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Just recieved my free Test test results. With a normal range of 7.2-23.0 I scored a OK 15.0.
My personal physical fitness war against HIV/AIDS: The War.
- Thread starter alanchiras
- Start date
A few leftovers:
I take a couple of 1-AD capsules a day. Is this something that I should be doing, or is this just a big waste of money?
I have an appointment with my Doctor obsessed with CD4 and viral load figures. I'm going to try to get her to run teste for cholesterol & Tryglycerides.
There was mention of something called BTG - what is this???
I am HEP C negative (don't know how)
Thanks all.
I take a couple of 1-AD capsules a day. Is this something that I should be doing, or is this just a big waste of money?
I have an appointment with my Doctor obsessed with CD4 and viral load figures. I'm going to try to get her to run teste for cholesterol & Tryglycerides.
There was mention of something called BTG - what is this???
I am HEP C negative (don't know how)
Thanks all.
NorCalBdyBldr
New member
Hi Alan,
You said:
"I take a couple of 1-AD capsules a day. Is this something that I should be doing, or is this just a big waste of money?"
Personally, I think prohormones are a complete waste of money so I wouldn't bother with them. As much as they cost, I would be far more inclined to spend my cash for something that actually works, like AAS.
You said:
"I take a couple of 1-AD capsules a day. Is this something that I should be doing, or is this just a big waste of money?"
Personally, I think prohormones are a complete waste of money so I wouldn't bother with them. As much as they cost, I would be far more inclined to spend my cash for something that actually works, like AAS.
NorCalBdyBldr
New member
Hi Alan,
You said:
"Just recieved my free Test test results. With a normal range of 7.2-23.0 I scored a OK 15.0."
This is a bit "abnormal" in that your free (unbound) testosterone levels are mid normal range. However, from what you told me during our chat, your total (bound plus unbound) testosterone levels are at the very bottom of normal (323 ng/dl with a laboratory reference range of 280-800 ng/dl) even with your Androgel "testosterone replacement" therapy (I did warn you that Androgel is fairly useless and will likely only raise your blood total testosterone levels by about 50 ng/dl). Frankly, you would typically expect that free testosterone should also be low if total is low under normal circumstances. So this brings up some questions and theories as this descrepancy is suggestive of possibly one or more things.
The first theory goes something like this. There used to be a medical theory that you had a set number of hormone (androgen) receptors and that number never changes. That would explain why AAS work much better for some guys than for others right from the start and not very well for some others. Some people CLEARLY have a higher receptor density and therefore a greater ability to process and utilize testosterone. The higher the number of receptors, i.e. the higher receptor density, that you have, the more testosterone you can process. This WAS and still IS, to a large degree, the CONVENTIONAL medical thinking.
Now there are some more recent theories circulating out there that the receptor density is not fixed but can fluctuate to some degree--still largely dependent on the individual genetics though. So guys that have continuously higher levels of testosterone circulating in their systems MAY actually increase the receptor density as a biological response within their specific genetic limitations. Once again, some guys will be more genetically "gifted" in this department as well. From personal observation and information, I strongly suspect that this second theory is correct. Namely, that the receptor density CAN vary in response to long term elevation of testosterone levels. This seems to make intuitive sense from a biological perspective as well.
So in your case, following this second theory, it is suggestive that maybe because your testosterone levels have been so low for so long, that the converse is true--namely that your receptor density is also quite low because there is no need to process very much testosterone simply because there just isn't much available over the long haul. Your body has just simply come to a new equilibrium so that you only process enough testosterone so that your circulating levels remain at mid normal and therefore equilibrium. This new equilibrium is what in biology is called "homeostasis"--the body's biological tendency to establish and maintain equilibrium or the "status quo." In bodybuilding, we also know that homeostasis can be changed to new equilibriums but it takes a lot of effort to overcome this. It is usually referred to in terms of body weight as changing "setpoints" but does apply, not surprisingly, to all kinds of other things like body composition, etc. as well. Once a new "setpoint" is established, your body will want to return to this equilibrium very strongly.
