Talk Cancer

Question:

I am at a loss to what the problem could be… If this is an HIV/AIDS-related question, it is probably the anti-retrovirals you’re taking.  Your doctor SHOULD know that already! If it isn’t HIV-AIDS-related, you might be better off asking in sci.med, or sci.med.cardiology. Could be nothing except genetics.

I thought I had heard that a side-effect of the various AIDS drugs was EXTREMELY high cholesterol, and I would assume high triglycerides as well.  One report I read said they took blood from such an AIDS patient and it came out milky white as it had so much cholesterol in it.  This does not happen to everyone though.  My brother has been on the drugs 8 years and AFAIK his cholesterol is relatively normal.  I don’t have AIDS but my cholesterol and triglycerides are very high (from both diet and genetics).

Response:

Thanks, Mr. Mailman.  My head wasn’t in the right place, I thought aids=medicinal aids, not AIDS=AutoImmunoDeficincy Syndrome.  Didn’t know where else to post.  Sorry.

Eh, not a biggie. As George says, try carnitine or high-dose niacin.  But do consult with a health professional before embarking on that. Speaking of which, George is also right about getting diagnoses from strangers on the ‘Net.  You might want to consider a second opinion or a referral to a cardiologist as well as nutritionist/dietician. B/

Response:

I received my results from my cholesterol panel: HDL is 22 LDL is unknown TRIGLYCERIDES 1,165 My doc said that the triglyceride levels are so high, that it obscured my LDL reading.  She has prescribed to me "Tricor." I am a non steroid using body builder and jogger/runner.  I run two miles every other day and weight lift six days a week.  I do not use supplements, except a store bought multivitamin.  I am 31 years old Hispanic male, weigh 235 lbs at 5′8", but my body fat is approximately 11-12%, which I had measured through hydrostatic weighing.  I have been exercising since I was 14 years old. There is a history of diabetes type 1 on my maternal side and a history of thyroid cancer on my fathers side. I am at a loss to what the problem could be and my doctor just wants me to take the prescription medicine but doesn’t have an answer to what is causing this.  Is there anyone out there with a suggestion on possible causes, any specialists I should see or any other tests I should take?

Response:

Thanks, Mr. Mailman.  My head wasn’t in the right place, I thought aids=medicinal aids, not AIDS=AutoImmunoDeficincy Syndrome.  Didn’t know where else to post.  Sorry.

