Supplements and Medications with Potential for Lipodystrophy and Related Problems

What	Why	How	Warnings
Acidophilous	Normalizing cholesterol	as directed	yogurt may work better for reducing cholesterol
Activated charcoal	Normalizes cholesterol	8 grams three times a day	Large doses will interfere with absorption of other nutrients from both food and supplements as well as drugs, so take large doses on an empty stomach. Do not exceed 25 g per day.
Acetyl-L-Carnitine	Normalize cholesterol and triglycerides	500 mg+ three times per day. Total: 1,500 mg+	.
Alcohol, avoidance of	Normalizes cholesterol and triglycerides	.	.
Alfalfa	Normalizes cholesterol	1-2 tsp dried leaves/cup of water for infusion drunk up to 3 times per day.	Do not use if you have lupus. Due to the presence of an unusual amino acid, L-canavanine, prolonged use (more than a couple months) is not wise.
Alpha Lipoic Acid	insulin sensitivity / glucose disposal / anti-oxidant	600 - 1,000 mg/day	watch for little red bumps on your skin if exceeding 600 mg/day
Almond, sweet	may help lower "bad" cholesterol (LDL, VLDL)	As a laxative, usually 30 milliliters (about an ounce) per day	.
Artichoke extract	Normalizes cholesterol	300 mg, 3 times a day	.
Aspirin	TNFa reduction	.	blood thinning, gastro upset...
Barley	Normalizes cholesterol	Consume in cereals, breads and soups, if possible	Grains have a high glycemic index which can aggravate insulin resistance.
Baycol (cerivastatin), prescription statin	lowering cholesterol and triglycerides	as directed	see package insert
Bitter Melon, Momordica charantia	glucose metabolism	85mg of 20% guanylhydrazine standardized extract three times per day	.
Biotin	glucose and triglyceride metabolism	5,000 mcg per day in 2 - 3 divided doses	.
Calcium	cholesterol reduction	500mg two or three times a day	Overdose unlikely unless you are magnesium deficient.
Cardura, prescription drug	alpha blocker, officially for hypertension, but normalizes cholesterol a bit	as directed	see package insert
Chelation therapy (possibly oral Chelation therapy)	normalize cholesterol levels	Chelation therapy is a procedure.	.
Chitosan	cholesterol reduction	1500 mg - 3000 mg right before a high-fat meal	take with ascorbic acid (Vitamin C)
Choline	improved fat and cholesterol metabolism	.	.
Cholestyramine resin, prescription drug	cholesterol reduction	as directed	see package insert
Chromium, trivalent or picolinate	glucose metabolism / insulin sensitivity	250 mcg - 1,000 mcg per day in 2 - 3 divided doses	1,000 mcg / day may be best for short-term use, 300 mcg / day best for long-term continuous use.
Coenzyme Q-10	antioxidant	.	statin use may lower the level of CoQ10
Conjugated Linoleic Acid	improves insulin sensitivity	.	.
Copper	Mentioned because of relationship to zinc.	5 mg	Avoid if you have hemochromatosis or Wilson's disease. Maintain a ratio of zinc to copper from 10-to-1 to 15-to-1.
Creatine Monohydrate	lowers lipid levels	5 grams four times a day for five days and then twice a day	.
Curcumin	reduce oxidation of cholesterol / anti-inflammatory / anti-cancer	1-3 grams per day	.
Eicosapentanoic acid (EPA)	lower triglycerides	1200 to 2400 mg a day	.
Estrogen replacement	normalizes cholesterol	.	For postmenopausal women only.
Exercise	enhanced body shape / Normalize lipid levels / Improve insulin sensitivity	Progressive Resistance Exercises (PRE) and aerobic exercises.	Use of aerobic exercises can exacerbate AIDS Wasting Syndrome (AWS)
Garlic	cholesterol reduction	900 to 8000 mg per day.	.
Ginger	cholesterol reduction	.	.
Ginko Biloba	antioxidant	120 mg twice a day	.
glucophage / glucovance	improve insulin resistance	as directed	see package insert
Green Tea	cholesterol reduction	350 mg of 95% polyphenyl extract	.