Assuming that the second theory is correct concerning receptor density and ability to process testosterone, it can be inferred that your body has lost its ability to process testosterone much above its current equilibrium (total testosterone levels permanently on the low side). Again, assuming the theory is correct, administration of testosterone to maintain your total testosterone levels above the mid normal range would be expected to force the body to adapt and increase the receptor density and therefore improve its ability to process testosterone in a more "normal" way over time. Anyway, this is just theory but it does seem to explain some things that have been observed in HIV patients and some others (non HIV). For example, you likely will be exhibiting symptoms of low testosterone (like depression, etc.) even though your circulating levels of free testosterone are mid normal. Remember, your free testosterone is only "available" testosterone but is not being utilized at the moment. Your total testosterone includes the bound fraction which is what is actually being processed/utilized and your total testosterone is actually very much on the low side. So you really do have to consider BOTH numbers together to understand what is going on.
The other possibility is that your body has developed some sort of hormonal resistance. This is also common in people with HIV disease. Hormonal resistance, however, tends to be more general in nature--not just testosterone specific--when it is observed. So things to watch for as indicators would also include blood sugar/glucose levels, etc. as the body CAN also develop insulin resistance with HIV disease and long term treatment. In other words, your phsycian would also be testing and looking for the same types of things that one would expect, including trends, towards developing either type II (onset) diabetes or even type I (insulin dependent) diabetes. It is also WELL known that certain HIV drugs do seem to increase the likelihood of insulin resistance and diabetes (several of the protease inhibitors in particular).
Remember, testosterone levels, both total AND free, NEED to be maintained at levels above the middle of "normal" in HIV disease because you are not only interested in testosterone replacement but also you need to offset the extremely catabolic metabolic processes tied in with HIV disease as discussed in my previous posts. Remember this is still theory and as far as I know this theory has never been actually "proven" yet.
However, that being said, it should be noted that even before ANY treatments were available for HIV, a number of West Coast physicians, in particular, did actually notice that those HIV patients that did AAS as recreational or competitive bodybuilders did, in fact, live AT LEAST 3-5 years or more longer and fared better in the interim than those that did not do AAS. Part of this is attributed to the large increased lean body mass that recreational and competitive bodybuilders carry because of AAS and lean body mass is absolutely correlative with survival with HIV disease. Part of this is also attributed to the fact that in HIV disease AAS tend to reverse some of the negative metabolic problems associated with HIV disease AND actually boost the immune system as well--this being contrary to what is normally taught in medical schools about steroids being immunosuppressive. In actuality what medical schools are REALLY saying is that CORTICOSTEROIDS are typically immunosuppressive, which is absolutely true without any question at all. And corticosteroids are normally the ONLY steroids that are administered theraputically in the United States as a matter of practice--at least until recently. They don't teach much of anything about AAS because, until recently, AAS were rarely ever administered to patients in the United States so there was no need to discuss them. Unfortunately, most physicians, because of this, actually believe that all steroids are immunosuppressive. The truth is that in HIV, they tend to BOOST immunity. This may be due to the fact that they tend to drive the bone marrow to produce things like white blood cells, platlets, etc. which offsets the bone marrow suppressive effects of many HIV drugs. These, of course, are things that also tend to fight infection and heal the body. So this actually makes sense, since the improved "resistance" from administration of AAS to HIV patients has been clinically observed many times over. They also tend to improve overall energy levels which helps offset the natural fatigue that is common with HIV disease. This is not really surprising because of the simple fact alone that they greatly increase the red blood cell counts and therefore the oxygen carrying capacity of the blood among other things. This also counteracts the tendency towards anemia on many HIV drugs. And it is well established that people with anemia typically have fatigue issues.
Additionally, it has also been my definite personal observation that those patients that are receiving AAS for anti wasting therapy as well as significant testosterone replacement are CLEARLY doing better in terms of living with HIV AND quality of life issues as well (and I know of many cases that the patient's physician allows their blood testosterone levels to be quite high because clinically the patient is doing very well that way).
So there is some more information you can float by your physician for his consideration and for further points of discussion.
You said:
"Just recieved my free Test test results. With a normal range of 7.2-23.0 I scored a OK 15.0."
This is a bit "abnormal" in that your free (unbound) testosterone levels are mid normal range. However, from what you told me during our chat, your total (bound plus unbound) testosterone levels are at the very bottom of normal (323 ng/dl with a laboratory reference range of 280-800 ng/dl) even with your Androgel "testosterone replacement" therapy (I did warn you that Androgel is fairly useless and will likely only raise your blood total testosterone levels by about 50 ng/dl). Frankly, you would typically expect that free testosterone should also be low if total is low under normal circumstances. So this brings up some questions and theories as this descrepancy is suggestive of possibly one or more things.
The first theory goes something like this. There used to be a medical theory that you had a set number of hormone (androgen) receptors and that number never changes. That would explain why AAS work much better for some guys than for others right from the start and not very well for some others. Some people CLEARLY have a higher receptor density and therefore a greater ability to process and utilize testosterone. The higher the number of receptors, i.e. the higher receptor density, that you have, the more testosterone you can process. This WAS and still IS, to a large degree, the CONVENTIONAL medical thinking.
Now there are some more recent theories circulating out there that the receptor density is not fixed but can fluctuate to some degree--still largely dependent on the individual genetics though. So guys that have continuously higher levels of testosterone circulating in their systems MAY actually increase the receptor density as a biological response within their specific genetic limitations. Once again, some guys will be more genetically "gifted" in this department as well. From personal observation and information, I strongly suspect that this second theory is correct. Namely, that the receptor density CAN vary in response to long term elevation of testosterone levels. This seems to make intuitive sense from a biological perspective as well.
So in your case, following this second theory, it is suggestive that maybe because your testosterone levels have been so low for so long, that the converse is true--namely that your receptor density is also quite low because there is no need to process very much testosterone simply because there just isn't much available over the long haul. Your body has just simply come to a new equilibrium so that you only process enough testosterone so that your circulating levels remain at mid normal and therefore equilibrium. This new equilibrium is what in biology is called "homeostasis"--the body's biological tendency to establish and maintain equilibrium or the "status quo." In bodybuilding, we also know that homeostasis can be changed to new equilibriums but it takes a lot of effort to overcome this. It is usually referred to in terms of body weight as changing "setpoints" but does apply, not surprisingly, to all kinds of other things like body composition, etc. as well. Once a new "setpoint" is established, your body will want to return to this equilibrium very strongly.
Assuming that the second theory is correct concerning receptor density and ability to process testosterone, it can be inferred that your body has lost its ability to process testosterone much above its current equilibrium (total testosterone levels permanently on the low side). Again, assuming the theory is correct, administration of testosterone to maintain your total testosterone levels above the mid normal range would be expected to force the body to adapt and increase the receptor density and therefore improve its ability to process testosterone in a more "normal" way over time. Anyway, this is just theory but it does seem to explain some things that have been observed in HIV patients and some others (non HIV). For example, you likely will be exhibiting symptoms of low testosterone (like depression, etc.) even though your circulating levels of free testosterone are mid normal. Remember, your free testosterone is only "available" testosterone but is not being utilized at the moment. Your total testosterone includes the bound fraction which is what is actually being processed/utilized and your total testosterone is actually very much on the low side. So you really do have to consider BOTH numbers together to understand what is going on.
The other possibility is that your body has developed some sort of hormonal resistance. This is also common in people with HIV disease. Hormonal resistance, however, tends to be more general in nature--not just testosterone specific--when it is observed. So things to watch for as indicators would also include blood sugar/glucose levels, etc. as the body CAN also develop insulin resistance with HIV disease and long term treatment. In other words, your phsycian would also be testing and looking for the same types of things that one would expect, including trends, towards developing either type II (onset) diabetes or even type I (insulin dependent) diabetes. It is also WELL known that certain HIV drugs do seem to increase the likelihood of insulin resistance and diabetes (several of the protease inhibitors in particular).
Remember, testosterone levels, both total AND free, NEED to be maintained at levels above the middle of "normal" in HIV disease because you are not only interested in testosterone replacement but also you need to offset the extremely catabolic metabolic processes tied in with HIV disease as discussed in my previous posts. Remember this is still theory and as far as I know this theory has never been actually "proven" yet.
However, that being said, it should be noted that even before ANY treatments were available for HIV, a number of West Coast physicians, in particular, did actually notice that those HIV patients that did AAS as recreational or competitive bodybuilders did, in fact, live AT LEAST 3-5 years or more longer and fared better in the interim than those that did not do AAS. Part of this is attributed to the large increased lean body mass that recreational and competitive bodybuilders carry because of AAS and lean body mass is absolutely correlative with survival with HIV disease. Part of this is also attributed to the fact that in HIV disease AAS tend to reverse some of the negative metabolic problems associated with HIV disease AND actually boost the immune system as well--this being contrary to what is normally taught in medical schools about steroids being immunosuppressive. In actuality what medical schools are REALLY saying is that CORTICOSTEROIDS are typically immunosuppressive, which is absolutely true without any question at all. And corticosteroids are normally the ONLY steroids that are administered theraputically in the United States as a matter of practice--at least until recently. They don't teach much of anything about AAS because, until recently, AAS were rarely ever administered to patients in the United States so there was no need to discuss them. Unfortunately, most physicians, because of this, actually believe that all steroids are immunosuppressive. The truth is that in HIV, they tend to BOOST immunity. This may be due to the fact that they tend to drive the bone marrow to produce things like white blood cells, platlets, etc. which offsets the bone marrow suppressive effects of many HIV drugs. These, of course, are things that also tend to fight infection and heal the body. So this actually makes sense, since the improved "resistance" from administration of AAS to HIV patients has been clinically observed many times over. They also tend to improve overall energy levels which helps offset the natural fatigue that is common with HIV disease. This is not really surprising because of the simple fact alone that they greatly increase the red blood cell counts and therefore the oxygen carrying capacity of the blood among other things. This also counteracts the tendency towards anemia on many HIV drugs. And it is well established that people with anemia typically have fatigue issues.
Additionally, it has also been my definite personal observation that those patients that are receiving AAS for anti wasting therapy as well as significant testosterone replacement are CLEARLY doing better in terms of living with HIV AND quality of life issues as well (and I know of many cases that the patient's physician allows their blood testosterone levels to be quite high because clinically the patient is doing very well that way).
So there is some more information you can float by your physician for his consideration and for further points of discussion.
R
Richard85
Guest
NorCalBdyBldr said:
do u have HIV, and if you dont mind me asking, how did u get it?
NorCalBdyBldr
New member
Richard85 said:
I am HIV positive and have lived with it for 20 years. My experience with it in a "nutshell" is:
After suffering years of symptoms, I finally progressed to a full blown AIDS diagnosis in 1993 along with a terminal malignant cancer diagnosis (biopsy proven) as well. I refused conventional treatment consisting of radiation therapy followed by intensive chemotherapy in 1993 as the oncologist said that "there was a 95% chance of the cancer returning within 3 months of cessation of therapy." I was expected to live no more than 1-3 years at that point. I told him that common sense would tell you that radiation and chemotherapy would likely suppress my immune system severely enough (especially considering how suppressed it already was) to allow HIV to finish the job while they are putting me flat on my back with projectile vomiting from the radiation/chemotherapy. I also told him that I had to somehow continue to work for a living to afford the health insurance to pay for his little scheme. I further added that "this is a quality of life issue, not a longevity issue the way I see it. If I am to die in one to three years, then so be it. I just don't have to make it the worst one to three years of my life and can try to make it as good as I can under the circumstances." So I never received ANY treatment for the cancer. My cancer progression stalled out before I was on any anti retrovirals even though my viral load was at 3.18 million virons per ml of blood. That was 1995. The immunologist asked me at that point "why are you still alive?" He also theorized that I would not live to see six more months. I had been on and off monotherapy for years but had not been on any drugs for the previous year.
I picked out a two combination therapy of available drugs which was not accepted at that time including the new experimental but not yet approved drug 3tc at that time and the immunologist thought that my reasoning was very sound and it was worth a try. It worked very well for me. The next year triple therapy came into play and things improved considerably. I made many changes to my life which also helped and the cancer went into full remission in 1997.
Unfortunately, the price of anti retroviral therapy caused me to develop neuropathy (the meds can destroy the sheathing of the nerves over time essentially causing the nerves to "short circuit" slowly making you loose control eventually as well) in the feet and slightly in the hands so I do not have much feeling in the feet and have no ability to sense hot or cold or pressure there either. Another side effect of the meds was extreme insulin resistance along with apparent damage to the beta cells of the pancreas causing insulin dependence leading obviously to Frank (severe full blown insulin dependent) diabetes. There is no doubt in any of my doctors' minds that the HIV drugs caused this and they are seeing more and more of it. There are other negative side effects that I have dealt with and am currently dealing with from the medications.
This is not to be taken as a condemnation of the HIV meds. Clearly I would have been dead in 1996 if I had not put myself on a double combo followed by a triple combo about nine months later when the double was starting to fail. So I consider that every year that I have lived since 1996 is "bonus time for me" and I am happy for that. Fortunately, I have always worked out since I was a teenager and competed in sports and carried a LOT of extra lean body mass which is probably what carried me through some dark days.
