Dr. Smith with Your Health

MINERALS AND THE HIV+ PERSON

by Brian A. Smith, DC

This article deals with the most common minerals associated with HIV infection. Minerals are used by the body as "co-factors" in many reactions. As a "co-factor" they facilitate the reaction and allow it to occur. When a depleted state exists, the reactions that are dependent on the mineral in question are greatly slowed down or even stopped. Minerals also exist as part of molecules, for instance the mineral cobalamin is part of vitamin B-12.

Zinc: Probably the most "talked about" mineral involving HIV is zinc, with selenium running a close second. Zinc is required for replication and proliferation of T-cells as well as protein metabolism, both important for immune function. Low zinc levels are associated with depressed T cell function. Low levels have been hypothesized as a cofactor in the loss of T4 cells. There are several published papers detailing all the uses on zinc, especially as it relates to HIV. Suffice it to say that low levels are very detrimental to proper immune functioning. Serum zinc levels have been shown to be lower with HIV infection. Further, HIV+ persons can have a wide variation of zinc concentrations in their bodies. The lower the concentration, the more rapid the progression of illness. It seems pretty obvious that an HIV+ person should supplement with zinc - or is it? Excess intake of zinc has also shown to be immunosuppressive. Reduced antibody response and reduced lymphocyte activation is the result of too much zinc. What to do? As many of my longtime readers know, I am a strong believer in lab work - so ... order a serum zinc (about $40.00), or even better, though harder to find and more expensive, a red blood cell zinc level. Instead of this, low zinc levels are associated with low serum alkaline phosphatase, which is a test that should be part of your regular "chemistry panel" - look for it - "alk phos" - couple this with some symptoms of zinc deficiency: slow wound healing, loss of taste, smell and appetite and/or lower sex drive. If your zinc levels are low - how much to take? Your total intake must be below 125 mgs. per day to be safe. The average obtained in the diet is around 10 mgs. Zinc picolinate, citrate and aspartate are better absorbed and cause less irritation. Long term intake of zinc can depress copper levels, so this may need to be monitored as well. A good multiple will contain around 20 mgs. so you may need to supplement with extra zinc. Unless you are under the care of a health professional knowledgeable in nutrition, I would not recommend more than 50 mgs. total per day.

Selenium: another mineral that has been shown to be decreased in HIV infection is selenium. Selenium is part of a complex called glutathione peroxidase. This complex is necessary for proper immune function and it helps in destruction of highly reactive free radicals which damage cell walls and cellular DNA. As the amount of free radicals in the body increases, so does viral replication. Glutathione is known to be low in most HIV+ persons. The use of NAC, or L-cysteine, is aimed at increasing glutathione levels. In addition to the above, selenium is necessary for the conversion of

one thyroid hormone, T4, into the more active T3 form, which is known to be low in HIV+ persons. This appears to be linked to weight loss. It is also known that retroviruses seek out, and incorporate, selenium in their proteins. This would deplete the bodies available selenium, causing weight loss and depressed immune function. Poor absorption of selenium is also thought to be a major problem. One theory about viral replication is that, since the virus seeks out selenium, it will remain in a cell and not multiply as long as it receives enough selenium. Once that level drops, the virus multiplies and seeks out a new source (cell) for more selenium. One group of researchers in France were able to demonstrate that serum selenium levels could predict the course of HIV illness better than p24 levels. In your lab work you can check your "serum albumin" levels - these correlate with selenium levels, the lower the albumin, the lower the selenium. Serum selenium testing is available ($80.00) but is not very accurate as it reflects recent intake and not cell levels. Red blood cell selenium is better but, once again, is much more difficult to obtain and is much more expensive. Recommended levels of supplementation are usually 200 or 400 mcg. Organic forms, such as selenocysteine, selenomethionine or amino acid chelates are safe. Inorganic forms such as sodium selenite are known to be toxic.

Copper: is another mineral that occasionally appears in the literature regarding HIV. Copper is required for maturation and proliferation of lymphocytes. Copper deficiency limits the formation of interleukin-2 (Il-2) by activated T-cells. Oddly, high copper levels are found in HIV+ persons with progressive illness, whereas low levels are found in "non-progressors." This may be due to the fact that copper, as "ceruloplasmin" is an "acute phase reactant" or, in other words, it increases during infection. Both ceruloplasmin ($35.00) and serum copper ($35.00) must be ordered to check for deficiency. Large intakes of zinc will lower copper levels. It has been suggested that anyone supplementing with zinc should also supplement with copper. Heavy exercise has also been shown to deplete copper levels. Most good multivitamin formulas will have 2 mg. of copper, which is adequate if you do not have a deficiency. It has been shown that copper deficient rats with low T4 cell counts will have those counts return to normal with copper supplementation. I would not recommend separate copper supplementation unless your lab work demonstrates the need.

Iron: is commonly given to HIV+ persons with low red blood counts (anemia). This is usually done when your lab work shows anemia and low serum iron. This is not smart! All doctors are taught to never supplement with iron based on a low serum iron only. There are other tests to perform, serum transferrin ($55.00) and serum ferritin ($50.00) being the best. A total iron binding capacity, TIBC, and "% iron saturation" are cheaper and, if interpreted properly, can be quite accurate. Many insurance companies will not pay for these tests claiming that a low serum iron is sufficient. Your doctor should not be pushed around by these companies, since the doctor knows that your health is at stake and that they are following correct procedure in ordering these tests. Large doses of iron may cause free radical damage which increases viral replication.

These are the most commonly discussed minerals, however there are many more: magnesium, potassium, calcium, manganese, chromium, etc., that may need to be added to your supplement regimen based on your individual need.

As always, never start supplementing without competent guidance. The person you trust for nutritional advice should be able to order all the blood tests necessary to determine your status. A hair analysis, for the most part, is useless in determining body amounts.

Since we now know that zinc, selenium, copper and iron levels are different with infection, it should be routine to have these levels checked or correlated with your other lab work, insist on it!

Dr. Brian A. Smith is a chiropractic doctor and naturopathic physician who has specialized in the treatment of immune-suppressed individuals since 1987. He is a scientific advisory board member of AIDS ReSEARCH Alliance.

He maintains a private practice in Los Angeles and can be reached at (323) 306-4909. Questions from readers are welcome as are suggestions for future articles. You can also contact him via E-mail at: Send e-mail to Dr. Smith

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Articles by Dr. Brian A. Smith:

HIV and CHIRO † VITAMIN C † BETA-CAROTENE † MINERALS † DMG † PROTEIN † DIET & HIV † MORE ON PROTEIN † NUTRITION † DHEA † LIVER † CHIRO † NAC † SILVER † ALT THERAPIES †