HIV: What to Know About Taking Vitamins and Supplements

Medically Reviewed by Jonathan E. Kaplan, MD on May 16, 2023
4 min read

Your body needs vitamins and other essential nutrients in order to work properly. Eating a variety of foods can help you get the nutrients you need. This also has the added benefit of adding fiber and antioxidants to your diet.

There’s evidence that some supplements may be beneficial for people with HIV. But some may be especially risky if you have the disease. And too much of almost anything can be dangerous.

Here’s what you need to know.

While safe, multivitamins don’t have the same benefits among people taking antiretroviral therapy (ART) or other similar drugs.

Still, some studies show that Multivitamin supplementation appears to be a simple, effective, safe, and scalable program to improve survival, reduce the incidence of TB, and improve treatment outcomes for adult HIV patients.

Some people call vitamin D “the sunshine vitamin.” That’s because your body can make it using sunlight absorbed into your skin.

Some foods naturally contain vitamin D. Those include fatty fish like salmon as well as eggs and some dairy products. Some foods also include added vitamin D. Examples are milk, alternative milks, orange juice, and breakfast cereals.

If you eat a lot of these foods, or if you spend time outdoors in the sun, you may get all the vitamin D your body needs.

But many people with HIV have low vitamin D levels. Because of this, it is standard practice to measure vitamin D levels by a blood test. 

There’s also some evidence that ART therapy may suppress the body's ability to produce vitamin D. This is a problem because vitamin D is important for bone health, and it also supports the immune system.

Some research has found that adults and kids who take vitamin D supplements improve their body’s levels of the vitamin. But whether this provides health benefits for people with HIV is not clear.

Vitamin D supplements may turn out to be helpful for people with HIV. It is standard practice to offer vitamin D supplementation to HIV-infected persons who have low vitamin D levels. 

Because of the potential impact on bone health, a study to measure bone density (called a DEXA scan) is frequently ordered for patients with vitamin D deficiency.

DHEA helps support healthy hormone levels in the body. There’s some evidence it can boost mood, energy levels, and quality of life among people with HIV.

But some research shows there’s no reason for people with HIV to take it. And taking too much DHEA may also raise hormones to unhealthy levels.

Other vitamins and nutrients also play a role in immune health. Some also help repair damaged cells. Supplements that contain these nutrients may be helpful for those who have HIV.

These include:

But again, the benefits are uncertain. It’s also not clear how much someone with HIV needs to take in order to see these benefits. In some cases, these vitamins or supplements may interfere with medications for HIV.

Be sure you talk to your doctor before you start on any supplement.

Certain supplements may be risky for people with HIV. Some of these supplements can interfere with HIV medications. Research has linked others to risks that have nothing to do with HIV.

Be sure to talk with your doctor before taking a supplement that contains vitamin A or iron. Vitamin A can be toxic in high doses. Iron may increase the activity of certain types of bacteria in your body. Both can be problematic for people with HIV.

There are also countless supplement products that claim to strengthen or boost the immune system. Many contain complex combinations of ingredients that could be risky.

While it’s possible that some of these could help people with HIV, the evidence is shaky even when it comes to very well-researched and common vitamins.

Some supplements (like St John's wort) specifically interfere with some HIV medications. If you have HIV, let your health providers know about the supplements you are taking.

Some vitamin or nutrient supplements may be helpful. But medical professionals usually recommend people try to get all the vitamins and nutrients they need from food.

Try to eat a range of foods, especially a variety of colored vegetables. If you decide to also take a supplement, be sure to discuss it with your doctor first.

Show Sources

SOURCES:

National Institute on Aging: “Vitamins and Minerals for Older Adults.”

U.S. Department of Veterans Affairs: “Do I Need Supplements?” “Vitamins and minerals that affect the immune system.”

New England Journal of Medicine: “A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality.”

Nature: “Multivitamins slow HIV.”

BMC Infectious Disease: “The effect of standard dose multivitamin supplementation on disease progression in HIV-infected adults initiating HAART: a randomized double blind placebo-controlled trial in Uganda.”

National Institutes of Health: “Vitamin D.”

Current HIV/AIDS Reports: “Continued Interest and Controversy: Vitamin D in HIV,” “Vitamin D in HIV-Infected Patients.”

AIDS Research and Human Retroviruses: “Dehydroepiandrosterone (DHEA) Effects on HIV Replication and Host Immunity: A Randomized Placebo-Controlled Study.”

American Journal of Psychiatry: “Placebo-Controlled Trial of Dehydroepiandrosterone (DHEA) for Treatment of Nonmajor Depression in Patients With HIV/AIDS.”

CATIE: “A Practical Guide to a Healthy Body for People Living with HIV.”

Antimicrobial Agents and Chemotherapy: “Effect of Ginkgo Biloba on the Pharmacokinetics of Raltegravir in Healthy Volunteers,” “Effect of Milk Thistle on the Pharmacokinetics of Darunavir-Ritonavir in HIV-Infected Patients.”

Annals of Pharmacotherapy: “Effect of Valerian in Preventing Neuropsychiatric Adverse Effects of Efavirenz in HIV-Positive Patients: A Pilot Randomized, Placebo-Controlled Clinical Trial.”

Cochrane Library: “Micronutrient supplementation in adults with HIV infection.”

AIDS Treatment News: “St. John's wort warning: do not combine with protease inhibitors, NNRTIs.”

National Library of Medicine: "Effectiveness of a multivitamin supplementation program among HIV-infected adults in Tanzania"

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