Anyway, this is probably more information than you wanted but gives you some idea of where I am coming from.
R
Richard85
Guest
NorCalBdyBldr said:
so how did you get it?
R
Richard85
Guest
If you dont wanna say I understand dude
MrBigorexia
New member
Richard85 said:
I think you miss the point of this thread completely by asking such an irrelevant question.
Alanchiras
I hope things are alright for you. I would be interested to see some follow up on your story over the last year and how things have progressed; how your therapy has changed; how your mood is?
Norcalbdybldr
You words are like a breath of fresh air.... I have a friend recently diagnosed hiv+ and the quantity of literature to attempt to distill and injest is simply overwhelming. I appreciate your opinions, and especially your experience, in dealing with HIV, and I admire your productive and pragmatic attitude to the condition. You are also, thankfully, easy to read
What is your current condition if I may ask? Are you still undetectable? Have you been mixing up your drug regime throughout this period at all or are you keen to stick with what is working? With regards my friend, do you believe (though I know this was not an option for you) in aggressive, early commencement of treatment, or do you believe side-effects to outweigh potential benefits from this approach? There seems to be so much contradictory information on this subject.
BTW to be at a ripped 250lbs given what you have been through in the last decade is more than impressive and an incredible achievement. I do hope my friend can be as successful, though he has been shown to be a very poor gainer of LBM in the past - even with AAS.
NorCalBdyBldr
New member
MrBigorexia
Thanks for your kind words. I also agree with your feeling about how I contracted hiv twenty years ago to be a largely irrelevant question at this point in time and for this discussion. People that know me know that I am not ashamed at all in telling how I contracted hiv but I figure, at this juncture, what is the point of obsessing over it. We all know how a person can get it and should know what to do so those that don't have it can remain that way.
I am very sorry to hear about your friend. I have no illusions about life with hiv and would not wish this on anyone. His/her life will be enormously more complicated now and knew considerations will happen that were not so worrisome before like getting and maintaining medical insurance and also getting the best possible medical insurance that is available. This means going to the higher priced PPO plans and avoiding HMO's like the plague. The American Medical Association did a survey of care provided by hiv practitioners across the nation and found that fully twenty five percent of hiv practitioners did not even meet the most basic of American Medical Association requirements for care and treatment of people with hiv. Most of the clinics and doctors that were in that category were either HMO's or doctors with less than 100 hiv positive patients so they didn't have the depth of experience needed to adequately treat people with this disease.
There is a huge amount of information out there on hiv and it will take your friend a while to try to digest it. I have mixed feelings about starting therapy vs waiting. On the one hand, it you start therapy immediately, you will preserve more of your normal immune system/function than by waiting until you are starting to fall off the cliff, so to speak, and then starting therapy. Experience has shown that there are parts of the immune system that apparently do not regenerate after being damaged too far or completely wiped out. Additionally, people that start the hiv medications with a relatively intact immune system tend to fare better in terms of getting the virus to undetectable levels and also have significantly less side effects than people that suffered a long time before starting therapy. For example, I now take 17 prescription medications--a triple combo for hiv and the rest basically counteract the side effects like high blood pressure, depression, ADD, sucky lipid profiles, diabetes (yes they are finding that the medications are clearly linked to triggering the onset of diabetes but the medical profession has absolutely no idea why and it is occurring with many more of the hiv drugs than just protease inhibitors as originally thought), excessive stomach acid and acid reflux, etc. My partner, however, started hiv medications immediately after contracting hiv about seven years ago. My partner is on only four medications and has no side effects, three of them are to treat hiv and one is for lipid control. Lipids are driven all out of whack by most of the hiv medications.
On the other hand, hiv drugs can and do cause many side effects that can also become life threatening in and of themselves. So some feel it is better to wait until you absolutely need to use them to stay alive. If your friend chooses this route, than make sure that he/she doesn't wait too long. I suppose that I still favor immediate treatment for the reasons that I stated above. I, of course, never had that option and things were quite far progressed by the time double and then triple combos came along. I have no issue with using medications when it is appropriate.
