N-acetyl cysteine (NAC), a derivative of the amino acid L-cysteine,is a potent antioxidant that regenerates glutathione in the cell . In this role, NAC protects liver cells by decreasing oxidation. Cysteine appears to decline in people with HIV who have low CD4+ cell counts and in those with wasting. NAC supplements may be able to replenish low glutathione and improve the antioxidant capacity of cells. Study doses have been as high as 2,000 mg per day, but this is expensive and may not be well tolerated. Side effects include nausea, vomiting, diarrhea and headache. The most beneficial dose is not certain, although a dose of 500 mg per day may offer some benefit with a reduced risk of toxicity.

Probiotics are live organisms, including the bacteria Lactobacillus and Bifidobacterium and yeasts. They help build a healthy population of good bacteria (microflora) in the intestines. Microflora keep the gut healthy by preventing the growth of disease-causing bacteria and maintaining the intestinal barrier. Probiotic supplements are helpful after a course of antibiotics because they replace the microflora that were damaged by the antibiotic. Probiotics may also reduce chronic diarrhea and improve symptoms of irritable bowel syndrome. The most common type of probiotic is L. acidophilus but some products now contain mixed organisms. These are found in foods that contain live culture, such as yogurt and kefir. Purchase supplements that are refrigerated and have a long shelf life.

Coenzyme Q10 (CoQ10) is a substance that plays a role as an antioxidant as well as a cofactor in mitochondrial energy production. It has been used to treat congestive heart failure and gum disease (gingivitis) and may help protect the heart and nerves. Statins, a class of cholesterol lowering drugs, reduce CoQ10 levels. The usual CoQ10 dosage range is 60 to 240 mg daily.

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