Antiretroviral drugs (ARV) used to treat HIV have had an enormous impact, where they are available, in reducing AIDS-related deaths. But they aren't a cure and they come with a long list of side effects. Most people using ARV will indeed experience one or more side effects. Some of which can be fatal. The list below should not, however, dissuade one from using ARV when the time is right. The risks of these developing and the problems they can cause don't match the risks of developing a lethal opportunistic infection (OI)!

On the other hand, there is no reason to just go along and think there is nothing that can be done. Below each potential side effect is a list of interventions that may either help to reduce the risk of a side effect developing or help to manage those that do arise. But there are many questions about these interventions. Are they effective? If so, how well do they work? Do they cause other problems, like side effects of their own--or interfere with ARV in any way? These are the types of questions that FIAR hopes to raise money to answer in clinical settings!

The ideas below come from a document written by FIAR's director for DAAIR. This list is not exhaustive but may form a basis for consideration of clinical studies. For a more complete discussion with citations to the relevant literature, please go to and click on "Countering Toxicities." Please note that the list under each indication is not complete and represents some (but not all!) of the possible botanical or dietary supplement interventions that may be helpful. These ideas need to be discussed with your physician and weighed against the risks and benefits of standard pharmaceutical treatment, where such is available.

Please note that the presence of ANY persistent signs or symptoms must be evaluated by your physician! An accurate diagnosis is critical. Some ARV side effects can be rapidly fatal (for example, serious cases of lactic acidosis) and/or may require an immediate change in your ARV treatment (e.g., d4T/Ziagen hypersensitivity reactions).


Elements Of The "Lipodystrophy" Syndrome: Metabolic Complications
High LDL Cholesterol
acidophilus, activated charcoal (see precautions), alfalfa, sweet almond, artichoke, barley, carnitine, coenzyme Q10, curcumin, dandelion root, evening primrose oil, exercise, fiber (different varieties, i.e., water-soluble or not, etc.), flax, garlic, guggul lipids, hawthorn, lecithin, niacin, omega-3 fatty acids, oats, onion, pantethine, reishi, rhubarbine/cordyceps, saffron, green tea, vitamin E, yogurt, yucca.

activated charcoal, carnitine, curcumin, exercise, garlic, niacin

High Triglycerides
Essential fatty acids, garlic, nutrient combinations including antioxidants, niacin, carnitine, alpha lipoic acid

Increases in Insulin Resistance/Diabetes
alpha lipoic acid, bitter melon, various herbs from Chinese or other traditional medicine systems, DHEA, milk thistle, minerals

Hypoglycemia (Low Blood Sugar)
Fiber, bilberry, dandelion, pancreatin

Bilberry, Panax ginseng, glycyrrhizin (licorice extract), ho shou wu (Polygonum multiflorum), milk thistle, various nutrients including alpha lipoic acid, raspberry leaves (tea), stevia (sugar substitute)

Lactic Acidosis
B complex (particularly riboflavin and thiamine), carnitine, coenzyme Q10, milk thistle, vitamins C and E.

Other Potential Serious Side Effects:

alfalfa, Chinese herb combination (e.g., as found in Marrow Plus), vitamin B12, rehmannia

Bone Loss/Osteopenia, Osteoporosis, Osteonecrosis, Avascular Necrosis
Minerals, particularly combinations that include calcium, magnesium, boron, zinc, copper, silicon. Some of the questions here relate not only to the efficacy of such approaches but to what forms are the best. Some claims are made regarding enhanced absorption with some forms but do the claims justify the increased costs?

Diarrhea, Other Stomach/Gut Problems
Again: an accurate diagnosis is critical!
Acidophilus, apple, aromatherapy, barberry, calcium, fennel, fiber (psyllium), glutamine, hydrochloric acid, homeopathic remedies such as Hyland's Diarrhex?, lactase, mullein, vitamins A, E (with selenium), pancreatic enzymes, poppy, Saccharomyces boulardii, tamarind, tannin-containing herbs (many).
Also herbal blends such as Biocidin or Quiet Digestion.

Bee pollen, cayenne, ginseng (various types), gotu kola, guarana, Rhodiola rosea, NADH, olive leaf tea, omega-3 fatty acids, fish proteins.

Kidney (Renal Trouble)
Artichoke, barberry, carnitine, cordyceps, cranberry, herbal diuretics (asparagus, birch, goldenrod, nettle), glutamine, glycyrrhizin.

Liver Problems
Artichoke, dandelion, Chinese herb formulations (e.g., Clear Heat, Ecliptex, Hepato C), glycyrrhizin, lecithin, alpha lipoic acid, milk thistle standardized to 80% silymarin, NAC, omega 3 fatty acids, s-adenosylmethionine (SAMe), whey proteins, vitamin c, ascorbic acid 1000 mg (now), vitamin e (w/selenium)

Neuropathy (Nerve Problems): Feet/Leg Tingling Or Shooting Pains
Acupuncture, acetylcarnitine or carnitine, B-complex, alpha lipoic acid, choline/myoinositol, coenzyme Q10, massage/reflexology.

Pancreatic Problems
Glutamine, glycyrrhizin, various micronutrients such as vitamins C, E (with selenium), B12, folate and minerals such as calcium, magnesium, molybdenum, copper, zinc; pancreatic enzymes.

Other Problems
--- Please see the DAAIR document for more information on these.
Lack Of Appetite
Dementia, Thinking (Cognitive) Problems
Diuretics/Herbs That Increase Urine Flow
Dizziness, Headache
Dry Lips/Dry Mouth/Xerostomia
Electrolyte Depletion
Flatulence (Farting)/Gas
Hair Loss
Heart Trouble/Cardiomyopathy
Loss Of Internal Flora/Friendly Gut Bacteria
Low White Blood Cells (Wbc) Or Bone Marrow Suppression
Menstrual Cycle Disruption

Myelopathy (Spinal Cord Problem)
Myopathy (Muscle Problem)
Nausea, Vomiting
Sexual Dysfunction
Skin Problems
Split Nails
Taste/Smell Alteration Or Loss
Varicose Veins Related To Lipodystrophy

FIAR, a 501(c)(3) not-for-profit, does not accept pharmaceutical or nutriceutical industry funding and relies upon your generosity to continue its efforts.

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