DR. J Frascino,

I am 22 plus HIVer with a decent body weight and had been the 10 mg dose of androgel when abnormal free testosterone reading came back at 6000 so my doctor adjusted the dose to 5 mg and i repeated the test, as months progressed i came with a range again but first there was a significant loss in sex drive i expected that, then a depression i again expected,but what transpired over the past two weeks has me worried, i hardly eat , and i never had a wasting problem, then recently my cognitive skills have falling off, i can't hardly drive my car with out exhaustion, and yesterday i almost made a critical error in judgment changing lanes, not to mention the spelling mistakes i have to correct in this question, could the first test been a fluke? and after all those years on androgel wouldn't there be enough to get me thru a lower dose?(7 years) current regiment is Intellence and Insentress with undetectable viral load and NOW extreme muscle weakness?In bed every night before 9pm with no energy to go back to the gym..6-2 240 lbs 47 yrs old

Hello,

Unfortunately, I cannot sort out complex problems, like yours, over the Internet. I would certainly encourage you to see your HIV specialist for a thorough evaluation of your recent symptoms anorexia, cognitive dysfunction, muscle weakness, etc. Certainly, hypogonadism (low serum testosterone) could be associated with many of your complaints depressed mood, decreased libido, fatigue, loss of lean body mass, etc. However, you shouldn't automatically assume this is the cause. There are a variety of other HIV-related or HIV-associated conditions that can cause problems like these. A thorough evaluation, including a recheck of your free testosterone level, is warranted.

Good luck.

Dr. Bob