Dr. Rath Health Foundation

Dr. Rath Health Foundation

Responsibility for a healthy world Dr. Rath Research Institute 100+ Studies Published In PubMed

Micronutrients as an Effective, Safe and Affordable Approach to Help Control AIDS

Matthias Rath, M.D.*, Maud August, M.D.**, Raxit Jariwalla, Ph.D.*, Aleksandra Niedzwiecki, Ph.D.*
* Dr. Rath Health Foundation Africa, 34 Bree Street, Cape Town, 8001, Südafrika ** South African National Civic Organization (SANCO)

Summary

Objectives:

Malnutrition – in particular micronutrient deficiencies – are a major contribut-ing factor to the continued spread of the Acquired Immunodeficiency Syndrome (AIDS) in the developing world. Moreover, micronutrient deficiencies are aggravated by AIDS-related symptoms including chronic diarrhoea, weight loss, fever and opportunistic infections. The community health education programme conducted by the South African National Civic Or-ganization (SANCO) in Khayelitsha, Cape Town, created an opportunity to evaluate the effect of a defined micronutrient programme on the course of AIDS related symptoms in HIV positive patients.

Micronutrient programme

The nutritional supplement programme consisted of a defined combination of micronutrients:

vitamins:
vitamin C (ascorbate),
vitamin B-1 (thiamine),
vitamin B-2 (riboflavin),
vitamin B-3 (nicotinate),
vitamin B-5 (pantothenate),
vitamin B-6 (pyridoxine),
vitamin B-12 (cyanocobalamin),
folic acid, · biotin, · beta-carotene,
vitamin D (cholecalciferol),
vitamin E (alpha-tocopherol);

minerals and trace elements:
magnesium, calcium, potassium, phosphate, zinc, manganese, copper, selenium, chromium, molybdenum;

amino acids:
L-lysine, L-proline, L-arginine, L-carnitine, L-cysteine, N-acetylcysteine, taurine;

other micronutrients:
green tea leaf extract, citrus bioflavonoids, inositol, coenzyme Q-10;

Natural Health Programme:

One hundred community members with AIDS were selected by community health professionals in this natural health programme. The participants included adult HIV positive men and non-pregnant women with advanced AIDS symptoms (stage 2 and 3 of the 4-stage grading according to the Center for Disease Control, CDC). None of the participants was or had been taking antiretroviral drugs (ARVs). The micronutri-ent programme consisted of a combination of vitamins, minerals, trace elements, amino acids and polyphenols from green tea, supplied in the form of tablets. At the beginning of this natural health programme and after 4 and 8 weeks of taking the nutritional supplement, a physician examined the patients. In addition, their health status was assessed with the aid of a graded questionnaire for AIDS-defining symptoms and general health.

Results:

In those participants who completed the entire 8 week micronutrient programme a substantial reduction of the AIDS-defining symptoms was observed. Specifically, micronutrient supplementation was associated with a statistically significant decrease of fever epi-sodes, weight loss, diarrhoea, severity of tuberculosis related symptoms in those patients infected with TB as well as the occurrence of fungal and other opportunistic infections. Daily micronutrient supplementation also significantly reduced other symptoms associated with AIDS including sores, colds, nausea, fatigue, depression, headache, skin rashes, swollen glands, joint pain and numbness in the extremities (hands or feet). There were no adverse side effects related to the intake of nutritional supplements.

Conclusion:

The micronutrients evaluated in this pilot community health programme offer an effective, safe, affordable natural health approach to halt the progression of AIDS-defining symptoms. Moreover, unlike any other health approach currently used, micronutrients offer the opportunity to reverse AIDS-related symptoms and significantly improve the health of AIDS patients. Thus, micronutrient supplementation should become the basis of public health strategies in the global fight against AIDS. The immediate implementation of these findings by national governments as well as the World Health Organization (WHO) would save millions of lives it would provide valuable time for the international research community to find lasting solution to end AIDS.

Introduction

Vitamins and other micronutrients are essential for the adequate production and optimum function of white blood cells, hormones and other factors essential in determining optimum immune response. In particular the critical role of vitamin C, vitamin A, vitamins B-5, B-6, B-12, folic acid as well as certain trace elements such as iron, zinc, selenium, copper and others have been an integral part of textbook knowledge in all fields of biology (1, 2, 3, 4) for decades.

Amazingly, this basic scientific knowledge has not been promoted by health policy makers to fight immune deficiencies, including the AIDS epidemic. Thus far, only a limited number of clinical studies have been conducted to test the health benefits of micronutrients in AIDS patients (5-8). Despite the fact that several of these micronutrient studies showed encouraging health benefits, none of them has been translated into public health policies to fight the AIDS epidemic.

