Vitamins and minerals are nutrients that our body needs in order to work properly. These nutrients occur naturally in food.

Most people can get all the vitamins and minerals they need by eating a balanced, varied diet that includes plenty of fruit and vegetables.

You can find out more about key vitamins and minerals, what foods they are found in, and recommended daily levels on the NHS Choices website at www.nhs.uk/conditions/vitamins-minerals. 

Pregnant and breastfeeding women have slightly different nutritional needs. Your healthcare team can talk to you about these. A dietitian can give you advice on food safety during pregnancy, as well as information on managing your weight while you are pregnant. You can also find more information at www.nhs.uk/livewell/pregnancy. 

Many people with HIV may consider supplementing their diet with additional vitamins, nutrients, and herbal remedies in the hope of protecting or strengthening their immune system, or maintaining or promoting their general health, weight or body shape.

HIV specialists advise that a healthy, balanced diet is enough. Evidence that many of these supplements have any effect is limited. Mega dosages of any nutritional supplement are not recommended (see below).

However, many people with HIV have low levels of vitamin D, and this has been associated with an increased risk of some health problems (see Conditions related to metabolic changes and ageing for more information on osteoporosis, one of these potential problems). Your vitamin D levels should be monitored as part of your routine HIV care, and your doctor may prescribe supplements if your levels are very low. Vitamin D is found in food, but you get most of your vitamin D from sunlight on your skin, so levels can also vary at different times of the year and depending on the colour of your skin. A dietitian can also advise you on dietary sources of vitamin D and on safe sun exposure.

Some people take high doses of certain vitamins and minerals because they believe that they may boost their immune system. Although vitamins and minerals play an essential role in staying well, research has shown that large doses of some can be harmful.

All the following vitamins and minerals are important in maintaining your immune system, but can cause health problems if you have too much:

• Vitamin A (also called beta carotene): large amounts can cause liver and bone damage, vomiting and headache. Doses above 0.7mg for men or 0.6mg for women may be harmful. Doses of more than 1.5mg may increase the risk of osteoporosis. Pregnant women should not take supplements containing vitamin A without consulting their doctor as high intake can be harmful to the developing baby.
• Vitamin C (ascorbic acid): doses above 1000mg per day may lead to kidney stones, diarrhoea and hardening of the arteries. Large doses of vitamin C have been shown to reduce concentrations of indinavir (Crixivan) in the blood, and it’s possible that there may be similar interactions between high-dose vitamin C and other protease inhibitors.
• Vitamin E: doses above 800mg per day are associated with adverse effects; special care is needed if you are taking an anticoagulant or if you have haemophilia.
• Zinc: high doses have been linked to copper deficiency, changes in LDL:HDL cholesterol ratios, neutropenia (low white blood cells) and anaemia (low red blood cells). A daily dose of 25mg a day as a supplement is considered the safe upper level for long-term use.
• Vitamin B6 (pyridoxine): more than 2g per day has been associated with nerve damage, with lower, long-term daily doses (from 500mg to 50mg) linked to neuropathy (although vitamin B6 is also used to prevent or treat neuropathy in some situations).