Re: Dr. Kaisers' vitamin study - Some hard questions and answers

[Guest guest]

Wow, these questions asked to Dr Kaiser were great. Those are the kinds of

questions we should be asking when anyone claims that their product produced a

" significant " increase in CD4 cells. I will save them for future use when a

multi-level company calls me ( I get probably 1-2 calls or emails a month from

people who have great claims on their products with shitty or no data)

Regards,

Vergel

powerusa dot org

Dr. Kaisers' vitamin study - Some hard questions and

answers

Interesting answers from Jon Kaiser to some hard questions about his vitamin

study.

These questions were given to Jon by a long-term AIDS treatment activist who

is quite knowledgeable and asks hard questions. I found Jon's answers very

interesting. I have no question myself that Jon's intentions are to study

and verify what benefits he has seen in his long-term practice with HIV

patients --- He is consistent in demonstrating his diligence. Skeptics can

think and say anything they like, but I know Jon to be quite sure that he's

seen wonderful things happen and that he has devoted his life to helping

people with HIV with what he has discovered. I won't get into anything

related to money or cost in this matter. That's another issue. His intent

and what good he can do to help people are what I focus on. Kudos to Jon for

devoting himself to helping others.

Mooney

www.michaelmooney.net

www.medibolics.com

************************************************

> Question: One main question I have is why there wasn't longer-term

follow-up,

> given that the study took place in 2002-2003. I'm sure we all remember

> how the 24 week data point in the original AZT study back in 1987 was

> contradicted by subsequent data points. What seemed true at 24 weeks was

> quite untrue at later data points. I would assume that the patients

> stayed on the regimen, though given the outcome, the placebo patients

> probably switched after 12 weeks.

Kaiser: It was hard enough to get BMS to fund this study for 12 weeks, so

there were no funds available for continuing the micronutrient treatment

beyond that time point or including a cross-over design. These are things I

definitely want to include in any subsequent studies.

> Question: A related question is about what happened at the other data

points,

> given as every 4 weeks. In a small study like this, it is common for the

> absolute CD4+ count to move around quite a lot, following the patients

> WBC and even the time of day the blood is drawn. At one data point, one

> arm might be superior, while at another, the opposite might be true. In

> a larger study these differences get equitably distributed, but in a

> small study there is considerable chance that they will have an undue

> effect. To have confidence in the final endpoint in a small study, I

> always like to see the interim data points and the standard deviations.

Kaiser: As you saw in the graphs I sent last week, the treatment effect of

the micronutrient formula on raising CD4 counts is steady and progressive.

My experience using this formula as an immunomodulator in the clinic during

the past five years shows that its effect is predictable and consistent.

Obviously, not every single patient sees an increase in their CD4 count of

24%, but the majority do.

> Question: I'm not clear as to just what the " HAART " regimens were, as the

part > of the article I saw just said they were " stavudine or didanosine

based. "

> Neither of these would be considered the basis of a HAART regimen, which

> by definition (at least for now) means a three drug regimen based on

> either a protease inhibitor or an NNRTI. I now see that people were on

> three drugs, though I still don't know if they actually constituted

> " HAART. "

Kaiser: In addition to taking D4T and/or DDI, the balance of the HAART

regimens that were taken by patients on this study included what you would

expect. Every patient was on at least 3 antiviral meds with a mix of PI and

NNRTI-based regimens that did not differ significantly between the two

treatment arms.

> Question: Considering how long people in both arms had reported

neuropathy,

> it's safe to say that most of them were on their drug regimens for a year

or

> longer. This suggests there would be no reason to expect an improvement

> in CD4+ count in the 12 week period. The surprise, of course, is the

> gain seen in the group on micronutrients. You seem to suggest that the

> rapid change in CD4+ count is necessarily an important change in the

> immune system. Some people would argue that rapid changes in CD4+ counts

> do not reflect real production of new cells but rather a change in

> distribution of the cells, from the lymph system into the periphery.

> This point was made many time in studies of the immunologic significance

> of the large and rapid CD4+ count improvements seen with protease

> inhibitors.