The neglect of micronutrient research in relation to developing global strategies to control AIDS is even more remarkable, since from the beginning of the AIDS epidemic, researchers noticed micronutrient abnormalities in AIDS patients. This was not surprising since chronic diarrhoea, anorexia, malabsorption, impaired nutrient storage, increased energy demands – all of which are symptoms occurring in AIDS – are known to be associated with and further aggravate these nutritional deficiencies (9).

An additional reason why micronutrients should have been used long ago in the fight against AIDS is the fact that the cellular mechanisms by which they strengthen the immune system are well understood. Beside the basic scientific fact that micronutrients are essential for optimizing white blood cell production and immune function, specific cellular mechanisms have been identified on how micronutrients can help fight AIDS.

One of the theories about AIDS is that this disease is caused by the human immunodeficiency virus (HIV). A combination of vitamin C and the natural amino acid lysine represents a therapeutic option to block viruses from spreading through the connective tissue of our body by inhibiting the secretion of collagen-digesting enzymes (10). In addition, vitamin C and other nutrients can almost completely inhibit the multiplication of HIV (11, 12) and induce cell death (apoptosis) in virus-induced malignant cells (13).

These findings are significant, since they establish micronutrient supplementation as an effective approach to fight AIDS – irrespective whether AIDS is caused by HIV or not. Thus, while the scientific debate about the causes of AIDS continues (14), the lives of AIDS patients are no longer compromised by it.

The need for effective, safe and affordable public health approaches to the AIDS epidemic is particularly compelling given the failure of pharmaceutical options. Despite representations by the manufacturers of ARVs and some media, these drugs can not cure AIDS. In fact, nowhere in the world have ARVs been allowed to be registered as a cure for AIDS. While ARVs are known not to cure AIDS, they are associated with severe side effects. One of the target organs of ARVs is the bone marrow where they exert direct damage to the production site of immune cells, causing or aggravating immune deficiencies. As a direct result, patients taking ARVs are prone to other infectious diseases, including tuberculosis and opportunistic infections (15, 16). These diseases develop in addition to other frequent side-effects of ARVs related to their cytotoxicity, including failure of the liver, heart, kidneys and other organs.

Particularly in sub-Saharan Africa and other developing regions of the world, the neglect of micronutrients as an effective, safe and affordable approach in the fight against AIDS continues to threaten the lives of tens of millions of people and the economies of entire nations.

Given the urgency of this situation, a comprehensive approach utilizing a nutritional intervention is required to help control AIDS and – if possible – improve the health and life-expectancy of AIDS patients. Therefore, our objective was to evaluate the efficacy of a science-based micronutrient programme as the foundation of an affordable public health strategy to combat AIDS. We were particularly interested in the potential health benefits of micronutrient supplementation in people with AIDS who were HIV positive and who did not take ARV medication.

Here we document the comprehensive health benefits of people living with AIDS from short-term micronutrient supplementation provided as part of a community health programme in South Africa.

Materials and Methods

Programme settings

In the community health education programme conducted by the South African National Civic Organization (SANCO) in Khayelitsha, a township of Cape Town, HIV positive people with AIDS were identified by community health professionals.

One hundred HIV positive men and non-pregnant women were included in the programme. They were over 13 years of age, had advanced AIDS symptoms (CDC stage 2 or 3) including ulcers, lymph swelling, skin rashes, joint pain, wounds and sores, colds and flu, nausea or vomiting, fatigue, depression, headache and numbness or tingling in the hands or feet. People who were currently taking or had been taking ARVs in the past were not included in this evaluation because their immune system was already compromised by the immune-suppressing effect of these drugs.

Of the 100 participants who initially started this programme, 56 completed all three examina-tions and questionnaires. This is a remarkable number considering the obstacles of conducting such documentation as a part of an open community health programme in a township. Specific challenges came from special interest groups promoting ARV drugs who tried to dissuade the patients from participating in this health programme.

The community health programme conducted by SANCO Khayelitsha is based on a broad educational approach about the role of nutrition and micronutrients in helping to improve health in general and immune function in particular. Those members of the community affected by AIDS were offered a micronutrient programme that had been donated to SANCO Khayelitsha by the Dr. Rath Health Foundation. In addition to the general educational material the participants received an information sheet detailing the role of micronutrients in the body.


Figure 1:
Changes in severity of fever, chills, and excessive sweating in people with AIDS before, after 4 and 8 weeks of micronutrient supplementation (n = number of participants experiencing these symptoms before and during the programme).