Glycyrrhizin	TNFa reduction / liver health	75mg - 225mg 3 times a day, alternate weeks (do not use continuously)	Not for those with high blood pressure or heart condition. Monitor potassium level and blood pressure. Inform your health care providers you are taking this.
Guggul lipids	fat metabolism	1000 - 2000 mg a day in divided doses	.
Gymnema Sylvestre	improves glucose uptake / prevents adrenaline from stimulating the liver to produce glucose	.	Adverse interactions with exogenous insulin and Glipizide.
Flax seed, source of Omega-3 and dietary fiber	Normalize cholesterol	Total dietary fiber should be about 3-4 grams a day	.
Iodine	fat metabolism	500 mcg / day	Do not use if you have hyperthyroid disease.
Iron, avoidance of excess	cholesterol	.	.
Ketotifen, prescription drug	TNFa reduction	as directed	see package insert
L-Carnitine (also available as Carnitor by prescription)	TNFa reduction / fat metabolism / triglycerides	500 mg - 5000 mg three times per day.	Avoid low-quality as it may contain toxic R-Carnitine. People with seizure disorders should avoid L-Carnitine supplements. High doses (over 4 grams) can cause GI upset.
L-Glutamine	TNFa reduction / insulin sensitivity	4,000 mg (1 heaping teaspoon) three times per day up to 1 heaping tablespoon three times per day. Split into five times per day works better to stop diarrhea	may increase cell growth in cancer patients
Lecithin	Normalize cholesterol	5-10 grams of 20% phosphatidylcholine.	May need up to 20 grams/day to treat cholesterol but as part of complete program
Lipitor (atorvastatin), prescription statin	lowering cholesterol and triglycerides	as directed	see package insert
Lopid (gemfibrozil), prescription	lowering LDL cholesterol and increasing HDL	as directed	see package insert
Lescol (fluvastatin), prescription statin	lowering cholesterol and triglycerides	as directed	see package insert
Lutein (carotenoid)	.	20 - 40 mg a day	.
Melatonin	antioxidant	1 - 5 mg / day as a single dose before sleeping.	.
Metformin, prescription medicine	improve insulin resistance	as directed	see package insert
Mevacor (lovastatin), prescription statin	lowering cholesterol and triglycerides	as directed	see package insert Not recommended with HIV/AIDS due to toxicities.
N-Acetyl-Cysteine	TNFa reduction / antioxidant / insulin sensitivity	500 - 2000 mg three times per day	more than 6g / day has been used, but is associated with GI upset
Nettles (an herb)	TNFa reduction / anti-inflammatory	.	.
Naltrexone, low dose, by prescription	TNFa reduction	as directed	see package insert
Niacin, not inositol hexanicotinate or slow release	lowering LDL cholesterol, increasing HDL Cholesterol, lowering triglycerides	500 to 1000 mg two to three times per day	Niacin can cause skin redness ("flushing") and/or irritation. Start with a small dose and work up. Do not take niacin at therapeutic (high) dosages with statins.
Oat bran	Normalize cholesterol	3-40 grams/day.	Not for celiac disease patients as it contains gluten.
Omega-3, fish or fish oil preferred over plants	normalize cholesterol / anti-inflammatory	1000mg or more three times a day	Monitor levels of coagulants.
Onion	Normalize cholesterol	5 ounces (1/4 to 1 cup chopped) fresh onion per day or with onion juice	.
Pantethine	Normalize cholesterol / triglycerides	May need up to 900 mg/day	.
Pravachol (pravastatin), prescription statin	lowering cholesterol and triglycerides	as directed	see package insert
Proanthocyadins such as grape-seed skin-skin extract	antioxidant	mg 100 mg twice a day	.
Protease inhibitor cessation	Normalize cholesterol and other serum (blood) lipids	Agenerase (Amprenavir) does not have much of a negative effect on lipids.	Never stop just part of an anti-viral combination.
Quercetin	glucose metabolism / anti-inflammatory	.	.
Red Yeast Rice (Monascus purpureus)	Normalizes cholesterol and triglycerides.	.	Do not use this with extra niacin as it contains lovastatin. Ritanovir (Norvir) increases lovastatin levels.
Reishi mushroom	Normalizes cholesterol	3600 mg a day in divided doses, Up to 9-10 grams per day at most.	Not for those with blood clotting problems. Use longer than 3 - 6 months may cause problems in a few people.
Resveratrol	Normalize cholesterol / antioxidant / anti-inflammatory, enhances ddI, ddC and AZT	.	.
Rosavin (Rhodiola rosea)	Reduces fat absorbtion	200mg three times a day	.
Rosiglitazone, prescription medicine	improve insulin resistance	as directed	see package insert
Saffron	Normalizes cholesterol	0.5-1.5 grams or a tea with 10-15 saffron threads.	.
Selenium	fat metabolism, part of the antioxidant glutathione peroxidase	600 mcg/day in divided doses	reduce dose if you get a "garlic" breath/taste
Smoking cessasion	increases HDL cholesterol	.	.
Soluble fiber (psyllium, guar gum, and/or pectin from fruits and vegetables including apples, bananas, beets, cabbage, carrots, citrus fruit, dried peas and okra)	Normalize cholesterol. Slow down the rate sugar is absorbed.	4-6 grams before any high-fat meal	May interfere with absorption of other medicines and supplements
Starchy vegetables	diminish insulin resistance	Use as a source of carbohydrates instead of concentrated sugar and grains.	Avoid grains (especially refined grains and any wheat) and concentrated sugars: fructose, dextrose, maltose, sucrose, cane juice, florida crystals, etc. as these drive up insulin.
Taurine (sulfur containing amino acid)	.	500 - 1000 mg a day in divided doses	.
Testosterone, cypionate or enanthate esters injections, Androgel by prescription	reduce truncal obesity / gel or creme applied directly to dorsal pad ("buffelo hump") may reduce it.	as directed	see package insert
Trental (Pentoxifylline), prescription medicine	TNFa reduction	as directed	see package insert
Vanadium, vanadyl sulfate	glucose metabolism	2mg three times a day	Take chromium at other times from Vandium. Possibly liver toxic, may inhibit lymphocytes and T cells. Not recommended with HIV/AIDS.
Vitamin A (not from Beta carotene)	reduction of LDL Cholesterol / oxidation of Cholesterol	a total of 5,000 IU/day, 20,000 IU/day max	cut dose if palms get orangish/yellowish
Vitamin A from Beta carotene	reduction of LDL Cholesterol / oxidation of Cholesterol	about 20,000 IU/day, in divided doses	1/6th of Beta carotene consumed will become Vitamin A (See: p. 614, Harper's Biochemistry, 24th Edition. Appleton and Lange, Stamford, Conn.). Beta carotene supplements may need to be reduced or eliminated for patients with a compromised liver.
Vitamin C / Rutin / Hesperidin / Citrus Bioflavonoids / Rosehips	TNFa reduction / anti-inflammatory / triglyceride-anti-oxidant	1000 - 4000 mg 2 to 3 times per day	No toxic limit, If you take too much too fast, you may have diarrhea. Start small and work up. Calcium Ascorbate is easier on GI system.
Vitamin D	assists Calcium in lowering cholesterol / insulin sensitivity / anti-cancer / inhibits TNFa	800 - 1200 IU/day	NAS has No Observed Adverse Effect for Vit. D set at 2,000 IU per day.
Vitamin E	TNFa reduction / anti-inflammatory / triglyceride-anti-oxidant	800IU 2 to 3 times per day	.
Vitamin K	glucose metabolism	80 mcg/day	.
Zerit (Stauvine, d4T) cessation	.	.	Zerit has been implicated in lipodystrophy studies, but nothing is proven yet. Never stop just part of an anti-viral combination.
Zinc	constituate of insulin and the antioxidant superoxide dismutase (SOD)	50-150 mg / day in divided doses	Do not take more than 200 mg a day. High doses should only be for short-term use with monitoring by a health care professional. Maintain a ratio of zinc to copper from 10-to-1 to 15-to-1. Excess zinc may deplete molybdenum.
Zocor (Simvastatin), prescription statin	lowering cholesterol and triglycerides	as directed	see package insert Not recommended with HIV/AIDS due to toxicities.

See also DAAIR's Managing or Preventing the Effects of Lipodystrophy

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