Kaiser: Actually, it is my belief that the 24% rise in the CD4 count in the

micronutrient arm patients is in fact due to the ability of the treatment to

suspend or delay apoptosis in their HIV-infected CD4 cells. The apoptotic

process has been shown to be fueled by increased oxidative stress and a

subsequent loss of mitochondria to below a critical threshold. When this

point is passed the cell programs itself to die. The antioxidant-rich

compound used in this study is specifically designed to protect the

mitochondria from the the high levels of oxidative stress generated by both

HIV infection and antiviral drugs. When the rate of decline in the CD4 cell

line is decreased, combined with the steady release of new CD4 cells into

the circulation, we see a net increase in the CD4 count over time. It does

remain to be seen whether the immune response is qualitatively enhanced as

well, but I believe this would also be observed as a result of enhanced

mitochondrial energy production across all the immune cell lines.

> Question: One piece of data that I don't find anywhere is the patients'

> historical use of these or similar micronutrients. It's hard to believe

that

> they just started using supplementation for the first time in this study.

> Certainly, if they were patients of yours, it would seem likely they had

> been on some form of supplementation long before the study began. I'm

> not sure how this would have effected the study outcome, but I think it

> would be an important piece of information.

Kaiser: I never had contact with any of the patients recruited for this

study. They were all recruited from the patient bases of four inner city

HIV community clinics (in NYC, SF, LA, and Philadelphia) with the specific

goal of recruiting patients who generally could not afford to have taken

micronutrients in the past due to economic factors.

> Question: While the gain in CD4+ cells seems impressive, I'm not sure what

it

> means without having access to the data on CD4+ percentage. In a small

> group, it's fairly easy to see a change in " absolute " CD4+ counts

> without seeing a change in CD4+ percentage. Most immunologists would

> argue that the smaller the study, the more important the percentage

> becomes as a real marker of change in the immune system. In larger

> studies, the larger numbers tend to smooth out any differences between

> number and percent. As a general rule though, I think most people

> believe that the percentage is the meaningful number, as the " absolute "

> number is simply a calculation of the percentage times the WBC. Any

> change in the WBC produces a change in the " absolute " number, whether or

> not the percentage has actually changed. Thus, I'd really like to see

> what happened to the percentages.

Kaiser: I agree that the change in the CD4 percentage is important, however,

the licensing trials of most antiretrovirals do focus on the change in

absolute CD4 count over time as being the more meaningful and commonly

reported variable. I will have to go back to the data set to examine the

change in CD4% more fully.

> Question: That said, it doesn't surprise me to see people improve as a

result

> of treatment with improved nutrients. The question is whether this would

> always be the case or whether it reflects nutritional deficiencies in a

> subset of patients or a subset that is experiencing mitochondrial damage

> from drugs like stavudine, which is now all but banned in the US, and

> didanosine, which is close behind. Still, they are widely used in the

> developing world, which I think is a crime.

Kaiser: Another good point. The goal of providing this level of

micronutrient supplementation is to drive biological processes toward a

clinically useful and important goal. I describe the dosages used in this

formulation as " pharmacologic " . They are not designed just to eliminate of

prevent nutrient deficiencies. If that were my goal, I would provide the

nutrients at about one quarter of the dosage used in this study. Given that

the participants in this study could safely be considered well-nourished,

the goal was to use pharmacologic dosages of a broad-spectrum micronutrient

supplement designed to enhance mitochondrial health and energy production in

patients with a disease (and treatment) that places extraordinary stress on

that critically important organelle.

> Question: Another subject for future study would be to compare this

particular

> micronutrient regimen in a similar study to the use of a simple once

> daily multi-vitamin. Since we have no idea which elements in the

> micronutrient used in this study were responsible for the results, I

> think it would be very important to compare it to a simple but far less

> expensive regimen.

Kaiser: I agree. My clinical experience is that, in patients who are

relatively well-nourished, there would be a wide discrepancy in the effect.

In patients with frank micronutrient deficiencies, that difference might be

less.

> Question: Lastly and most unfortunately, you should know that the HIV

> denialists are already aggressively describing this study as a head to

head

> comparison of micronutrients vs. HAART, which is simply untrue. They are

> screaming from the rooftops that it proves HAART is harmful and that

> AIDS " can be cured " simply by giving people a vitamin pill. I'm sure

> that wasn't something you had hoped for and it's already causing harm in

> South Africa, where nutritional supplementation has been pitted against

> the use of antivirals (by a combination of the denialists and wealthy

> vitamin peddler).

Kaiser: The results of this study indicate that the combination of this

micronutrient supplement and HAART provides a more robust rate of immune

reconstitution than HAART alone. It remains the role of future studies to

investigate whether or not this micronutrient formula can help delay HAART

in naïve patients (or help patients experience longer and safer treatment

interruptions). I will never state that micronutrients eliminate the need

for the intelligent use of HAART, which you and I know has and will continue

to save millions of lives.

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[Guest guest]

Dr Jon Kaiser had his patients on a d4T and ddI regimen in 2002 through 2003? What is wrong with him?

d4T is the drug which kills off 85% of the mitochondria in fat cells in fairly short order.

No amount of vitamins or patent medicines will prevent this damage.

Its not like Jon Kaiser is located in a Third World nation where less damaging drugs are not available.

Utterly bizarre.

>> Interesting answers from Jon Kaiser to some hard questions about his vitamin> study.> > These questions were given to Jon by a long-term AIDS treatment activist who> is quite knowledgeable and asks hard questions. I found Jon's answers very> interesting. I have no question myself that Jon's intentions are to study> and verify what benefits he has seen in his long-term practice with HIV> patients --- He is consistent in demonstrating his diligence. Skeptics can> think and say anything they like, but I know Jon to be quite sure that he's> seen wonderful things happen and that he has devoted his life to helping> people with HIV with what he has discovered. I won't get into anything> related to money or cost in this matter. That's another issue. His intent> and what good he can do to help people are what I focus on. Kudos to Jon for> devoting himself to helping others.> > Mooney> www.michaelmooney.net> www.medibolics.com> ************************************************> > > Question: One main question I have is why there wasn't longer-term> follow-up,> > given that the study took place in 2002-2003. I'm sure we all remember> > how the 24 week data point in the original AZT study back in 1987 was> > contradicted by subsequent data points. What seemed true at 24 weeks was> > quite untrue at later data points. I would assume that the patients> > stayed on the regimen, though given the outcome, the placebo patients> > probably switched after 12 weeks.> > Kaiser: It was hard enough to get BMS to fund this study for 12 weeks, so> there were no funds available for continuing the micronutrient treatment> beyond that time point or including a cross-over design. These are things I> definitely want to include in any subsequent studies.> > > Question: A related question is about what happened at the other data> points,> > given as every 4 weeks. In a small study like this, it is common for the> > absolute CD4+ count to move around quite a lot, following the patients> > WBC and even the time of day the blood is drawn. At one data point, one> > arm might be superior, while at another, the opposite might be true. In> > a larger study these differences get equitably distributed, but in a> > small study there is considerable chance that they will have an undue> > effect. To have confidence in the final endpoint in a small study, I> > always like to see the interim data points and the standard deviations.> > Kaiser: As you saw in the graphs I sent last week, the treatment effect of> the micronutrient formula on raising CD4 counts is steady and progressive.> My experience using this formula as an immunomodulator in the clinic during> the past five years shows that its effect is predictable and consistent.> Obviously, not every single patient sees an increase in their CD4 count of> 24%, but the majority do.> > > Question: I'm not clear as to just what the "HAART" regimens were, as the> part > of the article I saw just said they were "stavudine or didanosine> based."> > Neither of these would be considered the basis of a HAART regimen, which> > by definition (at least for now) means a three drug regimen based on> > either a protease inhibitor or an NNRTI. I now see that people were on> > three drugs, though I still don't know if they actually constituted> > "HAART."> > Kaiser: In addition to taking D4T and/or DDI, the balance of the HAART> regimens that were taken by patients on this study included what you would> expect. Every patient was on at least 3 antiviral meds with a mix of PI and> NNRTI-based regimens that did not differ significantly between the two> treatment arms.> > > Question: Considering how long people in both arms had reported> neuropathy,> > it's safe to say that most of them were on their drug regimens for a year> or> > longer. This suggests there would be no reason to expect an improvement> > in CD4+ count in the 12 week period. The surprise, of course, is the> > gain seen in the group on micronutrients. You seem to suggest that the> > rapid change in CD4+ count is necessarily an important change in the> > immune system. Some people would argue that rapid changes in CD4+ counts> > do not reflect real production of new cells but rather a change in> > distribution of the cells, from the lymph system into the periphery.