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Question
#2: My platelet counts have been low for many years now. Recently,
with the addition of HU (hydroxyurea) to my HAART regimen, my platelets
seem to be getting worse. They are not in the danger zone yet, but I would
like to know if any type of supplementation could arrest this decline.
Thanks. (November, 1998)
Answer: Charlie Smigelski,
RD responds: For treatment regarding platelets, I approach the issue in
two ways...
1. I would be certain
that a person is on an aggressive antioxidant supplement regimen, so that
free radical (stray electron) damage is not causing excessive destruction
of platelets. This includes 800 IU vitamin E, 1-2 grams vitamin C, 200
mcg selenium, and 10,000+ IU's beta carotene (from foods, like spinach,
carrots, broccoli, apricots, and winter squash). Glutamine 5-10 grams a
day is good too. (See NAC below).
2. I would look at the
supply side.... Are there plenty of nutrients available for platelet production?
In this case, we are looking at adequate levels of protein (1.5 grams protein
per kg of ideal weight) and calories (17 calories per pound of ideal weight),
and especially adequate levels of B-complex vitamins, including 25-50 mg/day
of B6 and 800 micrograms/day of Folate. B12 is important, but should be
adequate in the C-complex 25 or complex 50 pill. Len Herzenberg at Stanford
once mentioned taking supplemental NAC to restore low platelets, and a
while ago I asked a colleague to confirm the dose. I have not yet gotten
a response. So far I would recommend 2 grams a day.
3. Drugs like AZT can
hinder platelet production as well. Some studies suggest that the 800 IU
of vitamin E should offset some of that damage to bone marrow by AZT. In
cancer care, 100 mg per day of Co-Enzyme Q10 can reduce toxicity of drugs
like Adriamycin, given in chemotherapy. I have not yet read about using
it for HIV drug toxicity. It has energizing benefits in HIV care, and is
an antioxidant as well as an immune cell (PBMC) fuel. One side note, it
is PBMC's that can stimulate CD4 cell production, and I wonder about using
C0-Q10 in this way for immune reconstruction).
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