It’s OK. People make that error all the time…. One thing you might try is getting a prescription for Carnitor, which is the amino acid, carnitine. It may help bring down the TGs. Of course, it is essential to have a more complete profile that may help get at why the TGs were so high!! HIV or no, you cannot get that kind of insight from the internet–only a good physician can.                 George M. Carter ]*** CATIE News 31 July 2001 <boldCarnitine for high triglycerides</bold Carnitine is an amino acid that is used to help move fatty substances to places inside cells where they can be burnt to release energy. The parts of a cell where this energy release takes place are called mitochondria. Carnitine can also act as an antioxidant and appears to play a role in maintaining the health of nerves and protecting the liver and kidneys from the toxicity of drugs. Carnitine exists in several forms; the two most commonly used are L-carnitine and L-acetyl-carnitine. A number of studies have found that people with HIV/AIDS (PHAs) may have less-than-normal levels of carnitine. Signs/symptoms of carnitine deficiency include the following:         higher-than-normal levels of triglycerides         weak and/or tired muscles As some PHAs can develop high triglyceride (TG) levels in their blood – whether or not they are taking anti-HIV drugs – research teams in Montreal and Rome have found that supplements of this nutrient may be helpful for PHAs. The Montreal team recently conducted a small study to observe the effect of carnitine supplements on high TG levels in people with HIV. Study details Researchers enrolled 16 adult subjects who had the following profile at the start of the study:         1 female, 15 male         average age – 43 years         all but one were using protease inhibitors         average viral load – 2,500 copies         average CD4+ count – 218 cells         average TG level – 5.67 mmol/Litre (normal range 0.5 to 2)         average cholesterol – 5.6 mmol/Litre (normal range 2 to 5.2)         average glucose – 5.3 mmol/Litre (normal range 3.6 to 6.1) Subjects received 3 grams of L-carnitine daily for an average of nine months. Results One month after entering the study TG levels had decreased by an average of 39% – a significant decrease from their pre- study levels. This decrease was maintained throughout the study. According to the researchers, "near-normal TG levels (3 mmol/Litre or lower)" were seen in 54% of subjects after two months of L-carnitine use, and in 69% of subjects after their last lab test. There were no significant changes in cholesterol or glucose levels during the study. No serious side effects from L-carnitine were reported and, at a dose of 3 grams/day, L-carnitine appears to be relatively safe. The results of this pilot study will be used to plan a larger more complex trial. Carnitine is sold in North America as the prescription drug Carnitor. L-carnitine and L-acetyl-carnitine are also available from some health food stores, particularly in the United States.<smaller REFERENCES 1. Loignon M and Toma E. L-carnitine for the treatment of highly active antiretroviral therapy-related hypertriglyceridemia in HIV-infected adults. AIDS 2001;15(9):1194-1195 2. Famularo G and De Simone C. Carnitine stands on its own in HIV infection treatment. Archives of Internal Medicine 1999;159:1143-1144. 3. Famularo G. Alternative strategies other than growth hormone for the treatment of immune diseases. Trends in Immunology 2001;22(1):14-15. 4. Bohan TP, Helton E, McDonald I, et al. Effect of L-carnitine treatment for valproate-induced hepatotoxicity. Neurology 2001;56:1405-1409. 5. Myers CD. Carnitine – updated. 1998 available at: http://www.catie.ca/myers.nsf. Last accessed on 27 July, 2001. *** Clin Ther. 2003 May;25(5):1429-39.  Related Articles, Links   The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Derosa G, Cicero AF, Gaddi A, Mugellini A, Ciccarelli L, Fogari R. Department of Internal Medicine and Therapeutics, University of Pavia, BACKGROUND: A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a) (Lp[a]) levels in patients with hypercholesterolemia. OBJECTIVE: To test a tolerable Lp(a)-reducing agent in diabetic patients, we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels, particularly Lp(a), of patients with type 2 diabetes mellitus (DM) and hypercholesterolemia. METHODS: In this 6-month, randomized, double-masked, placebo-controlled clinical trial, patients were enrolled, assessed, and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia, Pavia, Italy. All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study, as well as hypercholesterolemia. Patients were randomized to 1 of 2 groups. One group received L-carnitine, one 1-g tablet BID. The other group received a corresponding placebo. We assessed body mass index, fasting plasma glucose, postprandial plasma glucose, glycosylated hemoglobin, fasting plasma insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein (apo) A-I, apo B, and Lp(a) at baseline and at 1, 3, and 6 months of treatment. RESULTS: This study included 94 patients. The treatment group included 24 men and 22 women (mean [SD] age, 52 [6] years). The placebo group included 23 men and 25 women (mean [SD] age, 50 [7] years). The baseline characteristics of the groups did not differ significantly. The mean (SD) body weight, height, and body mass index were 78.2 (5.8) kg, 1.70 (0.04) m, and 27.3 (2.5) kg/m(2), respectively, in the L-carnitine group and 77.6 (6.4) kg, 1.71 (0.05) m, and 26.8 (2.2) kg/m(2), respectively, in the placebo group. In the treatment group, Lp(a) was significantly reduced at 3 and 6 months compared with baseline (P < 0.05) and P < 0.01, respectively). We observed a significant improvement after 6 months (P < 0.05) in the Lp(a) value in patients taking L-carnitine compared with those taking placebo. Between-group differences in other variables did not reach a level of significance at months 3 and 6. No drug-related adverse events were reported or observed. CONCLUSION: In this preliminary study, after 3 and 6 months, L-carnitine significantly lowered the plasma Lp(a) level compared with placebo in selected hypercholesterolemic patients with newly diagnosed type 2 DM.

Response:

I am at a loss to what the problem could be…

If this is an HIV/AIDS-related question, it is probably the anti-retrovirals you’re taking.  Your doctor SHOULD know that already! If it isn’t HIV-AIDS-related, you might be better off asking in sci.med, or sci.med.cardiology. Could be nothing except genetics. B/

Response:

Thanks, Mr. Mailman.  My head wasn’t in the right place, I thought aids=medicinal aids, not AIDS=AutoImmunoDeficincy Syndrome.  Didn’t know where else to post.  Sorry.

Response: