New Year, New You

Resolutions are hard to keep. None more so than losing weight and starting an excerise plan. Fitness regimens are often at the top of everyone's list, yet often are the first ones that we give up on, which has spawned more than a few funny Facebook memes showing an over packed gym on January 1st, and empty one on the 10th. Part of the reason people give up so quickly is because they try too much too fast or don't have a plan of action. That's why we offer you these tips to put together a reasonable workout routine, that may preclude you from ever having to make it a resolution again.

I’ve been lifting weights five or six days a week for the past year, but instead of building muscle I’m feeling tired and unmotivated. Is it possible to work out too much?
Yes. You are probably lifting weights too frequently and inadvertently hampering your muscle growth. It’s called “overtraining,” and it involves training too hard and too often without giving your body enough time to rest in between. The effects usually show up as fatigue and extreme muscle soreness. Sometimes, as in your case, the signs are even more serious: depression, low energy, insomnia, loss of appetite, and worst of all, loss of lean body mass. Cut back on your training and make sure you’re getting adequate rest in between workouts. A trainer can help you schedule what to do each day. Also, take a hard look at everything you’re eating—or not eating—to make sure you’re getting enough macronutrients (carbs, fat, and protein).

I’m worried about wasting and body-fat redistribution. I’ve heard that taking glutamine and creatine can help. Do these sports supplements have any potential interactions with antiretroviral therapy? 
Unfortunately, research is scant and inconclusive. Supplementing your diet with the amino acid L-glutamine has been shown to fight wasting and is used to counteract chemotherapy side effects like diarrhea, neuropathy, and muscle and joint pains. Creatine may also have a place at the table, especially for vegetarians, but your muscles can only retain a certain amount of creatine; taking more won’t raise levels higher.
While no adverse effects have been reported with glutamine or creatine use, other supplements such as Saint-John’s-wort have significant interactions with some HIV meds, and illustrate the complexity of adding even “natural” substances to an antiretroviral regimen. It’s best to communicate with your doctor about all the supplements you’re using. That way, he or she can take them into account if you develop any side effects or if your viral load response is off. You might also want to check out the Plus Treatment Guide, which includes information about potential drug interactions.

I’ve been feeling down since my doctor told me to drop exercises like lunges, squats, or deadlifts because of degenerating discs in my spine. How do I keep my body—especially, my butt—in shape?
While the primary touchstone for people with HIV is weight training, cardiovascular exercise is probably the best natural medicine for depression, and regular cardio results in feelings of self-mastery and accomplishment. Yoga is also an option for you, allowing you to connect with your body while quieting your mind. Many gyms offer classes that target the glutes. Consider joing a spin classes, or doing exercises with your own bodyweight, too.

It’s been months since I’ve been in the gym, and I’m finding it hard to go back. How can I break this cycle?
Stopping exercise enhances feelings of isolation, anxiety, and depression.When you’re under a lot of stress, remember exercise is a gift that you give yourself. The best thing you can do for your physical and mental health is to recommit to a more active lifestyle. The mood-enhancing benefits of exercise and its effects on the immune system are well documented and more durable than once thought, lasting up to 12 hours after the workout ends. Get outside. Change your environment. Take advantage of your surroundings.  Go for a brisk walk around the neighborhood, swim at a local pool, hike a new trail, take a self-defense class, join a team, or sign up for the AIDS Walk. Many AIDS Walks offer pre-walk trainings where groups get together and walk increasing amounts of distance each week, working up to the big day.

My trainer told me that doctors sometimes prescribe testosterone for people with HIV. Would that help me build muscle faster?
Yes, raising your testosterone levels can increase lean body mass, reduce fat, and increase energy. However, the long-term risks are largely unknown and, as the Harvard Men’s Health Watch, points out, you should be particularly cautious if you have cardiac or prostate issues. Also, once you start taking hormone supplements there’s a chance your body may stop producing testosterone naturally. Instead of rushing into it, talk with your doctor and get blood work to check on your natural levels. You can also enhance your testosterone levels by eating a balanced diet, taking a multivitamin, getting enough sleep, and avoiding excessive caffeine, alcohol, and nicotine. Ask your trainer to use more multiple joint exercises (e.g., lunge, bench press, deadlift, clean, squat, pull-up) as these can play a role in higher levels of post-workout testosterone. If your natural level of testosterone turns out to be below the normal reference range, there are a variety of choices including patches, gels, creams, injections—even implants. Unfortunately, not all insurance companies cover all options.

Do I need to be worried about picking up bacteria like methicillin-resistant staphylococcus aureus or other forms of staph at gyms?  
Yes. According to the Centers for Disease Control and Prevention, HIV-positive people may be at risk for more severe illnesses from MRSA than the general population. Treatments may be invasive, take days to administer, and are not always successful. As these infections become increasingly resistant to treatment they become harder to get rid of. To protect yourself, wash your hands frequently. Wash your whole body with soap and running water. Keep fingers out of your nose. Protect any areas of broken skin, since this is one common way for the bacteria to get inside you. Use a towel during your workout to create a barrier between your skin and anything it might touch, like the weight bench. After your workouts, wash your towels in hot water and dry them in a hot dryer. Before and after your workout, make use of hand-sanitizer dispensers, alcohol-based sprays, or wipes for equipment.

One of my friends raves about taking human growth hormone. Can you tell me more about it? Do I need a prescription?
Human growth hormone is just that: a hormone that stimulates growth and reproduction of human cells. It’s responsible for a variety of functions in the body, most notably the increase in height during adolescence. It’s a controlled substance available by doctor’s prescription and is sometimes prescribed for people with HIV who are suffering from wasting syndrome or lipodystrophy (the redistribution of fat). In clinical trials, men receiving a low dose of human growth hormone gained lean body mass, experienced reductions in abdominal fat, and had lower triglycerides. Reductions in ‘buffalo humps’ have also been reported, but potential side effects include breast development in men, skin cancers, gastrointestinal bleeding, and inflammation of the arteries. There’s more reason to be cautious: while HGH may also work as an immune-based therapy to help the body produce new T cells, it’s been shown to increase HIV reproduction in the lab. Therefore, growth hormone must always be used in combination with an anti-HIV drug regimen that’s able to keep your viral load undetectable. People who have an active form of cancer must never use it. For these reasons, it’s essential to only use HGH with a doctor’s supervision.

Sam Page is a coach, advocate, speaker and writer in Los Angeles. For more than a decade now, he's built a loyal network of men and women, helping them to unleash their inner athletes and ignite their desire to change their health.  For years, producers and celebrities have relied on me to help them get into the best shape of their lives.  Twitter:@SamPageFitness, Facebook: SamPageLA. Additional research by Savas Abadsidis.