|
|
Medications, Diet & Nutrition Curtailing Adverse Effects
by Irene Romano, R.D.
People living with HIV and AIDS use various medications, both prescription and over the counter, to treat the symptoms of HIV and its related opportunistic infections. Medications can have an adverse effect on your nutritional status when interacting with caffeine, alcohol and some nutritional supplements (vitamins and minerals). They may cause such adverse side effects as decreased appetite, nausea, vomiting and diarrhea which can lead to weight loss or dehydration. Foods may also affect the absorption of medication. Therefore, it is important to be aware of these interactions, how they may affect your immune and nutritional status, and what you can do to deal with them.
Caffeine acts as a diuretic and will induce the loss of water and minerals (such as calcium, magnesium, sodium and chloride). Excessive caffeine consumption may lead to decreased nutrient absorption. Common sources of caffeine are coffee, tea, soft drinks, chocolate, and a variety of over-the-counter medications. Limit your caffeine intake to a minimum and always drink an extra glass of juice or water for every caffeine-containing beverage you consume.
Alcohol consumption causes nutrient deficiencies due to a decrease in absorption and a decrease in actual food intake. Excessive alcohol consumption can affect the digestive tract in such a way that nutrients are not absorbed as efficiently as possible. Alcohol also acts to impair the body's supply of antioxidants, vitamins E and C, selenium and glutathione.
Alcohol acts as a depressant. Combining alcohol with central nervous system depressantsnarcotics, sedatives, antihistamines, tranquilizers, anti-depressants, antipsychotics, and muscle relaxants--will increase the medication's sedative action. Alcohol may also increase the extent of nausea caused by some HIV/AIDS medications.
This is a significant issue for those living with HIV/AIDS, given that it is often recommended to take nutritional supplements to prevent nutritional deficiencies. Medications that are taken orally enter the digestive tract and are then metabolized and absorbed into the blood stream. Various nutritional supplements and anta-cids may interfere with the absorption of medications from the digestive tract into the blood stream. If medications cannot reach the blood stream, they cannot work effectively. For example, the calcium, magnesium, iron, zinc and aluminum commonly found in supplements and antacids may decrease the absorption of certain medications and should NOT be taken at the same time.
Just as nutritional supplements and antacids can interfere with the metabolism and absorption of medications, certain medications can affect the metabolism and absorption of nutritional supplements. While some medications alter the absorption of many vitamins and minerals, other medications will prevent absorption altogether, which may then contribute to a nutritional deficiency. For example, Sucralfate, an anti-ulcer drug, may interfere with the absorption of vitamins A, D, E, and K. Isoniazid (INH), an antibiotic, may deplete the body's reserves of vitamin B6. Some studies suggest that long-term antibiotic therapy destroys intestinal flora which play a role in the absorption and metabolism of nutrients.
Before starting a new medication, make sure that you know:
- the name of the medication
- what it is for
- how you should take it
- how often
- with food or on an empty stomach
- possible side effects
- interactions
- special instructions
If you are unsure of how your medications should be taken, contact your pharmacist who can review your medication profile and answer questions specific to your situation.
When starting a new medication, antacid or nutritional supplement you might experience adverse side effects such as decreased appetite, nausea, vomiting or diarrhea. In some cases these side effects will go away after your body gets used to the new medication. However, if these side effects are prolonged and disruptive to your food intake, significant weight loss may occur. Therefore, it is best to discuss any new medication with your pharmacist, physician or medical provider so that it can be evaluated for potential interactions.
- take medications 30 minutes prior to OR two hours after meals, unless indicated otherwise
- take medications two hours prior to OR after taking antacids or supplements containing calcium, magnesium, iron, zinc or aluminum.
- eat nutritious meals and snacks frequently (5-6 times a day)
- keep convenient high-calorie, high-protein snacks on hand
- drink liquids 30 minutes before or after solid foods
- take a short walk before mealtimes
- eat in a comfortable setting
- if nausea is a problem, eat cold foods to minimize food odors
- open a window for fresh air at meal times
- If you experience weight loss or other symptoms after beginning a new medication, consult your pharmacist, physician or medical provider to discuss your medical regimen.
Maintaining a good nutritional status through the consumption of a nutrient-rich diet is your best defense to minimize adverse effects from the interaction of medication with caffeine, alcohol, and nutritional supplements. N
Irene Romano is a registered dietician and doctor of pharmacy currently living in the San Francisco Bay area.
|
