Should I Take Supplements?

I've heard that taking the amino acid glutamine and creatine can have positive effects in people who are HIV-positive. But there doesn't seem to be much information about these sports supplements and any potential interactions with antiretroviral therapy. Can you shed some light on this?--John, Los Angeles You're right. Studies on the role of micronutrient supplements in people with HIV are ripe for further research, according to Alice Tang, Ph.D., an associate professor at Tufts University School of Medicine and an expert in the area of supplementation and HIV. A few of these studies have examined glutamine, primarily for its muscle-building effects. To my knowledge, there are no published studies on creatine in HIVers. When it comes to sports supplements and their potential interactions with anti-HIV meds, research is inconclusive. While no adverse effects have been reported with glutamine use, other supplements such as Saint-John's-wort have illustrated the complexity of adding 'natural' substances to an antiretroviral regimen. Kathleen Squires, MD, says it's best to avoid products that have documented interactions and to communicate with your doctor about all the supplements you're using. That way, he or she can take them into account if you develop any side effects or your viral load response is not appropriate. Meds interactions aside, the larger question is, What potential benefits can an HIVer gain from glutamine and creatine supplements? Wasting, the loss of lean body mass, is a concern for all seropositive people, since even a 5% or 10% loss is associated with early mortality and susceptibility to opportunistic infections. Products such as Juven (which contains glutamine, arginine, and beta-hydroxy beta-methylbutyrate) are useful weapons in your arsenal to maintain lean body mass. Every study I've encountered boldly demonstrates that glutamine will build and preserve muscle mass. In one double-blind study, participants who took two doses of Juven twice daily for eight weeks gained almost six pounds, compared to a loss of almost two pounds by the participants receiving placebo. Glutamine doses of at least 20 grams per day have also been shown to improve the absorption of nutrients in the lower intestine. My personal take is that an ounce of prevention is worth a pound of cure, and supplementing with glutamine is a smart way to keep your lean body mass up. Creatine may also have a place in the mix, but your doctor should be able to help you balance the benefits of these sports supplements with your overall treatment regimen. Page is a certified fitness trainer and journalist. As president of Sam Page Fitness, he operates two private studios in Southern California. He contributes to several national and international magazines and also publishes a weekly e-newsletter from SamPageFitness.com and a daily blog at PeaceLoveLunges.com.