> > This point was made many time in studies of the immunologic significance> > of the large and rapid CD4+ count improvements seen with protease> > inhibitors.> > Kaiser: Actually, it is my belief that the 24% rise in the CD4 count in the> micronutrient arm patients is in fact due to the ability of the treatment to> suspend or delay apoptosis in their HIV-infected CD4 cells. The apoptotic> process has been shown to be fueled by increased oxidative stress and a> subsequent loss of mitochondria to below a critical threshold. When this> point is passed the cell programs itself to die. The antioxidant-rich> compound used in this study is specifically designed to protect the> mitochondria from the the high levels of oxidative stress generated by both> HIV infection and antiviral drugs. When the rate of decline in the CD4 cell> line is decreased, combined with the steady release of new CD4 cells into> the circulation, we see a net increase in the CD4 count over time. It does> remain to be seen whether the immune response is qualitatively enhanced as> well, but I believe this would also be observed as a result of enhanced> mitochondrial energy production across all the immune cell lines.> > > Question: One piece of data that I don't find anywhere is the patients'> > historical use of these or similar micronutrients. It's hard to believe> that> > they just started using supplementation for the first time in this study.> > Certainly, if they were patients of yours, it would seem likely they had> > been on some form of supplementation long before the study began. I'm> > not sure how this would have effected the study outcome, but I think it> > would be an important piece of information. > > Kaiser: I never had contact with any of the patients recruited for this> study. They were all recruited from the patient bases of four inner city> HIV community clinics (in NYC, SF, LA, and Philadelphia) with the specific> goal of recruiting patients who generally could not afford to have taken> micronutrients in the past due to economic factors.> > > Question: While the gain in CD4+ cells seems impressive, I'm not sure what> it> > means without having access to the data on CD4+ percentage. In a small> > group, it's fairly easy to see a change in "absolute" CD4+ counts> > without seeing a change in CD4+ percentage. Most immunologists would> > argue that the smaller the study, the more important the percentage> > becomes as a real marker of change in the immune system. In larger> > studies, the larger numbers tend to smooth out any differences between> > number and percent. As a general rule though, I think most people> > believe that the percentage is the meaningful number, as the "absolute"> > number is simply a calculation of the percentage times the WBC. Any> > change in the WBC produces a change in the "absolute" number, whether or> > not the percentage has actually changed. Thus, I'd really like to see> > what happened to the percentages.> > Kaiser: I agree that the change in the CD4 percentage is important, however,> the licensing trials of most antiretrovirals do focus on the change in> absolute CD4 count over time as being the more meaningful and commonly> reported variable. I will have to go back to the data set to examine the> change in CD4% more fully.> > > Question: That said, it doesn't surprise me to see people improve as a> result> > of treatment with improved nutrients. The question is whether this would> > always be the case or whether it reflects nutritional deficiencies in a> > subset of patients or a subset that is experiencing mitochondrial damage> > from drugs like stavudine, which is now all but banned in the US, and> > didanosine, which is close behind. Still, they are widely used in the> > developing world, which I think is a crime. > > Kaiser: Another good point. The goal of providing this level of> micronutrient supplementation is to drive biological processes toward a> clinically useful and important goal. I describe the dosages used in this> formulation as "pharmacologic". They are not designed just to eliminate of> prevent nutrient deficiencies. If that were my goal, I would provide the> nutrients at about one quarter of the dosage used in this study. Given that> the participants in this study could safely be considered well-nourished,> the goal was to use pharmacologic dosages of a broad-spectrum micronutrient> supplement designed to enhance mitochondrial health and energy production in> patients with a disease (and treatment) that places extraordinary stress on> that critically important organelle.> > > Question: Another subject for future study would be to compare this> particular> > micronutrient regimen in a similar study to the use of a simple once> > daily multi-vitamin. Since we have no idea which elements in the> > micronutrient used in this study were responsible for the results, I> > think it would be very important to compare it to a simple but far less> > expensive regimen. > > Kaiser: I agree. My clinical experience is that, in patients who are> relatively well-nourished, there would be a wide discrepancy in the effect.> In patients with frank micronutrient deficiencies, that difference might be> less.> > > Question: Lastly and most unfortunately, you should know that the HIV> > denialists are already aggressively describing this study as a head to> head> > comparison of micronutrients vs. HAART