In answer to your question, my viral load is still undectable and my T-cells vary but are generally around 600-700, normal being somewhere around 1100 on average but CAN dip for very short periods of time as low as 500 and still be considered "normal." If they stay at that level for very long, then it clearly indicates that the immune system is suppressed and most of the time "normal" is certainly somewhere around 1000-1200.
I have been consistently undectable for around seven to eight years now.
My general attitude about using the drugs is to find something you can tolerate and works to reduce the viral load to undectable and stick with it as long as you can. Eventually, side effects and other health conditions may and likely will develop which necessitates the changing of your drugs. I have never dropped an hiv drug because it failed since I have been on triple combo therapy. I have had to make several changes over the last eight years due to side effects. For example, I used zerit (d4t) for eight years with no apparent problems. Then, this year neuropathy started to develop in my feet and I noticed that I am starting to drop things a LOT. I have never been clumsy before and dropping things for no apparent reason other than they just "fall out of my hands" is something entirely new for me. Apparently I have early stage neuropathy in my hands now as well. Your sense of pressure is one of the first things to go so apparently, I do not get adequate feed back for light or small objects to tell me how hard to grip since I don't register it now. Heavier objects are not a problem because I can feel significant pressure as opposed to not feeling light pressure in my hands. I used the Zerit because it is one of the most durable nucleoside analog drugs and it worked well. I had to go off it, however, as it is a really bad offender for neuropathy. Just in case you didn't know, neuropathy is the result of the destruction of the nerve cells and nerve sheathing around the nerves. When the sheathing is removed it is kind of like stripping the insulation off of wires with the result that they short out. The shorting out of nerves, for example in my feet, gives a permanent numb and unpleasant tingling "electric" feel that never goes away. It also feels like there is something between my feet and the floor when I walk even when I am not wearing shoes. A friend of mine who suffers the same problem noted that it feels kind of like walking on bubble wrap and I totally agree with this description. Since the EMG tests indicated that only a few of the nerves in my feet are firing and none are firing all that well, I have to be careful not to injure my feet as I can slice them wide open now and probably not notice. I no longer can feel heat or cold in my feet and I also don't feel pressure. Unfortunately, the damage to the nerves is apparently irreverseable so you just learn to accept it and live with it as a part of life. So this is an example of one of the kinds of toxicity the hiv drugs can have. Interestingly, hiv disease can and will invade the nervous system and the brain so it can also cause neuropathy even in the absense of any hiv drugs. Additionally, it can cause all kinds of havoc with lipids and quite a number of things before the onset of full blown AIDS. In fact, one of the very first casualties is the gastro intestinal tract--almost from the outset it starts to suffer and decline.
As for your friend being a hard gainer, there are a number of ways to approach that issue too. He/she will find, though that it becomes even harder to gain with hiv disease whether you are on meds with an undectable viral load or not. This has to do with issues surrounding the gastrointestinal tract and metabolic issues particular to HIV. Your friend, if your friend is a guy, should get testosterone levels checked as well. Eventually, testosterone production will fall off because the virus invades and damages the Leydig Cells in the testes and can also invade and damage the pituitary gland itself. A number of hiv medications have also been indicated for reducing testosterone levels to below normal. Also, I don't know if your friend uses recreational drugs or not. If he/she uses crystal or ecstasy, he/she needs to loose the habit ASAP because as hiv progresses, you eventually loose the ability to burn fat as well as loose the ability to absorb much fat through the intestines. This means that when the person uses crytal meth, etc. it will burn only lean tissue off, resulting in excelarated wasting. It will largely tend to leave all of the fat behind because of the metabolic problems in buring fat caused by hiv disease. Of course there is always the exception to the rule but for the most part, this is true from what I have seen. And true addicts will be the first to deny it.
Mostly, I am able to be the size I am because I have lifted most of my life so I always had a really good base and never carried much fat anyway. That is good because I don't seem to be able to burn fat anymore, not that I really have that much to speak of and I don't seem to get fat from eating anything I feel like. But if I eat too much fat, I get a really bad case of the sh*ts...LOL So that keeps me away from downing the Haagen Daaz--gee and just when you thought you'd get some perk out of all of this.......LOL
Anyway, your friend needs to concentrate on gaining lean mass with a vengence as it is your best insurance policy for the times when you get really knocked down. It clearly provides some buffer as the immune system consumes a huge amount of protein when you are sick and your muscles are the first place it takes it from. Remember also, that with hiv, you are permanently sick as far as the body is concerned so you already have wasting going on from the start. Even with undectable viral loads, your body is trying to clear the infection. Just because it does not show up in your blood doesn't mean that you don't have active infection going on in places that are hard if not impossible for most of the medications to get to, like the cerebral fluid around the brain and spinal fluids. So you have to fight this tendency with a continuously declining GI tract and all the other "fun stuff" that comes with it. So it is not easy and "clean living" to the greatest degree possible will help. So drop the cigarettes and cigars, drop the alcohol and drop the recreational drugs. Your liver will have enough to deal with processing all the hiv and related medications on a permanent basis.
