When I lift weights or exercise, sometimes I get sick to my stomach and throw up. Why is this?
—Mark, Pasadena
During exercise, blood flow patterns change. Through the action of the sympathetic nervous system, blood is redirected away from areas where it is not essential to those areas that are active during exercise. Only 15 to 20% of resting cardiac output go to muscle, but during exhaustive exercise, like leg workouts, the muscles receive 80 to 85% of the cardiac output. This shift is accomplished by reducing blood flow to the kidneys, liver, stomach and intestines, which cause the feelings of nausea associated with intense workouts. Also, the red blood cells which carry oxygen to the working muscles as well as the entire body gets diverted to the working muscles which leads to feelings of being light-headed due to lack of sufficient oxygen to other systems.

If you experience nausea from a non-workout related cause, consider the following steps, which may help:

• The BRAT Diet (Bananas, Rice, Applesauce, and Toast) helps with nausea and diarrhea.
• Leave dry crackers by your bed. Before getting out of bed in the morning, eat a few and sit in bed for a few minutes. This can help reduce nausea.
• Try some peppermint, chamomile or ginger tea-they can calm the stomach.
• Sip cold carbonated drinks like ginger-ale, 7-Up or Sprite.
• Avoid hot, spicy, strong-smelling and greasy foods.
• If vomiting occurs, replenish fluids with broth, carbonated beverages, juice, Jell-O or popsicles.

I’VE HEARD THAT TAKING THE AMINO ACID glutamine with creatine can have positive effects in people who are HIV-positive. But there doesn’t seem to be much information about these sports supplements and any potential interactions with HAART therapy. Can you shed some light on this?

You’re right. Studies on the role of micronutrient supplementation in people with HIV are ripe for further research, according to Dr. Alice Tang, associate professor at Tufts University School of Medicine, and an expert in the area of supplementation and HIV. A few of these studies have examined glutamine, primarily for its muscle-building effects. To my knowledge, there are no published studies on creatine in people with HIV.

When it comes to sports supplements and their potential interactions with HIV meds, the answer is inconclusive. While no adverse affects have been reported using glutamine, other supplements such as St. John’s Wort, have illustrated the complexity of adding “natural” substances to a HAART regimen. Kathleen Squires, MD, says it’s best to avoid products that have documented interactions and communicate with your doctor about all the supplements you’re using. That way, he/she can take them into account if you develop any side effects or your viral load response is not appropriate.

Med interactions aside, the larger question is: “What potential benefits does supplementation with glutamine and creatine have for the person with HIV?” Wasting, (the loss of lean body mass), is a concern for all HIV-positive individuals. Since even a five or 10 percent loss of lean body mass is associated with early mortality and susceptibility to opportunistic infections, products such as Juven (which contains glutamine, taurine and HMB) are useful weapons in your pro-lean body mass arsenal.

Every study I’ve encountered boldly demonstrates that glutamine will build and preserve muscle mass. In one double-blind study, participants who took 2 doses of Juven twice daily for eight weeks gained almost six pounds, compared to a loss of almost two pounds by the participants receiving placebo. Glutamine doses of at least 20g/day has also been shown to improve the absorption of nutrients in the lower intestine.

My personal take is: “an ounce of prevention is worth a pound of cure” and supplementing with glutamine is a smart way to keep your lean body mass up. Creatine may also have a place in the mix, but your doctor should be able to help you balance the benefits of these sports supplements with your overall treatment regimen.

Recently I started playing on a soccer team. There are two practices a week which are a few hours long, and two games which are a couple hours long. But, I’m finding myself really fatigued during the day and having trouble sleeping at night. Also my appetite just hasn’t been what it used to be. What’s happening to me?
—Karen, Eagle Rock

You may be overtraining. Symptoms of overtraining can include loss of appetite, strange or disturbed sleeping patterns, muscle soreness that doesn’t seem to go away, and general fatigue.The best way to minimize the risk of overtraining is to try “cyclical training” procedures, (alternating easy, moderate and hard periods of training). As a general rule, 1 or 2 days of intense training should be followed by an equal number of easy training days.Some other ways you can avoid overtraining are:

• Varying your training methods.
• Taking advantage of, scientific application of the many therapeutic modalities at your disposal (such as chiropractic, massage, acupuncture, acupressure, yoga, sound therapy, stretching).
• Following sensible, scientific nutritional practices and supplementation.
• Using good lifting techniques.
• Getting proper sleep and rest.
• Taking advantage of various psychological techniques that promote restoration (for example, therapy, meditation, visualization, hypnotherapy, aromatherapy).
• Avoiding all other stressors in your life that can become problematic to your training efforts (whether environmental, psychological, sociological, biochemical, physiological or anatomical in nature).

Hey Sam, I noticed the other day when I was working out, that I yawned 4 or 5 times. I had gotten a good night’s sleep the night before. What’s up with that? -Bronson

Hey Bronson. I get this question a lot. When you yawn, you are also stretching your neck and head muscles in order for the veins to constrict and move blood (and oxygen) more rapidly to the brain. This action is triggered by carbon dioxide or hypoxia.

There’s really no definitive scientific explanation for this phenomenon. However, I did some research and found a few possible causes (and some fun, “yawn facts.”)

The first hypothesis is that when a room builds up carbon dioxide, the carbon dioxide causes you to become sleepy, so you begin to yawn (even if you’re not feeling tired).

Other explanations:

A recent theory is that yawning is how your body regulates its own internal temperature.

Some claim that yawns are caused by the same chemicals (such as serotonin, dopamine, glutamic acid and nitric oxide) in the brain that affect emotions, mood, appetite and other phenomena. As more of these compounds are activated in your brain, the frequency of yawning increases.

Some folks are actually superstitious about yawning! A few Christian sects believe that yawning is brought on by the Devil who “sends evil demons to enter a person’s body when your mouth is open.” (This is why some people cover their mouths when they yawn).

Other superstitions:

* A yawn is a sign that danger is near.
* Counting a person’s teeth robs them of one year of life for every tooth counted. This is why some people cover their mouths when they laugh, smile, or yawn.
* If two persons are seen to yawn one after the other, it is said that the one who yawned last bears no malice towards the one who yawned first.

I hope this helps! –Sam

Hey Sam, I have heard through various sources that the chlorine in tap water can contribute to (or cause) cancer. Is this true or not? -Chad

Hey Chad. Some studies have shown a link to cancer but not always. Most of the large scale research seems to indicate that there may be a small increase in the rates of bladder cancer, especially in men.

However, many public health agencies, such as the WHO say that the existing studies are not sufficient to draw any conclusions and that chlorinated water is obviously much better for you than, say, nonchlorinated water.

The EPA also sets maximum levels for chlorine in tap water. Most cities in the United States fall far below the maximum levels.

Overall, some studies show a slighter risk associated with chlorine in the water, but the findings are not conclusive.