herbal use and hiv disease - catie · herbal use and hiv disease canadian aids treatment...
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Herbal use and HIV Disease
Canadian AIDS Treatment Information Exchange,
2006Devan Nambiar
Treatment Information Educator
CATIE Programs & ServicesTreatment Information Call Centre: 1-800-263-1638Treatment Information Web Site: www.catie.caLibrary and Resource CentreNumerous FREE publications FREE Workshops on treatment topics delivered across CanadaFact sheets on HIV drugs, CAM therapies for HIV and HIV-related diseasesResources for specific populations with specific needs: women, Aboriginal people, IDUsInnovations, InfoCATIE
Publications: TU and PS
Publications – Practical Guides
Managing Your Health
Other Publications of InterestFact sheets on HIV drugs, complementary therapies for HIV and HIV-related diseasesResources for specific populations with specific needs: women, Aboriginal people, IDUsInnovations, InfoCATIE
Objectives of workshopHistory of herbal use in HIV diseaseEfficacy of herbsHerbal use in multicultural communitiesHerb-antiHIV drug interactionsResources
HerbsUsed globally in “traditional” medicine by many cultures Extracted from plant parts; roots, bark, leaves, petals, flowers, buds, etc.Potency varies from geographical regions, time of harvest, soil and weather conditions, method of harvesting, species of plants, part of plantAvailable in tincture, creams, pills, capsules, powder, teas, essential oils, etc
Properties of herbs
Anti HIV Detoxifying Immune stimulantsLipid loweringAdaptoghensAnti cancer
GI problemsAntioxidantsInfections fighter-anti-fungal, anti-parasitic, anti-viral, etc.Skin Weight gain/appetite stimulant
HerbalsAshvagandhaAfrican Potato PlantAstragulusGarlicGinsengJeevani
MarijuanaMilk ThistleMushroomsSt.John’s WortSutherlandiaTriphala
Ashwagandha (WithaniaSomnifera)
Used in Ayurvedic medicine
For HIV use: rejuvenates immune system, increases testosterone, assists in building muscle mass and has adaptogenic properties
Long-term use is not recommended.
Prescribed month on/ month off, as needed.
Available inpowdered, teatincture or capsule
African Potato Plant (Hypoxis rooperi)
Immune enhancer: sterols and sterolins have been shown to be beneficial at enhancing an under-active immune system or decreasing an overactive system.Also increase the number and action of NK cells and increase DHEA levels
Reduce the stress hormone cortisol and the proinflammatoryimmune factor, interleukin 6 (IL 6) while increasing IL 2
Caution: in vitro clinical data on drug interactions-decreased levels of antiHIV drugs (NNRTIsand PIs)
AstragulusUsed in Traditional Chinese Medicine A non-specific immune enhancer with activity on T cells, antibodies and cytokinesUsed with other herbs Caution: May enhance rather than suppress HIV replication with long-term use
Cats Claw (Uncaria tomentosa)
Has antiviral and anti-tumor properties.Not recommended as it stimulates the humoral arm (antibodies) of the immune system Can increase HIV replication
Garlic (allium sativum)
Garlic contains many sulphurcompounds (e.g. allicin) Anti- fungal/ bacterial& parasitic-used to prevent and treat infections
Used by PHAs to:Strengthen immune system (to increase NK cells)Lowers cholesterol and triglycerides -contradictory results with CVD (aged garlic may be more effective)
CAUTION: Can increase blood levels and intensifying side effects of PIs and NNRTIs or lower levels of PIs
May reduce anti-coagulation effect of Warfarin and aspirin and may cause gastro-intestinal
GinsengDerived from the root or leafKorean or Asian ginseng (panaxginseng)North American ginseng (panax
quinquefolium) Siberian ginseng (Eleutherococcussenticosus
Used by PHAs to:Modulate immune system-Prevent stress and fatigue (adaptogen) Improve alertness & cognitive function Not recommended for long-term useMay stimulate wrong arm of immune system
Golden SealAnti-bacterial, anti-viral Ability to soothe inflamed or infected mucous membranes( cold, flu, sinus). Traditional Chinese Medicine: goldenseal (berberine- plant alkaloids, one of the largest groups of natural products, provide many pharmacologically
active compounds) specifically to cancer patients for weakened immune from chemotherapy treatment.