, which is simply untrue. They are> > screaming from the rooftops that it proves HAART is harmful and that> > AIDS "can be cured" simply by giving people a vitamin pill. I'm sure> > that wasn't something you had hoped for and it's already causing harm in> > South Africa, where nutritional supplementation has been pitted against> > the use of antivirals (by a combination of the denialists and wealthy> > vitamin peddler). > > Kaiser: The results of this study indicate that the combination of this> micronutrient supplement and HAART provides a more robust rate of immune> reconstitution than HAART alone. It remains the role of future studies to> investigate whether or not this micronutrient formula can help delay HAART> in naïve patients (or help patients experience longer and safer treatment> interruptions). I will never state that micronutrients eliminate the need> for the intelligent use of HAART, which you and I know has and will continue> to save millions of lives.>

[Guest guest]

During the interview, Dr. Kaiser stated that the patients in his study were not his patients, but were recruited from inner city HIV community clinics:

Kaiser: I never had contact with any of the patients recruited for this

study. They were all recruited from the patient bases of four inner city

HIV community clinics (in NYC, SF, LA, and Philadelphia) with the specific

goal of recruiting patients who generally could not afford to have taken

micronutrients in the past due to economic factors.

This makes me wonder why he specifically chose patients who were on d4T and ddI. Why would he limit his study to patients taking two drugs that are very rarely used nowadays because of their toxicity? Am I missing something?

Allan

Dr Jon Kaiser had his patients on a d4T and ddI regimen in 2002 through 2003? What is wrong with him?

d4T is the drug which kills off 85% of the mitochondria in fat cells in fairly short order.

No amount of vitamins or patent medicines will prevent this damage.

Its not like Jon Kaiser is located in a Third World nation where less damaging drugs are not available.

Utterly bizarre.

[Guest guest]

"Dr Jon Kaiser had his patients on a d4T and ddI regimen in 2002 through2003? What is wrong with him?"I couldn't agree more.  Why didn't he add Hydroxyurea, and just blow out the body count?Sounds like HIV Tuskeegee. Barrowpozbod@...

[Guest guest]

At 08:20 PM 8/28/2006, Barrow wrote:

" Dr Jon Kaiser had his patients on a d4T

and ddI regimen in 2002 through

2003? What is wrong with him? "

I couldn't agree more. Why didn't he add Hydroxyurea, and just blow

out the body count?

Sounds like HIV Tuskeegee.

Wow. This is just really insane. I mean, when Kaiser started the study

probably in '01 or '02, they were still scratching their asses trying to

figure out if d4T did anything naughty. Clearly, it does.

I'd suggested at the time that they try using a lower, equally effective

dose. 40 mg/day may work fine. Just like 300 mg/day of AZT may work just

fine without all the toxicities.

Abacavir can be a very nasty drug. I think maybe tenofovir is a bit less

toxic overall--but still more toxic than 3TC. PIs are just going to be

toxic in their own ways as are all the NNRTIs.

What fantasy land are you people living in that you think that these

drugs are all so much better?

And the sad, grisly reality is that many people will NEED to use these

drugs, short of a cure. If you buy the hype that they're trying to push

that one should never ever stop the meds--you can be sure that resistance

issues will make it probably likely that d4T or ddI will still be

needed.

Meantime, nobody has commented on what a complete hatchet job load of

worthless crap stuff like the KLEAN study was.

My god. Say that there is evidence that something simple and totally

non-toxic like antioxidants can have a benefit, and some of you get so

completely bent out of shape. It's not a definitive study--but what the

fuck is going on in your minds really?

It's not science.

M.

[Guest guest]

At 01:52 AM 8/30/2006, you wrote:

,

The problem isn't that it's Non definitive, it's that the study produced

no statistically significant results and it's presented as if it

challenged the theory of relativaty.

Wow. You did NOT read the study, did you?

It DID produce statistically significant results. Specifically, an

increase in CD4 count of 25% overall among those receiving the

intervention over a loss among placebo recipients. This was a

statistically significant finding (p=0.01).

