Herbal use and HIV Disease Canadian AIDS Treatment Information Exchange, Devan Nambiar Treatment Information Educator

Transcription

1 Herbal use and HIV Disease Canadian AIDS Treatment Information Exchange, 2006 Devan Nambiar Treatment Information Educator

2 CATIE Programs & Services Treatment Information Call Centre: Treatment Information Web Site: Library and Resource Centre Numerous FREE publications FREE Workshops on treatment topics delivered across Canada Fact sheets on HIV drugs, CAM therapies for HIV and HIV-related diseases Resources for specific populations with specific needs: women, Aboriginal people, IDUs Innovations, InfoCATIE

3 Publications: TU and PS

4 Publications Practical Guides Managing Your Health

5 Other Publications of Interest Fact sheets on HIV drugs, complementary therapies for HIV and HIV-related diseases Resources for specific populations with specific needs: women, Aboriginal people, IDUs Innovations, InfoCATIE

6 Objectives of workshop History of herbal use in HIV disease Efficacy of herbs Herbal use in multicultural communities Herb-antiHIV drug interactions Resources

7 Herbs Used 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 plant Available in tincture, creams, pills, capsules, powder, teas, essential oils, etc

8 Properties of herbs Anti HIV Detoxifying Immune stimulants Lipid lowering Adaptoghens Anti cancer GI problems Antioxidants Infections fighter-antifungal, anti-parasitic, anti-viral, etc. Skin Weight gain/appetite stimulant

9 Herbals Ashvagandha African Potato Plant Astragulus Garlic Ginseng Jeevani Marijuana Milk Thistle Mushrooms St.John s Wort Sutherlandia Triphala

10 Ashwagandha (Withania Somnifera) 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 in powdered, tea tincture or capsule

11 African Potato Plant (Hypoxis rooperi) Immune enhancer: sterols and sterolins have been shown to be beneficial at enhancing an underactive 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 proinflammatory immune factor, interleukin 6 (IL 6) while increasing IL 2 Caution: in vitro clinical data on drug interactions-decreased levels of antihiv drugs (NNRTIs and PIs)

12 Astragulus Used in Traditional Chinese Medicine A non-specific immune enhancer with activity on T cells, antibodies and cytokines Used with other herbs Caution: May enhance rather than suppress HIV replication with longterm use

13 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

14 Garlic (allium sativum) Garlic contains many sulphur compounds (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 gastrointestinal

15 Ginseng Derived from the root or leaf Korean or Asian ginseng (panax ginseng) North American ginseng (panax quinquefolium) Siberian ginseng (Eleutherococcus senticosus Used by PHAs to: Modulate immune system- Prevent stress and fatigue (adaptogen) Improve alertness & cognitive function Not recommended for long-term use May stimulate wrong arm of immune system

16 Golden Seal Anti-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

17 Jeevani Used 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 properties Dose: taken on empty stomach, (BID) with warm water and honey Not recommended for long-term use

18 Marijuana Active 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.

19 Milk Thistle Derived 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 diseases Interaction with PIs or NNRTIs Caution: may the blood levels of some cardiac drugs, antibiotics, antiseizure drugs, anti-depressants, anti-fungals, sedatives, lipid lowering drugs, methadone, etc.

20 Mushrooms Used in Traditional Chinese Medicine Used with other herbs Shitake, reishi, maitake Stimulate antibody response Can cause increase of HIV replication Not recommended on longterm basis

21 St.John s Wort Commonly 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

22 Sutherlandia (S. Frutescens) Known uses as anti-depressant, to treat wasting, STDs, cancer, TB, diabetes, schizophrenia Benefits: weight gain, energy booster and increase in appetite Caution: in vitro clinical data on drug interactions-decreased levels of NNRTIs & PIs

23 Triphala Used in Ayurvedic medicine for health maintenance Triphala 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 properties No known studies with anti HIV medications Powder or capsules

24 Contraindicated with HAART Echinacea 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 antihiv drugs in vitro)

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27 Disclaimer Decisions 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 good faith 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.