So I hope that helps. Good luck to your friend.
PS Your friend should continue to use the AAS, particularly the injectable ones that are not liver toxic as a countermeasure to offset the wasting problems with hiv.
Thanks for your kind words. I also agree with your feeling about how I contracted hiv twenty years ago to be a largely irrelevant question at this point in time and for this discussion. People that know me know that I am not ashamed at all in telling how I contracted hiv but I figure, at this juncture, what is the point of obsessing over it. We all know how a person can get it and should know what to do so those that don't have it can remain that way.
I am very sorry to hear about your friend. I have no illusions about life with hiv and would not wish this on anyone. His/her life will be enormously more complicated now and knew considerations will happen that were not so worrisome before like getting and maintaining medical insurance and also getting the best possible medical insurance that is available. This means going to the higher priced PPO plans and avoiding HMO's like the plague. The American Medical Association did a survey of care provided by hiv practitioners across the nation and found that fully twenty five percent of hiv practitioners did not even meet the most basic of American Medical Association requirements for care and treatment of people with hiv. Most of the clinics and doctors that were in that category were either HMO's or doctors with less than 100 hiv positive patients so they didn't have the depth of experience needed to adequately treat people with this disease.
There is a huge amount of information out there on hiv and it will take your friend a while to try to digest it. I have mixed feelings about starting therapy vs waiting. On the one hand, it you start therapy immediately, you will preserve more of your normal immune system/function than by waiting until you are starting to fall off the cliff, so to speak, and then starting therapy. Experience has shown that there are parts of the immune system that apparently do not regenerate after being damaged too far or completely wiped out. Additionally, people that start the hiv medications with a relatively intact immune system tend to fare better in terms of getting the virus to undetectable levels and also have significantly less side effects than people that suffered a long time before starting therapy. For example, I now take 17 prescription medications--a triple combo for hiv and the rest basically counteract the side effects like high blood pressure, depression, ADD, sucky lipid profiles, diabetes (yes they are finding that the medications are clearly linked to triggering the onset of diabetes but the medical profession has absolutely no idea why and it is occurring with many more of the hiv drugs than just protease inhibitors as originally thought), excessive stomach acid and acid reflux, etc. My partner, however, started hiv medications immediately after contracting hiv about seven years ago. My partner is on only four medications and has no side effects, three of them are to treat hiv and one is for lipid control. Lipids are driven all out of whack by most of the hiv medications.
On the other hand, hiv drugs can and do cause many side effects that can also become life threatening in and of themselves. So some feel it is better to wait until you absolutely need to use them to stay alive. If your friend chooses this route, than make sure that he/she doesn't wait too long. I suppose that I still favor immediate treatment for the reasons that I stated above. I, of course, never had that option and things were quite far progressed by the time double and then triple combos came along. I have no issue with using medications when it is appropriate.
In answer to your question, my viral load is still undectable and my T-cells vary but are generally around 600-700, normal being somewhere around 1100 on average but CAN dip for very short periods of time as low as 500 and still be considered "normal." If they stay at that level for very long, then it clearly indicates that the immune system is suppressed and most of the time "normal" is certainly somewhere around 1000-1200.
I have been consistently undectable for around seven to eight years now.