Figure 2:
Changes in severity of diarrhea in people with AIDS before and after 4 and 8 weeks of micronutrient supplementation.


Figure 3:
Changes in severity of weight loss in people with AIDS before and after 4 and 8 weeks of micronutrient supplementation.


Figure 4:
Changes in severity of persistent cough in people with AIDS before and after 4 and 8 weeks of micronutrient supplementation.


Figure 5:
Changes in severity of TB symptoms before and after 4 and 8 weeks of micronutrient supplementation in people with AIDS who had also been diagnosed with TB.


Figure 6:
Changes in severity of fungal and opportunistic infections in people with AIDS before and after 4 and 8 weeks of micronutrient supplementation.

Health and nutritional assessment

Upon entry into the nutritional programme, the participants were examined by a physician. In addition, their health status was further assessed with the aid of a bilingual questionnaire grading their symptoms on a scale of 0 to 4 (0 = no symptoms, 1 = mild, 2 = medium, 3 = advanced, 4 = severe). The symptoms included fever, diarrhoea, cough, weight-loss, TB, and opportunistic infections associated with AIDS-defining diseases for Africa (20, 21, 22). Among other physical symptoms assessed were: swollen glands, joint pain, numbness in the hands or feet, nausea or vomiting, headache, bloating, irregular heart beat, oral sores and dis-comfort, gum bleeding, loose teeth, eyes burning or itching, eyes sensitive to light, blurred vision, wounds that would not heal, dry or itchy skin, skin bruises, muscle cramps, cold hands or feet, sweating without work or exertion, unusual thirst, and colds. Indicators of general well-being recorder were: nervousness, irritation, anxiety, depression, insomnia, loss of appetite, fatigue, dizziness, memory loss.

At 4 and 8 weeks participants were re-examined by a physician. Their current health status was reassessed on the graded questionnaire described above. The participants were also questioned about the composition and frequency of their daily meals. These included among others corn, white bread, brown bread, rice, noodles, milk, fish, chicken, red meat, cereals, hot chips, sweets, sweet potatoes, green peppers, salads, lemons, oranges, tomatoes, bananas, apples, grapes, and nuts.

Results

The daily micronutrient supplementation was associated with a statistically significant decrease of fever, diarrhoea, persistent cough, weight loss and TB symptoms. This is a highly significant fact since these five symptoms were defined by the 1985 WHO reference conference in Bangui, Central Africa, as “AIDS-defining”. (22)

The specific results for each of these symptoms were as follows: Micronutrient supplementation was associated with a rapid and statistically significant reduction (p=0.0001) in the severity of fever, chills and excessive sweating which decreased by 52 % after 4 weeks and continued throughout the 8 week period. These findings are summarized in Figure 1.

Daily intake of micronutrient supplements decreased diarrhoea by 50 % after 4 weeks and 51 % after 8 weeks, which was also statistically significant (p=0.003). These results are documented in Figure 2 .

As shown in Figure 3, weight-loss in people with AIDS who supplemented their daily diet with micronutrients was significantly reduced by up to 70 % after 8 weeks of intake (p= 0.0001).

Micronutrient supplementation was associated with a significant decrease in the severity of coughs by 33 % after 4 weeks and by 39 % after 8 weeks (p= 0.007) as presented in Figure 4.

In those participants who were also infected with TB (18 patients), the daily intake of micronutrients decreased the severity of TB-related symptoms by 40 % after 4 weeks and 61 % after 8 weeks (Figure 5 ), which was also a statistically significant result (p=0.02).

In addition, fungal and other opportunistic infections frequently accompanying AIDS were present in 9 participants of the micronutrient programme. Severity of these opportunistic in-fections was 76 % lower after 4 weeks and 89 % lower after 8 weeks of micronutrient intake. This result too was statistically significant (p= 0.009), as represented in Figure 6 .

Other AIDS related symptoms – outside those of the Bangui definition – also significantly im-proved under the micronutrient programme. These results are summarized in Table 1. The severity of colds decreased by 45 % after 4 weeks and 35 % after 8 weeks of vitamin in-take (p=0.001). Lymphadenopathy (swelling of lymph nodes) decreased by 57 % after 4 weeks and by 67 % at the end of 8 weeks of nutritional supplementation. This change was statistically significant (p= 0.006).

