Supplements to Avoid With HIV (and Some That May Help)

Not all vitamins and supplements bring health benefits, especially when you’re living with HIV. Here are more than 10 supplements that should give you pause – and four that may help. But before you add any supplement to your daily regimen, no matter what the possible benefits, ask your doctor.

Antiretrovirals (ART) are the cornerstone of HIV treatment and your path to undetectable status. St. John’s wort, often used as a natural antidepressant, can make these medications less effective, and your viral load may creep up. In fact, it doesn’t mix well with a long list of prescription drugs. If you have symptoms of depression, talk to your doctor about safer alternatives. 

Garlic may seem harmless, but high doses found in garlic capsules and pills can reduce the effects of two classes of ART: protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). It’s fine to enjoy garlicky food, but steer clear of highly concentrated doses.

These minerals can prevent your body from absorbing a type of ART called integrase inhibitors and make them less effective. Calcium, magnesium, and iron come as supplements. Aluminum, calcium, and magnesium can be found in certain antacids, which might interact with ART in your gut. Doctors may recommend you take an antacid, if you need it, several hours apart from your ART.

When taken in high doses or with certain HIV medications, vitamin A may cause liver damage. It’s best to get vitamin A from foods such as orange and yellow fruits and vegetables, leafy greens, eggs, shrimp, and salmon. Supplements run the risk of giving you too much.

A study published in the International Journal of STD & AIDS found that vitamin C, zinc, multivitamins, ginkgo, and milk thistle may lower levels of ART meds in your bloodstream, making them less effective at controlling your viral load. 

When you have HIV,  you may also have a vitamin D deficiency. That can have negative effects on your bone health, thinking skills, mood, heart health, blood pressure, and metabolic health. If blood tests show you’re low in vitamin D, supplements may bring your levels back up and possibly reverse some of the damage to your immune system. But taking supplements you don’t need won’t help and could cause harm. Ask your doctor first. 

Found in the spice turmeric, curcumin has antiretroviral effects. Some evidence suggests it may behave in your body like ART medication and boost effects of conventional prescription ART while easing side effects like diarrhea.

If you’re pregnant and living with HIV, you’re at higher risk for preterm delivery. Research suggests folate and selenium may help lower your risk of giving birth too soon. Talk to your doctor first before taking any supplements.

Once your doctor clears you to try a supplement, shop smart. Unlike prescription drugs, dietary supplements aren’t FDA-approved for safety and effectiveness. Look for third-party seals of approval from the NSF or USP. When possible, choose products from major manufacturers. Be wary of megadoses, proprietary blends, and products that promise to “boost” your immune system or cure a disease.