Q and A


Can I use herbs or supplements with Atroiza?

Can I use herbal formula with Atroiza. Its ingredients are eletherococcus senticocus, ginkgo biloba, sarsaparilla, guajava, mellisa officinalis, alchemilla vulgaris, discorea villosa tincture blend: Preservative: citric acid, methyl paraben?



i-Base are always cautious to say any herbal formulas are safe. This is because there are so few studies that look at drug interactions and because the contents of herbal formulas vary so much.

The efavirenz in Atroiza has the potential to interact with many drugs, herbs and supplements. This includes ginkgo biloba in your list, which might make your HIV meds less effective. See below for a detailed explanation.

Instead, we emphasise the consistent evidence from research that HIV medicines are so good that supplements are unlikely to make any difference – other than costing you money.

HIV meds (antiretrovirals) are the only proven way to reduce viral load and increase your CD4 count. There is no evidence showing that herbs or supplements have any impact.

Liver enzymes – inducing and inhibiting

An enzyme is a type of chemical that increases a process. For example, liver enzymes are one of the ways that chemicals in drugs and supplements can be cleared from your body.

There are lots of specific liver enzymes, categorised by letter and numbers. One of the main enzymes is called CYP3A4 (used by 90% of drugs), another is CYP2B6. (CYP stand for “cytochrome P450”).

The levels of these enzymes is not constant though. Sometimes drugs (or herbs or supplements) increase or decrease the levels of different enzymes. This makes things very complication.

Efavirenz is processed by both 3A4 and 2B6 (and also UGT1A1). But it also induces (ie makes more) of these enzymes. So any other drug that uses these enzymes will be cleared more quickly from the body. This means drug levels might become too low to be active.

In a similar way, if other drugs or supplements increase 3A4 or 2B6, efavirenz will be process more quickly. If the other drugs slow down (inhibit) these enzymes, efavirenz levels will be much higher. Higher levels can cause more side effects and serious toxicity.

As examples, ritonavir and grapefruit juice inhibit both these enzymes, increasing efavirenz levels. Ginkgo biloba extracts and St. John’s wort both induce these enzymes – and reduce efavirenz levels, making your HIV medicine less effective.


  1. Josh Peasegood

    Hi Asana, you do not need to experience side effects for the drug to work. In most cases people will not experience side effects.

    The best way to know that your medication is working is to have a viral load test in a few weeks. After a month of treatment most people will have a suppressed viral load. This will mean that your treatment is working.

  2. Asana

    I just started taking treatment but I’m not having any side effects so is the drug working?

  3. Roy Trevelion

    Hi Nokubonga,

    It’s great news that you started ARVs and now have a healthy HIV negative young boy. A CD4 count of 800 is strong. So it sounds like you’re doing all you can. Many congratulations.

    But it’s a good idea to talk to your doctor about your body pain symptoms. You can ask for a check up to see what’s causing them.

    If you live in South Africa you can contact the Treatment Action Campaign at this contact link. They might be able to help with local support.

    What ARVs are you taking? Please let us know.

  4. Nokubonga

    Hi I was tested positive on 2011 I started to use ARVs from 2011 and I was pregnant am lucky because my boy is health and negative the thing is now my CD4 court is more than 800 but I always fill body pains I don’t know what happened

  5. Roy Trevelion

    Hi Asanda,

    I’m sorry to hear about your recent diagnosis. Testing HIV positive can be a shock for all of us.

    But HIV treatment (called ART) is safe and effective. And once you’re taking successful ART it can protect your partner from HIV.

    Please talk to the clinic about your tests. You can discuss starting ART and talk about what HIV meds will be good for you to take. You can also talk about getting HIV to undetectable levels. This is the aim of successful ART. Please see Undetectable = Untransmittable (U=U) at this link.

    Here’s the Introduction to ART for lots of info.

    Telling a partner you’re HIV positive can be difficult. But please see this link to a similar question https://i-base.info/qa/11449

  6. Asanda

    Hi went to the clinic for my injection they sad i must tast HIV they test me my blood was positive know i am skirt to tell my partner we’ve been dating a year now the are day he goes to the clinic he tested HIV the results was negative


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