AIDS is also accompanied by mental health problems, especially depression, fatigue as well as frequent headaches. The results presented in Table 1 indicate that all these symptoms im-proved after 4 and 8 weeks on the vitamin programme. After 4 and 8 weeks of micronutrient supplementation the severity of depression decreased by 48 % and 47 % respectively (p< 0.0001). Occurrence of fatigue decreased by 60% after 4 weeks and 68% after 8 weeks on the micronutrient programme. These results were statistically significant as well (p<0.0001). Headaches decreased by 38 % after 4 weeks and 35 % after 8 weeks on the micronutrient pro-gramme.

Signs of neuropathy, such as pain and numbness in the fingers and feet was scored lower af-ter 4 and 8 weeks on the micronutrient programme (54 % and 56 % respectively) compared to the programme entry (p<0.0001). Also joint pain score was lower by 49 % and 54 %, respectively after 4 and 8 weeks of vitamin supplementation and these changes too were statistically significant (p<0.0001).

During micronutrient supplementation there was a notable effect on the healing of wounds and sores that had persisted for months prior to entering the vitamin programme. The severity of these lesions decreased after 4 weeks of taking micronutrients by 59 % and after 8 weeks by 84 %, which was a statistically significant difference (p=0.004). In addition, the severity and appearance of skin rashes decreased by 37 % already after 4 weeks and by 64 % after 8 weeks on the programme, which also reached statistical significance (p=0.04).


Figure 7:
Micronutrient supplementation and wound healing: These pictures document the neck ulcer of a young woman living with AIDS before (top) and after 4 weeks (above) on the micronutrient programme. The wound infection (white area in the top picture) had completely disappeared after 4 weeks of vitamin intake. The wound itself, visible as a deep hole (top) had almost been completely closed (above). No such effect has been documented with antiretroviral drugs (ARVs).

The healing of AIDS related wounds during the micronutrient programme was a particularly obvious and objective observation. Figure 7. documents the changes of such an AIDS-related wound – an infected ulcer on the neck of a woman living with AIDS – before and after 4 weeks of vitamin supplementation.

Discussion

The results of the community nutrition programme presented in this report show that a daily supplementation of vitamins, minerals and other essential nutrients significantly reversed all the symptoms that define AIDS, namely fever, weight loss, diarrhoea, and persistent coughs, and it decreased the severity of tuberculosis.
This nutritional health programme also helped to improve other AIDS related symptoms including fungal and other opportunistic infections, sores, colds, nausea, fatigue, depression, headache, skin rashes, swollen glands, joint pain and numbness in hands or feet.

Previous intervention studies with vitamins and other micronutrients in AIDS patients have used single vitamins or a combination of a few micronutrients 9. Notably, in certain studies a combination of vitamins C and E was shown to reverse the damaging effects of ARVs in HIV infected adults 20. The same combination of vitamins was shown to reduce viral load and the damage from oxidative stress in AIDS patients 21.

In another nutritional study, vitamin C in combination with N-acetyl cysteine – a bio-available form of the amino acid cysteine – was reported to improve the immune response and lower the viral load in patients with advanced AIDS 22. Other studies conducted in Durban, South Africa examined the effects of vitamin A supple-mentation on the morbidity and mortality of HIV infected mothers with AIDS and their children. Among all children, those receiving vitamin supplements had a 30 % lower overall morbidity – i.e. a 30 % lower risk to develop diarrhoea, lower and upper respiratory tract in-fections and rashes – compared to the control group 5.

The health programme documented here differs from the above studies in the use of a defined combination of micronutrients targeting AIDS-defining symptoms. Since these symptoms determine the quality of life of people living with AIDS as well as their life expectancy, the findings reported here have a potential to halt the otherwise deadly course of this disease.

The findings of this community health programme are even more important, since no study with ARVs or any other pharmaceutical drug has ever shown the reversal of AIDS-defining symptoms. Thus, in the absence of pharmaceutical drugs that can cure AIDS, the encourag-ing health benefits of this pilot nutrient programme have important implications for the control of AIDS.

Conclusions

Micronutrient supplementation offers an effective, safe and affordable approach towards the global control of AIDS. In developing countries micronutrients combined with general food programmes should form an essential part of public health strategies to successfully fight immune deficiencies, including AIDS. The immediate implementation of these findings by national governments as well as the WHO and other interna-tional organizations will save millions of lives – and it provides valuable time for the international research community to find a lasting solution to end AIDS.

Acknowledgments

We would like to recognize SANCO Khayelitsha and the entire SANCO organization for having launched this important community health programme. We would like to thank the following individuals for their assistance in this programme: T. Bottoman, R.Gool, M. Holtrop, H. Kura, R. Langner, S. Langner, W. Maggott, S. Mkosi, N. Mkubekeli, M. Ndibongo, Dr. D. Saka, T. Xaso.

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