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Q#1: Physical Exercise
I tend to train quite a bit: weights, running, and aerobic exercise classes. Some days I am too sore to train, and I KNOW I'm supposed to give my body a break. I do, but I was wondering if there was any herbal remedy, or natural way to ward off the muscle fatigue. I have a healthy diet, I take nutritional supplements from time to time, and I get plenty of rest. I also know when to lay off the alcohol... I just want to go 'to the next level', if you will.
A: Charlie Smigelski, RD responds:
For HIV+ people doing a lot of exercise I suggest a vigorous antioxidant supplement plan. Remember, chronic infection generates a good number of free radicals, (stray electrons from the break up of T cells). Strained muscle cells get damaged, and besides making you sore, they also generate a lot of free redical electrons.
You already know about anitoxidant vitamins, like vit C and E and beta carotene. Another whole antioxidant system is the glutathione peroxidase system. This especially repairs muscle cells. So 500mg vit C 2 times a day, 400 iu vit E 2 times a day, selenium at 200 micrograms a day, plus beta carotene foods like carrots, broccoli, spinach, sweet potato, winter squash, parsley, or apricots covers some antioxidant basics.
To keep the glutathione system in great repair I would also either take one gram of N-acetylcysteine (NAC) 2 times a day or have a serving of a Designer Whey protein drink (at GNC, the vanila praline flavor is great) that provides about 25-30 grams of protein (which contains the NAC. The other amino acid that supports the glutathione system is L-glutamine. Find some glutamine powder at your local buyers' club, or use Boston Buyers Club (617 266-2223) and take 5-10 grams a day of glutamine, (1/2 to 1 tablespoon). This especially helps reduce muscle soreness after workouts. Many people also take glutamine to prevent or stop protease inhibitor diarrhea.
You might also like to know that when glutathione levels are low, it seems that Hepatitis C replication and therefore viral load goes up. The virus senses that the cell is unhealthy (under a lot of oxidative stress), and it's time to replicate and move on.
So yes, there are some smart antioxidant supplements to use for both your immune system and for muscle recovery. Meanwhile be sure you are eating a high protein diet as well, double the RDA for protein for a person your size. This works out to be about 3/4 grams protein for every pound of ideal weight. If you are 160 lbs, then 120 grams of protein a day. Read labels, notice that a 6 oz can of tuna has 42 grams of protein, a 8 oz glass of milk has 8 grams, a 9 oz box of frozen green beans has 3 grams.
This sounds like a lot of pills, but you can get combo vitamins at buyers clubs that have C and E and selenium all mixed together (Jarrow brand). There are NAC and Glutamine and C and E drinks too (Cambridge Nutraceutical brand). Everyone who is positive should be taking a B-complex vitamin as well, like B-complex 25.
Q#2: Physical Exercise & Hepatitis C
I have hepatitis C and take creatine. I also exercise 6 days a week about 1 hour a day. My question is: Am I hurting or helping myself? I'm 37 years old (ex-marine)and I want to stay strong but don't want to weaken immune system buy pushing too hard! Your thoughts please!
A: Charlie Smigelski, RD responds:
Some of this response repeats the answer I gave above some months ago, but I will tailor it a bit here for Hepatitis C involvement. How to support the liver in HCV is still a matter of controversy. Since no animal or cell model exists to mimick HCV infection, it is hard to study intervention trials. Even elevated liver function tests do not relate to "damage" levels in Hep C infection.
However, based on the general liver disease literature, where the majority of people accept the hypothesis that oxidative stress is a significant player in liver cell injury, even in reperfusion injury, I suggest that people hedge their bets and take decent antioxidant pills.
Target amounts are 500 to 1000 mg vit C, 400 iu E, B-complex 25 or B-complex 50, for the B-6 and folate involved in cell repair.
Hep C is an RNA virus, like HIV and Ebola, and its growth levels are sensitive to selenium deficiency, so an extra 200 mcg selenium per day is important.
Good nutrition in general keeps the glutathione system, a major antioxidant system in the liver, replenished. Chester [Myers] has been a strong advocate for people taking 1-2 gms a day of NAC (n-acetylcysteine) and 5 grams a day of L-glutamine to support glutathione production.
I know of no studies where Creatine hurts liver. Creatine is simply a fuel source. I call it muscle candy. But if you use it to work your muscles harder, then I suggest you support muscle oxidative stress clean-up with all the above antioxidants. Drink lots of water with it though.
I would skip the Creatine-loading phase that people sometimes do, this does give lab reports that mimic kidney failure, and would freaek out your MD if you had blood tests at that time.
A: Diana Peabody, RD responds:
I have just written an article on creatine; not specifically for HIV but maybe some useful information. Having done the research on safety, I think it is probably best to take it for about 8 weeks. Long term use does suppress endogenous production and maybe loses it efficacy. (Administrator's Note:" Diana's full article on creatine will be available soon on this website.)
Also, regarding your specific question as to your exercise regimen, this article at Health Central may be of interest to you. Basically, it supports the idea that lighter training is better for the immune system.
