, if the supplement is made in a foreign country or not by a reputable company the supplement may not contain correct product, or correct dose or may even be counterfeit.

There are many supplements that do have benefit in patients with HIV: Omega 3 fatty acids help with cholesterol levels; multiple vitamins help replenish vitamins not in patient diets; and vitamin D helps absorb calcium to maintain strong bones.

Additional writing by Amanda Wong, student pharmacist at the St. Louis College of Pharmacy.

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