Weight loss commonly occurs with AIDS, and appetite stimulants and anabolic agents have been utilized in an attempt to reverse this catabolic state. Nutritional interventions, which enhance caloric intake are generally associated with fat and water gain, not enhancement of lean tissue. We evaluated the effect of administering the amino acid l-glutamine to 10 subjects (9 males, 1 female) with non-IV drug related HIV infections. All subjects had weight loss (body weight 90% of ideal) and two had diarrhea (pasty or liquid stool 4 times per day). All received 30-40 grams of l-glutamine per day in divided doses (Cambridge Nutraceuticals, Boston, MA) for at least 12 weeks in this phase 1 open-label trial. Following baseline studies, the patients were evaluated monthly; bodyweight, and bioelectrical impedance assessment were performed (RJL Systems, Clinton, MI). Routine chemistries and hematology obtained during this time were reviewed. The average values for the group are shown in the table below.

No adverse effects were noted. Both subjects with diarrhea had complete resolution of this symptom during the study. Six of the patients continued an additional 6 months of L-glutamine supplementation and gained an additional 0.8 kg over this time period.

L-glutamine, a conditionally essential amino acid, can replete body protein in depleted AIDS patients. The increase in intracellular water which occurs signals protein anabolism as reflected by the increase in body cell mass. Randomized blinded trials are now indicated to confirm these findings, which demonstrate that gain in functioning protein-containing tissue can be achieved by providing this low cost amino acid supplement to AIDS patients.

Comment: Several non-HIV studies have shown that glutamine is both anabolic and anti-catabolic in effect (Hickson, 1995). This is one that looked at HIV-positive subjects with weight loss and showed not only that glutamine helped turn around weight loss, but in the two subjects that had diarrhea, the diarrhea stopped. Glutamine is very effective in stopping diarrhea. Note that the doses are up to 40 grams per day, This is best taken in 3 to 5 doses spread throughout the day. HIV(+) people who are not losing weight and are healthy with no diarrhea are typically taking a maintenence dose of approximately 8 to 12 grams per day spread out in 2 to 3 doses. One heaping tablespoon is 12 grams, one heaping teaspoon is 4 grams. Note: buy glutamine in bulk powder, rather than in capsules; powder is much more cost effective.

For more glutamine information visit the Cambridge Nutraceuticals web site.