M.

[Guest guest]

Jon Kaiser's study was obviously definative enough for Bristol-Meyers-Squibb.

If the micronutrients had shown any sign of reducing the damage caused by d4T (Zerit, stavudine) BMS would have greedily paid for a greatly expanded trial. If something as simple as mixing vitamins and minerals with d4T could have made d4T a mainstream therapy again, well that's worth billions to BMS.

Jon Kaiser, like most researchers when they find themselves with a study disproving their hypothesis, chose to portray the results as proving micronutrients are well tolerated and possibly related to an increase in T4 count - although I assume not an increase in T4 percentage. (This probably means micronutrients are associated with a rise in White Blood Cell Count in malnourished people - or maybe that the 15 people experienced an allergic reaction to the micronutrients.)

If Kaiser had highlighted the failure of micronutrients to prevent mitochondrial damage induced by d4T, I think a lot of people would have had more respect and given a better hearing to his reports of success in other areas. But very few researchers are emotionally prepared to offer that level of honesty. Its understandable that most want to underline the happy face aspects.

>> ,> > The problem isn't that it's Non definitive, it's that the study > produced no statistically significant results and it's presented as > if it challenged the theory of relativaty.> > > Barrow> pozbod@...>

[Guest guest]

I assume the patients in Jon Kaiser's study started the micronutrients and d4T at the same time.

If this is true, since the micronutrients failed to protect against damage by d4T, continuing the d4T with micronutrients for a longer period of time would have made things worse, not better.

I received monthly IV vitamin and mineral infusions from 1990 through 1995, in addition to daily oral supplements.

I used d4T for six weeks in 1992, and quickly developed neuropathy that took me months to recover from.

So obviously micronutrients quickly failed me as well in 1992 as a protection from d4T induced mitochondrial toxicity and neuropathy.

As a result, I don't find the results of Jon Kaiser's study surprising. My personal experience predicted these results.

>> > Perhaps the patients involved the study were not taking the> micronutrients long enough to experience an improvement in> mitochondrial damage? This sort of thing does not reverse itself> overnight. It would probably be more accurate to say that no> significant improvement was observed in the length of time the> study was done, which was not a long time at all.

> It would be interesting to me to know how many people on this list> who are so critical of this sort of thing are actually taking> vitamins/supplements themselves............> >

[Guest guest]

At 01:46 PM 8/30/2006, Norm Stuart wrote:

>I assume the patients in Jon Kaiser's study started the micronutrients and

>d4T at the same time.

This presumption is inaccurate. These were people on d-drugs suffering from

neuropathy.

You're right, the study did NOT find a significant benefit for it in terms

of managing neuropathy and yep, BMS doesn't give a shit if it raised CD4 in

a statistically significant fashon and would not pay for further studies to

confirm this finding. It's not about science or health. It's about profit.

By contrast, Youle's group, using JUST acetylcarnitine at a 3 g/day dose

(not the 1 g in the Kaiser protocol) DID find a benefit for neuropathy. See

abstract below.

And yes, if people can avoid drugs like ddI and d4T, great. Or use lower

doses--but that would impact profits so we can't study that either. It's

about money. Not your life. They don't give a fuck about your life.

Kaiser does care about peoples' lives and well-being from everything I know

about the guy. And I have known him for years.

Having started FIAR ( www.fiar.us ), through the inspiration of people like

Fred Schaich's IFARA and my friend who runs www.citta.org

(different kinds of inspiration), I know how damn hard it is to raise funds

for studies of these types of interventions. Damn near impossible.

When you write " When one of your many friends from India, Thailand,

Zimbabwe and Nepal write to you, I wish you would stop suggesting d4T. " You

really have no clue how most people with HIV on the planet live. Or die. Do

you? Tenofovir is horrifically overpriced. A $1 a day in Thailand is more

than most people MAKE in a day. That's because Gilead doesn't give a shit

about life. They ONLY care about their bottom line.

You claim with certainty that micronutrients do not work for mito tox, I

think you are wrong. It depends. Interventions like thiamin, riboflavin and

carnitine have been used to prevent people from dying from lactic acidosis,

for example. Carnitine may help offset myopathy.

