Q: What can I buy over the counter to slow disease progression and help eliminate drug side effects and other nasty symptoms?

A:Try this: your body’s optimal requirement of nutrients. Since virtually every known nutrient affects some aspect of immune function, it’s not surprising that studies show that people with HIV who have high levels of nutrients lead longer and healthier lives. Alas, studies also show that, from infection onward, most HIVers are consuming less than half of the daily recommended amount of one or more micronutrients (vitamins and minerals)—and that even those who scarf down the recommended levels still end up with deficiencies.

Part one of your purchase should be a high-quality diet with plenty of protein, whole grains, fruits and vegetables, as well as lots of water and other healthful liquids. But a University of California at Berkeley study found the slowest disease progression in people consuming a level of nutrients not obtainable through diet alone. So, more HIV docs are advising a little nutrient insurance—a high-potency daily multivitamin/mineral supplement. And many HIVers experiencing drug side effects or other symptoms report that certain supplements help spell relief. The following five should top your list:

Multi: A high-potency multiple, taken daily with a meal, provides a base of vitamins and minerals that can help make up for overall dietary deficiencies and maintain nutritional balance. The best have high levels of the antioxidants—vitamins C and E, selenium, carotenoids, alpha-lipoic acid (ALA), glutathione and N-acetyl-cysteine (NAC)—that can help counter HIV-related oxidative stress, a cause of cellular damage. Super Blend (sold by Super Nutrition, 800.262.2116) is the most comprehensive and potent.

B-12: Research has repeatedly found a B-12 deficiency in a large percentage of HIVers. A Johns Hopkins University study found that those who were B-12 deficient progressed to AIDS four years earlier than those who were not. Deficiencies can also cause memory loss, severe fatigue, neuropathy and low red-blood-cell counts. Replenishing B-12 can greatly improve energy and may help reverse memory loss and nerve problems. (Note: Research has found that standard blood tests do not accurately reflect tissue status of B-12 in HIVers.) Because of problems with oral absorption, a nasal gel (available by prescription as Nasocobal), used at least once weekly, is best.

Essential fatty acids (EFAs): Derived from fats, EFAs are converted into hormone-like chemicals called prostaglandins, which not only control many body functions, including immune responses and inflammation, but protect the heart and improve skin and nerve health. Deficiency is common in HIVers, partly because of maldigestion and malabsorption of fats. Supplementation of one or more capsules daily of flaxseed oil can improve dry, itchy skin and boost energy. GLA—an EFA found in the oil from the borage plant—in doses of 480 milligrams (mg) daily may help prevent or reverse neuropathy.

L-Carnitine: Italian researchers report that many PWAs lack this amino acid  and, as a result, may have wasting in the heart and other muscle tissue. Their studies showed that 6,000-mg daily doses improve immune function, increase energy, strengthen the heart muscle, help reverse muscle wasting and normalize levels of blood fats, including triglycerides. Recently, L-carnitine has been proposed as a therapy for the toxicity to mitochondria (energy factories in the cells) that may contribute to many drug side effects, including lipodystrophy. The prescription form, Carnitor, is best. Beware: More than four grams daily can cause nausea, cramps or diarrhea.

Glutamine: This amino acid is crucial for maintaining optimal glutathione levels, building muscle tissue, boosting immune function and maintaining the healthy intestinal tissue that can absorb both drugs and nutrients properly. Harvard University researchers report that deficiencies can contribute to wasting, intestinal malabsorption (which, in turn, could contribute to reduced drug levels), and susceptibility to lung, intestinal, cervical and oral infections. They recommend five to 15 grams per day, and up to 40 grams for those with intestinal damage or wasting, so powder is best. Try Immune System Booster (Cambridge Nutraceuticals, 800.265.2202) or Glutamine (Jarrow, 800.726.0886).