Forum on Nutrition and Exercise

SSA disability update report

Sat, 28 Oct 2017 21:28:41 -0400

Q: I just got disability update report from social security administration for first time since Im digonceed with hiv and aids since 2005Since that time Im getting ssid and Medicare My question is why ssa asking nowAnd am I losing my medical and Medicare What I have Check or answer question #3 and 5Reason for visiting?Thank you.

A: Good question. Many people are getting letters from social security with the new administration. Please read this in detail: How to handle a letter from Social Security Change in Social Security Disability: HIV-Positive Recipients May Now Have to Go Through Revie...

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PRO-140

Sat, 28 Oct 2017 21:22:53 -0400

Q: Dear Sir,Hope this E-mail find you well.Wanted to find out at what stage of it trial is PRO-140.When will it be available to patients.Does it have side effects as experienced by other class of HIV medication.Will it cause harm to kidney or liver or other organs of the body.Will patients on say Tivicay+Truvada be able to change to Pro-140.and continue to be undetectable.or does require other hiv drugs to work.Will it be expensive and how expensive and when will it be available in Africa.thank yo...

A: PRO-140 is a weekly injection that is a monoclonal antibody effective only for patients who have HIV that is CCR5 tropic (google CCR5 TheBody.com).It is in phase 3 studies. It requires the use of two other drugs for it to work.It will only be approved in the United States first. I do not know the potential price or the manufacturer's plans for international access.There is a study that is looking at people who have had undetectable HIV for a while taking oral daily medications who are then swit...

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Testosterone treatments

Sat, 28 Oct 2017 21:17:55 -0400

Q: Can trt affect your meds

A: There are no known interactions between testosterone replacement therapy and HIV medications. In fact, there are several studies using testosterone in HIV+ people that have seen no increase in viral load.For more information visit the forum page on ExcelMale.comIn health,Nelson

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vitamins with genvoya

Wed, 28 Jun 2017 04:39:29 -0400

Q: Hello Dr, I will start genvoya soon and i also take multivitamin but i read there could be interaction or something like that. the pill that i take contains most of multivitamins and mineral supplements needed. I'm 40 years old, please advise

A: A general multivitamin should be OK with Genvoya. Just make sure that it does not have large enough proportion of calcium or magnesium. Genvoya is a one pill regimen that has elvitegravir (an integrase inhibitor, a booster, and two nucleoside analogs). It's the new version of Stribld that replaces tenofovir with TAF, a nucleoside that may have fewer kidney or bone issues. Please read the following and talk to your doctor about this. Read More

Can Sermorelin or Magnesium increase/effect viral load

Wed, 28 Jun 2017 04:34:14 -0400

Q: Earlier this year. My viral load was undetectable. My last two visits my viral load has been detectable. the only thing that Ive added in my daily regain is Sermorelin and Magnesium Malate pills. I was on Stribild and switch to Genoveya. Can either of these two effect meds or viral laod

A: Magnesium can decrease the absorption of integrase inhibitors, even in the presence of a booster like cobicistat. Stribld is made up of an integrase inhibitor, a booster, and Truvada (two nucleosides).Sermorelin is a growth hormone releasing peptide. This type of products has been used in HIV lipodystrophy without virus blips in several studies.I answered this question before. It is unfortunate that many patients do not tell their doctor about supplements they are taking and some doctors know li...

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Cost of erectile dysfunction injection

Wed, 21 Jun 2017 18:46:12 -0400

Q: where can i get trimex at a reasonable cost, sex shouldnt cost me a 100 a pop..

A: You can get Trimix for $65 with a prescription faxed to Empower Pharmacy. Products to treat erectile function More information on Trimix I hope this helps!Nelson

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Egrifta Dosage

Thu, 15 Jun 2017 17:11:23 -0400

Q: I am a 46 year old man living with HIV and have been prescribed Egrifta by my doctor. I have also recently begun the poWer cycle of testostetone and nandrolone. For the first several months I was receiving the Egrifta, I did not take it, so I have a surplus. My question is, if I double on the recommended dose, will it help the drug begin to work faster, thus allowing me to see results sooner than 3-6 months?

A: Taking more than 2 mg per day of Egrifta will not increase IGF-1 beyond normal levels. The studies done in HIV with this growth hormone releasing hormone to decrease abdominal fat showed that 2/3 of people lost an average of 1 inch of waist circumference with 2 mg per day. Using the PoWeR cycle was effective in reversing wasting syndrome but it is not without risks. Increased blood pressure and blood thickness are common issues, so please educate yourself and make sure you discuss these with yo...

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Coolsculpting for lypodystrophy

Fri, 02 Jun 2017 15:27:17 -0400

Q: Have you heard of any success with a procedure such as Coolsculpting for getting rid of excess belly fat related to side effects of HIV meds?

A: Hello and thanks for posting. I have used Cool Sculpting successfully for lipohypertrophy fat accumulation. The key is that the fat deposits need to be in the subcutaneous location. Cool sculpting is not indicated for visceral fat. I have also found it to be helpful for treatment of buffalo hump fat too. I hope that this information helps and best of luck to you!

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CoQ10 and DHEA

Wed, 24 May 2017 18:57:20 -0400

Q: Hi. I'm a female and take kivexa, ritonavir and atanazivir. Is it safe for me to take DHEA 75mg a day and coq10 600mg a day?No other health issues that I'm aware of. I can't seem to find a consistent answer. Probably because there isn't one!Many thanks, Freya.

A: Hello FreyaThere are no known interactions between Coenzyme Q-10 and HIV antiretrovirals.DHEA is a steroid androgenic hormone produced by the adrenal glands. High doses may cause aggressiveness, irritability, trouble sleeping, and the growth of body or facial hair on women.t also may stop menstruation and lower the levels of HDL ("good" cholesterol), which could raise the risk of heart disease. It is not known whether ritonavir boosts its level.Some studies show that this over-the-counter suppl...

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Viral load increase on treatment.

Sun, 30 Apr 2017 17:16:02 -0400

Q: I was tested undetectable in January of this year after starting Genvoya treatment in Sept. of 2016. My viral load has increased however (98 now, before it was <50). My doctor has asked me to have a checkup in 2 months time. I'm not sure why the wait before retesting is so long, or what an increase in viral load might mean?

A: In general, I would not be concerned. It sounds like you had a great response to HIV treatment, where your HIV viral load became undetectable. Sometimes we see the HIV viral load blip (going from undetectable to detectable, and then usually back to undetectable again). Many times this is assay related. Sometimes it could be from having another infection. We are usually not concerned unless the viral load increases above 200 or greater and remains that way. I think retesting in 2 months is fine.

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drinking aloe vera juice

Fri, 28 Apr 2017 15:47:04 -0400

Q: Is there a chance of curing hiv/aids by drinking aloevera juice daily.is there any who has been cured by consuming this juice?

A: No chance. We tried it in the 1990's with no results. Causes diarrhea in many.Nelson

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Pregunta VIH

Thu, 27 Apr 2017 18:15:39 -0400

Q: Hola Nelson soy colombiano tengo 22 año soy positivo VIH desde octubre de 2016 empecé a tomar medicamento el 21 de abril de 2017 se llama atripla. Que me recomiendas para tomar algo más . Quiero entrar el gym podré tomar proteína normalmente y que hago para no estar pensando en esta enfermedad todo el tiempo gracias. No quiero morir joven :(

A: Toma 5000 unidades de vitamina D para proteger tus huesos.La creatina a no mas de 5 gramos por dia es efectiva para fuerza y masa muscular pero dile a tu doctor ya que el puede creer que tus rinones no estan trabajando tan bien (este suplemento puede aumentar la creatinina en la sangre artificialmente).No te vas a morir de esto, asi que no dejes de trabajar en tus suenos.NelsonVe estos videos Informacion de Nelson Vergel

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Pruebas de VIH en Venezuela

Thu, 27 Apr 2017 18:12:31 -0400

Q: Hola Nelson, como estas, te comento que hace 10 meses tuve una relación de riesgo, a los 11 dias, después de la relación de riesgo, me realice una carga viral con mínimo de 20 copias y resulto no detectable, luego a los 44, 59 y 82 días me realice una prueba Screening de 4ta generacion Negativo, a los 93 días me realice otro test Elisa junto con Hepatitis B y C, resultado Negativo y por ultimo a los 100 días me realice una prueba rápida de tercera generacion Alere Determine VIH-1/2 igual...

A: Si son cofiables. No te conviertas obsesionado por un miedo que te va a afectar tu vida sexual. Condones siempre! (aunque me dicen que estan dificiles de conseguir en Venezuela).Nelson

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saludos desde venezuela

Sun, 23 Apr 2017 21:38:48 -0400

Q: desde hace un año estoy tomando viraday y me cuesta subir de peso seria recomendable hacerme un examen de testosterona?? estoy en el gym y no aumento masa muscular gracias

A: Si tienes bajo deseo sexual, yo te recomendaria que si te hagas el examen de testosterona total y libre. Otra razon podria ser bajas T3 libre y T4 libre (funcion de la tiroides). La ultima razon seria que no estas comiendo lo suficiente o haciendo los ejercicios apropiados.Aqui te mando un link de info que tengo traducida: Informacion de ejercicio, nutricion y hormonas Suerte y cuidate en nuestro pais en crisis.Nelson

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Activated charcoal and hiv meds

Thu, 20 Apr 2017 13:34:13 -0400

Q: Hi Currently im on meds (artripla).. Im taking those meds on midnight (12am)... If i wanna take some activated charcoal around afternoon or evening (before 6pm) to remove some toxins from my body, will it reduce the effectiveness of the hiv drugs? Or will it cause drug resistance?

A: Activated charcoal can affect absorption of HIV medications and has not been proven to remove toxins from your body. I would not take it.In health,Nelson

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gimnacio creatina y atazanavir

Wed, 19 Apr 2017 17:17:52 -0400

Q: Hola gusto en saludarlo.. Consumo atazamavir,norvir y truvada. Tengo un mes que retome el gimnacio , despues de dejarlo 2 años.... quiero empesar a tomar suplemento creatina. Sin embargo necesito su opinion ¿lo puedo consumir ?por estar tomando atazanavir. no tendre problemas? Ya que me han comentado que atazanavir incrementa los niveles de creatina.. saludos y gracias

A: El tenofovir en Truvada sube la creatinina, la cual mide la funcion renal. El suplemento creatina aumenta la creatinina tambien aunque no es importante clinicamente. Pero los doctores no entienden eso. Informale al doctor que estas tomando el suplemento.No tomes mas de 5 gramos de creatina por dia sino puede alarmar a tu doctor.Nelson

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Serum CPK is too High

Mon, 17 Apr 2017 17:22:06 -0400

Q: Dear Sir, My CPK Level is too high, it's almost 1007. Am suffering from muscle pain. Weakness, and feeling low.Pls guide me some exercise or medicine for that.Pls help me

A: You should consult a doctor to find out the cause of your high CPK. Here are a few potential ones:High CPK High CPK is usually treated by removing the offending agent. Some diseases like MS may also cause high CPK, so it is important to talk to a doctor. In health,Nelson

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DIARREA CRONICA

Mon, 17 Apr 2017 17:17:43 -0400

Q: MI CONSULTA ES SI EL VHI PUEDE ALOJARSE EN UNA PARTE U ÓRGANO DEL CUERPO Y NO SER DETECTADO POR UN ANÁLISIS ELISA O LOS DE 4 GENERACIÓN, LOS TESTS RÁPIDOS, MI CONSULTA NO ESTÁ RELACIONADA CON EL PERÍODO VENTANTA, QUE ES GENERALMNETE COMO MÁXIMO DE 6 MESES, DEPENDIENDO DE CADA ORGANISMO.MUCHAS GRACIAS, ESTIMADO NELSON.PD: POR CIERTO SE LO VE MUY GUAPO, SALUDOS DESDE ARGENTINA

A: La diarrea tiene demasiadas causas y no es primordialmente un sintoma de infeccion. El periodo de ventana es 3 meses.Averigua si tienes una alergia a algo que estas comiendo o consulta a tu doctor para ver si tienes un parasito.Nelson

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Elevar CD4 y CD8

Mon, 17 Apr 2017 17:15:51 -0400

Q: Hola! cómo puedo o qué debo hacer para elevar mis CD4 y CD8. Aunque soy indetectable, estos valores están considerablemente bajos.

A: Lo unico que mas o menos ha trabajado es el consumo de proteina whey (de suero) que se estudio en un estudio con placebo. Los pacientes tomando whey tuvieron un aumento de 34 CD4 mas que los de placebo.Whey Protein and HIV OBJETIVO:Hemos planteado la hipótesis de que el aumento de la ingesta dietética con alto valor biológico de proteína mejoraría el peso y el tejido magro en sujetos con peso estable con una pér...

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Lipodistrofia después de 5 años con tratamiento.

Sat, 15 Apr 2017 00:34:43 -0400

Q: Hola estimado Nelson, le mando un saludo desde Mexico. Al igual que usted soy venezolano, tengo actualmente 5 años tomando tratamiento antiretroviral, y aproximadamente 8 de mi diagnostico. Todo iba bien hasta este ultimo año en el que siento cambios físicos en mi cuerpo. Mi terapia consiste en Efavirenz y Duovir. Mido 171 cm y mi peso oscila entre 70 y 73 kg. Esto haciendo referencia a las veces que me tallan y pesan en consulta. Mis niveles de CD4 cuando inicie tratamiento estaban por los 4...

A: Hola compatritotaDuovir tiene AZT + 3TC. Todos sabemos que AZT causa lipoatrofia y perdida muscular. Pidele a tu doctor que te cambie de Duovir a Truvada (la cual es tenofovir + emtriva) o abacavir + 3TC.Te recomiendo que leas esto: La Lipodistrofia y el VIH Por favor dejame saber que te dice el doctor. A veces no quieren cambiarte de medicinas ya que el AZT es mas barato que las otras medicinas.Buena suerte y un abrazo.Nel...

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Advocare and HIV meds

Sat, 08 Apr 2017 16:29:39 -0400

Q: I was recently diagnosed with HIV and was just placed on medications. I am on the Dolutegravir (Tivicay). I was told not to take herbal supplements "like" St. John's Wort or Echinecea. I have done lots of research and cannot find a problem with other herbal supplements besides those two. My question is can I use the Advocare system, being a herbal based weight control program, on mine or other HIV medications?

A: This is what their website says:Ingredients PlusMinusVitamin C (as ascorbic acid), Thiamine (as thiamine HCL), Riboflavin, Niacin (as niacinamide and niacin), Vitamin B-6 (as pyridoxine HCL), Folic acid, Vitamin B-12 (as cyanocobalamin), Biotin, Pantothenic acid (as calcium pantothenate), Zinc (as zinc monomethionine OptiZinc symbol), Inositol, Taurine, System 343 Herbal Concentrate (cranberry fruit juice powder, extracts of burdock root, Silymarin (from milk thistle leaf), senna leaf, astraga...

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hello

Fri, 07 Apr 2017 20:18:09 -0400

Q: I have been on ARV's for more than ten years now and have noticed that its difficult to gain weight.please ,what to l do if l want to grow fat.currently l am a size 30 and need to be atleast 36

A: I suggest that you read the following. But why would anyone want to go from a waist size of 30 to 36 inches (I am assuming that is what you mean)? How to gain weight Nelson

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Uso de Nebido

Fri, 31 Mar 2017 14:34:33 -0400

Q: El 29 de enero 2017 me puse la primera dosis de nebido y realmente no he visto mejoria alguna,se me receto nebido por falta del apetito sexual o falta de libido,¿hasta cuanto podre ver los resultados necesarios?

A: Toma tiempo. Usualmente el Nebido es inyectado a 1000 mg cada 10 semanas. El doctor tiene que asegurarse que nu nivel de testosterona no esta debajo de 400 ng/dL el dia que te toca la proxima inyeccion. Cuanto tiempo toma para que la testosterona tome efecto? Read More

Raltegravir TAF/genvoya and herbs

Mon, 27 Mar 2017 17:16:50 -0400

Q: Hi Nelson I'm currently taking a plethora of herbs in the morning and arvs at night - ral and taf. I have been considering genvoya but I'm concerned about the cobicistat. Is it possible to tell me what effect this could have on my body/labs/meds. The brand of herbs is from aus - Astragalus 8 and Detoxelim (mix of different herbs). No st John's wort or milk thistle..Thanks

A: Cobicistat will increase blood levels of most herbal products.I would avoid switching to Genvoya. The fact is that we have zero information on interactions between herbs and ARVs.Nelson

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SLEEP LESS

Wed, 22 Mar 2017 14:55:11 -0400

Q: Dear Nelson,with response to your answer for my question.****************************************************NaniTrustiva can cause sleep disturbances due to one of its components (Sustiva or Efavirenz). Talk to your doctor about switching you to a regimen that does not contain efavirenz. You will probably sleep much better then.You can also try taking the drug on an empty stomach 2 hours before breakfast to see if that helps. If you are taking it at night, make sure it is after at least 2 hours...

A: Thanks for getting back to me. I would continue doing what you are doing. If you still have sleep problems, you may want to talk to your doctor about switching you to a non-efavirenz regimen.In health,Nelson How to deal with sleep problems

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