I think mito tox can be slowed to some degree and/or help the body repair

after the assaults of HIV and/or ARVs are either stopped through a

treatment interruption or through switching to those ARVs that have

different toxicity profiles. The addition of a multi and various

antioxidants can address various aspects of ARV side effects. I've seen it

happen many times. Especially when undertaken in conjunction with stopping

smoking, a good diet, exercise--the basics.

Many countries, such as Tanzania, have been able to incorporate the use of

a mutli into national programs. It's a cheap intervention. South Africa's

situation is screwed up because they have an idiot denialist running the

country and supporting a fucking nutjob, Matthias Rath, who tells people

multis CURE AIDS and they should STOP ARV. That's insanity.

There have been a number of micronutrient initiatives over the years,

mostly for iron and iodine, that have been funded by agencies. There's

PLENTY of money in the world--but then we have an asshole named

Dubya Bush who'd rather squander resources to wage wars based on lies that

get botched while pushing trade agreements that serve pharma's interests

and cause more suffering and death.

Many governments are complicit. India's government is so self-absorbed and

arrogant, it doesn't really much give a damn about people with HIV, with a

few exceptions, even though the generic ARV industry is right there. The

poverty there is intense. Nepal's government has been in disarray. Zimbabwe

is run by a dictator. Yes, many governments have lots to answer for--and

ours (US) is one of the worst in the world for the poor.

The system of drug discovery has been horribly distorted in this

" privatized model " where all the money goes for studies designed to be

marketing tools for pharma and then published in prestigious journals who

get funding from ads more than subscriptions and passed off as good

medicine to doctors who are bribed, coddled and beaten into prescribing

what they want, coupled with insidious " direct to consumer " advertising

that creates artificial demand.

And the result overall is that the US spends more on healthcare than any

other country on the PLANET and yet has outcomes more akin to the Czech

republic (in terms of measures like overall mortality, infant mortality, etc.)

We need a revolution.

Norm, I think you are a really amazing and smart guy. You are also an

arrogant SOB with a chip weighing about 50 pounds on your shoulder. I know.

Cause it takes one to know one!

M.

***

Herzmann C, MA, Youle M. Long-term effect of acetyl-L-carnitine

for antiretroviral toxic neuropathy. HIV Clin Trials. 2005 Nov-Dec;6(6):344-50.

Royal Free Centre for HIV Medicine, Royal Free Hospital, London, United

Kingdom. christian.herzmann@...

BACKGROUND: Nucleoside analogue reverse transcriptase inhibitors (NRTIs)

used for the treatment of HIV can a cause distal symmetrical peripheral

polyneuropathy by disruption of mitochondrial metabolism. Treatment with

acetyl-L-carnitine (ALCAR) has shown short-term symptomatic and

histological improvement. Long-term effects have not been investigated.

PURPOSE: To assess the subjective and objective degree of antiretroviral

toxic neuropathy (ATN) during treatment with ALCAR. METHOD: A cohort of 21

patients with ATN who commenced treatment with ALCAR between March 1999 and

October 2001 was reviewed after a mean of 4.3 years using standardized

questionnaires and neurological examination. RESULTS: Of the 21 patients, 2

had died and 3 were lost to follow-up. 16 patients were assessed. 10 were

still on potentially neurotoxic drugs. 13 were still taking ALCAR. 9 were

pain free. The most common symptom was numbness (mild, moderate, and severe

in 12, 3, and 0 patients, respectively), followed by paraesthesia (8, 2,

2), pain (4, 3, 0), and burning (5, 2, 0). There was mildly reduced

sensation in the toes of 8 patients. 13 patients reported that ALCAR had

improved their symptoms very much or moderately, 2 reported no change, and

1 reported a moderate worsening. CONCLUSION: ALCAR led to long-term

symptomatic improvement in most patients without the need to discontinue

neurotoxic drugs. Although in this study there was no control group, this

agent appears to be an effective pathogenesis-based treatment for ATN.

[Guest guest]

well, if you consider that the control group, for some reason, had more t-cells than the treatment group, I'm not sure that it's valid.All other points examined were not statistically significant.  Only when the control group and the treatment group were not comparable does a "benefit" obtain. Barrowpozbod@...