HIV Side Effects … Needless Suffering? The science editor of POZ magazine visits Houston on World AIDS Day to discuss "how to live well with HIV, not just longer"Last year a study commissioned by the Ryan White Planning Council showed that over 80 percent of people living with HIV/AIDS stopped taking their drugs at some point. Why? Over half said they stopped because of the side effects.

"Needless suffering" is what Lark Lands, Ph.D., labels many of the side effects resulting from HIV drugs. Currently the science editor of the nationally recognized POZ magazine, Dr. Lands is a treatment advocate and HIV survivor, and is leading populations of chronically ill people back to wellness. She has spent 16 years helping people learn about the potential for nutrient supplementation to slow disease progression, resolve symptoms, and lessen side effects of drugs while improving their effectiveness.

Dr. Lands will be speaking at the Houston Buyers Club World AIDS Day Health Fair at Bering Church, 1440 Harold, on World AIDS Day, Saturday, December 1, 10 a.m. (For more information, see the two-page advertisement in this issue). She will also participate in a Q&A session with Dr. Patricia Salvato and Nelson Vergel during the conference. Call 713/520-5288 for information about the event or about the Houston Buyers Club. You can find out more about Dr. Land at www.LarkLands.net.

Fred Walters of the Houston Buyers Club interviewed Dr. Lands.

Fred Walters: You’ll be talking at the Houston Buyers Club’s upcoming World AIDS Day Health Fair on December 1. Can you summarize what you think are the most important things you’ll be covering?

Dr. Lark Lands: How to eliminate symptoms, whether you’re currently taking HIV drugs or not. How to reduce or eliminate HIV drug side effects if you are on HIV meds. How to increase the absorption of HIV drugs in order to improve their effectiveness and lessen the chance for the development of resistance. How to lessen the risk of infections and cancers. How to slow disease progression if you’re not yet on HIV drugs, or, if you are on HIV meds, how to increase the life-extending effects more than HAART [highly active antiretroviral therapy] alone can provide. We have learned a lot in recent years about how to accomplish these things with the appropriate use of nutrients, as well as hormonal therapies, exercise, and other approaches, and it’s high time that we started teaching people all of this.

Is it really possible to reduce drug side effects with this sort of approach?

Absolutely. We are hearing more and more from researchers looking at the underlying causes of drug side effects and the possibility of countering them with various combinations of nutrients, and we can add to that scientific info all that we have learned through anecdotal reports from HIVers over the years. The bottom line seems simple: Good nutrition and nutrient supplementation can help to maintain a body that is healthy enough to withstand the assault of drugs, to the greatest extent possible. The simple fact is that what could keep many people from using antiretroviral drugs long-term is all the nasty side effects that so many people get. So by using an integrated approach to reduce such problems, we can not only help people live better with the disease, we can also greatly increase the chances for long-term effective use of the drugs.

What does a person with HIV or any chronic illness consider when taking nutritional supplements?

We need to look at the specific effects of all the drugs someone is taking in order to design a program that contains the nutrients that can help the body to tolerate them. With nucleoside analogues [drugs like AZT], we need to consider countering the "mitochondrial toxicity" [damage to the cells’ energy factories] with nutrients like carnitine and riboflavin and antioxidants. With protease inhibitors and NNRTI’s [drugs like Viramune and Sustiva], it’s critical to maintain the health of the liver and there are a number of nutrients–including alpha-lipoic acid, n-acetyl-cysteine, glutamine, and vitamin C–that can help. So ensuring an optimal supply of nutrients is a critical step for anyone taking antiretroviral drugs. I know lots of people taking aggressive antiretroviral combos that just don’t get the side effects that other people get.

Could you tell us more about eliminating symptoms?

Absolutely. Whether your symptoms are caused by HIV disease, or by the HAART meds, there’s a lot that can be done to get rid of them. In fact, most of the symptoms that can make people’s lives just plain miserable can be eliminated or at least greatly reduced with the right combinations of nutrients, along with hormone replacement, when necessary. That includes fatigue, loss of sex drive, skin problems, memory changes, neuropathy, impotence, digestive problems, loss of your senses of smell or taste, appetite loss, depression and anxiety, muscle cramps, and, of course, that perennial favorite, stinky smell gas, along with many others. And we’re even learning how to reverse some of the body effects that lipodystrophy can cause by using things like human growth hormone [Serostim] to reduce big bellies and buffalo humps, and polylactic acid injections to reverse facial wasting, and so on.

The bottom line is simple. In order to be able to continue to manage a difficult disease long-term, you need to feel good, and you need to feel good about yourself. We absolutely shouldn’t let people’s lives continue to be affected by symptoms that we may be able to eliminate, or at least reduce.

Can nutrients help slow disease progression?

Many studies have now shown that they can. With some nutrients, the effects may be dramatic. In separate studies, people with deficiencies of either selenium or B-12 were shown to progress twice as quickly compared to those without deficiencies. And both those nutrients are commonly deficient in HIVers. Earlier studies had shown much slower disease progression in people with higher levels of nutrients. So we absolutely need to keep people’s nutrients at optimal levels. This is particularly important in an era when we are again becoming more conservative about when people start using antiretroviral drugs. Since people are beginning meds at later stages now, it’s very important to teach people every possible thing that could help them slow disease progression during all the years that they are not yet taking meds.

Can an integrated approach also prevent or reverse wasting and help people maintain strong bodies?

Absolutely. We don’t see as much traditional wasting (as opposed to the kind associated with lipodystrophy) as we used to, but it’s definitely still around. So preventing it–or reversing it where it’s already present–with nutrients, hormone therapies like human growth hormone (Serostim) and testosterone (Androgel), and exercise is a must, not only to ultimately prevent death but also to help people maintain their strong healthy bodies and look better, feel better, and function better throughout.

You mentioned ways to improve absorption. Can you tell us more about that?

The combined effects of HIV and, in many people, other infections, along with the nutrient deficiencies that are omnipresent with this disease, have created intestinal damage in many people. The result is malabsorption, which can greatly diminish how well both nutrients and drugs are taken up. A recent UCLA study found that fat malabsorption was present in almost all the HIVers studied, and a highly likely cause of diarrhea in many. With malabsorption, you may not get the full dose of the drugs you’re swallowing and the effect will be the same as taking a dose that’s too low. They’ll work less well, allowing greater viral activity and speedier development of resistance. Since some of these drugs are in forms that are difficult for the body to absorb anyway, worsening the situation with intestinal malabsorption is a very bad idea.

Nutrients can help repair the intestines and boost the capacity for proper drug absorption. Unfortunately, for many reasons, the very nutrients that are needed for this may be missing in a majority of people living with HIV. So supplementation with these nutrients–especially glutamine, as well as zinc and vitamin A–may be crucial for maintaining long-term drug effectiveness. And taking pancreatic enzymes may be hugely important for preventing diarrhea and gas, whether people are on drugs or not.

Would you mind sharing how you have used this approach in your own life to stay healthy?

When I was a kid, I was diagnosed with severe Type 1 diabetes. I wasn’t given much hope for growing up. When I was in my 20s, I was told I would be dead in two years. I ignored that kind of pessimism and incorporated nutritional therapies into my own treatment approach. I think that’s why I’m alive today. It’s why I’m so passionate about teaching people about these types of therapies.

If we asked you to summarize the topic of your speech in one sentence, what would it be?

How to live well with HIV, not just longer.