Tincture, teas, capsules
JeevaniUsed in Ayurvedic medicine Made from fruit of Arogyapacha
The cellular immune system is activated. It exhibits hepato-protective activities
Used to build up vitality and vigor- has adaptogenic propertiesDose: taken on empty stomach, (BID) with warm water and honeyNot recommended for long-term use
MarijuanaActive ingredient: THC(delta-9-tetrahydrocannabinol
Used by PHAs :Stimulate appetite, reduce nausea, elevate mood, mgn. mild depression and pain Dronabinol (Marinol) - derived from marijuana, used for anorexia, appetite loss, and nausea
Cautions: Chronic use may potentiate more serious depression or may actually lower pain threshold
Can adversely affect complex thinking processes; problem solving, decision making. May cause immuno-suppression and respiratory problems similar to tobacco products.
Milk ThistleDerived from the seeds of the plant silybum marinum, containing active compound silymarin
Dosage: Some studies have recommended 450 mg per day (usually divided into three 150mg doses taken with meals) --equivalent to 360 mg silymarin
Used by PHAs :Protect liver and kidneys and lessen effects of co-morbid Hepatitis B or C and liver diseasesInteraction with PIs or NNRTIs
Caution: may the blood levels of some cardiac drugs, antibiotics, anti-seizure drugs, anti-depressants, anti-fungals, sedatives, lipid lowering drugs, methadone, etc.
Mushrooms Used in Traditional Chinese Medicine Used with other herbsShitake, reishi, maitakeStimulate antibody response Can cause increase of HIV replicationNot recommended on long-term basis
St.John’s WortCommonly used to relieve mild to moderate depression Not to be used along with prescription anti depression Not recommended for PHAs on HAART as it lowers levels of indinavir and other PIs and NNRTIs
Sutherlandia (S. Frutescens)
Known uses as anti-depressant, to treat wasting, STDs, cancer, TB, diabetes, schizophreniaBenefits: weight gain, energy booster and increase in appetite
Caution: in vitro clinical data on drug interactions-decreased levels of NNRTIs & PIs
TriphalaUsed in Ayurvedic medicine for health maintenanceTriphala is a combination of three fruits, haritaki, amalaki and bibhitaki.
Taken half hour after a meal with warm/hot water It is used strictly for maintaining a healthy digestive system.
Tones and cleans the intestinal tract, improves digestion, has laxative propertiesNo known studies with anti HIV medications
Powder or capsules
Contraindicated with HAARTEchinacea and Cats Claw (can increase HIV replication)
St.John’s Wort (may decrease levels of PIs and NNRTIs)
Milk thistle (may decrease or increase levels of PIs)
Sutherlandia and African Potato plant (decreased antiHIVdrugs in vitro)
Resourceswww.catie.cawww.hivaidsdpg.org/www.aidsnutrition.org/www.wholehealthmd.com/www.integrativehealthconsulting.com/www.medibolics.comwww.hivmedicationguide.comwww.tthhivclinic.com/interact_tables.htmlwww.hiv-druginteractions.org/http://hivinsite.ucsf.edu/InSite?page=ar-00-02
DisclaimerDecisions about particular medical treatments should always be made in consultation with a qualified medical practitioner knowledgeable about HIV- related illness and treatment question.
The Canadian AIDS Treatment Information Exchange (CATIE) in goodfaith provides information resources to help people living with HIV/AIDS who wish to manage their own health care in partnership with their care providers. Information accessed through or published or provided by CATIE, however is not to be considered medical advice. We do not recommend or advocate particular treatments and we urge users to consult as broad a range of sources as possible. We strongly urge users to consult with a qualified medical practitioner prior to undertaking any decision, use or action of a medical nature.