My general attitude about using the drugs is to find something you can tolerate and works to reduce the viral load to undectable and stick with it as long as you can. Eventually, side effects and other health conditions may and likely will develop which necessitates the changing of your drugs. I have never dropped an hiv drug because it failed since I have been on triple combo therapy. I have had to make several changes over the last eight years due to side effects. For example, I used zerit (d4t) for eight years with no apparent problems. Then, this year neuropathy started to develop in my feet and I noticed that I am starting to drop things a LOT. I have never been clumsy before and dropping things for no apparent reason other than they just "fall out of my hands" is something entirely new for me. Apparently I have early stage neuropathy in my hands now as well. Your sense of pressure is one of the first things to go so apparently, I do not get adequate feed back for light or small objects to tell me how hard to grip since I don't register it now. Heavier objects are not a problem because I can feel significant pressure as opposed to not feeling light pressure in my hands. I used the Zerit because it is one of the most durable nucleoside analog drugs and it worked well. I had to go off it, however, as it is a really bad offender for neuropathy. Just in case you didn't know, neuropathy is the result of the destruction of the nerve cells and nerve sheathing around the nerves. When the sheathing is removed it is kind of like stripping the insulation off of wires with the result that they short out. The shorting out of nerves, for example in my feet, gives a permanent numb and unpleasant tingling "electric" feel that never goes away. It also feels like there is something between my feet and the floor when I walk even when I am not wearing shoes. A friend of mine who suffers the same problem noted that it feels kind of like walking on bubble wrap and I totally agree with this description. Since the EMG tests indicated that only a few of the nerves in my feet are firing and none are firing all that well, I have to be careful not to injure my feet as I can slice them wide open now and probably not notice. I no longer can feel heat or cold in my feet and I also don't feel pressure. Unfortunately, the damage to the nerves is apparently irreverseable so you just learn to accept it and live with it as a part of life. So this is an example of one of the kinds of toxicity the hiv drugs can have. Interestingly, hiv disease can and will invade the nervous system and the brain so it can also cause neuropathy even in the absense of any hiv drugs. Additionally, it can cause all kinds of havoc with lipids and quite a number of things before the onset of full blown AIDS. In fact, one of the very first casualties is the gastro intestinal tract--almost from the outset it starts to suffer and decline.
As for your friend being a hard gainer, there are a number of ways to approach that issue too. He/she will find, though that it becomes even harder to gain with hiv disease whether you are on meds with an undectable viral load or not. This has to do with issues surrounding the gastrointestinal tract and metabolic issues particular to HIV. Your friend, if your friend is a guy, should get testosterone levels checked as well. Eventually, testosterone production will fall off because the virus invades and damages the Leydig Cells in the testes and can also invade and damage the pituitary gland itself. A number of hiv medications have also been indicated for reducing testosterone levels to below normal. Also, I don't know if your friend uses recreational drugs or not. If he/she uses crystal or ecstasy, he/she needs to loose the habit ASAP because as hiv progresses, you eventually loose the ability to burn fat as well as loose the ability to absorb much fat through the intestines. This means that when the person uses crytal meth, etc. it will burn only lean tissue off, resulting in excelarated wasting. It will largely tend to leave all of the fat behind because of the metabolic problems in buring fat caused by hiv disease. Of course there is always the exception to the rule but for the most part, this is true from what I have seen. And true addicts will be the first to deny it.
Mostly, I am able to be the size I am because I have lifted most of my life so I always had a really good base and never carried much fat anyway. That is good because I don't seem to be able to burn fat anymore, not that I really have that much to speak of and I don't seem to get fat from eating anything I feel like. But if I eat too much fat, I get a really bad case of the sh*ts...LOL So that keeps me away from downing the Haagen Daaz--gee and just when you thought you'd get some perk out of all of this.......LOL
Anyway, your friend needs to concentrate on gaining lean mass with a vengence as it is your best insurance policy for the times when you get really knocked down. It clearly provides some buffer as the immune system consumes a huge amount of protein when you are sick and your muscles are the first place it takes it from. Remember also, that with hiv, you are permanently sick as far as the body is concerned so you already have wasting going on from the start. Even with undectable viral loads, your body is trying to clear the infection. Just because it does not show up in your blood doesn't mean that you don't have active infection going on in places that are hard if not impossible for most of the medications to get to, like the cerebral fluid around the brain and spinal fluids. So you have to fight this tendency with a continuously declining GI tract and all the other "fun stuff" that comes with it. So it is not easy and "clean living" to the greatest degree possible will help. So drop the cigarettes and cigars, drop the alcohol and drop the recreational drugs. Your liver will have enough to deal with processing all the hiv and related medications on a permanent basis.
So I hope that helps. Good luck to your friend.
PS Your friend should continue to use the AAS, particularly the injectable ones that are not liver toxic as a countermeasure to offset the wasting problems with hiv.
