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Fatigue and AnemiaFatigue and Anemia
          
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life's a beach...thanks for teaching us how to swim
Feb 25, 2002

Hey Dr. Bob, Why is it that you are the only one who gives straight answers around here. I've never asked you a question until now but I've read all your posts and think you are better than Miss Manners and Carrie Bradshaw combined. Based on what I learned in your responses I realized that I was becomming more and more anemic. Now why my PA didn't realize this is still a bit of a wonder and frustration to me. Don't get me started on how bad medical care is around here!!!!!! OK so now we know why my tired butt has been dragging and it's time to do something about it. I asked my PA about the options for treatment and he mentioned blood transfusions and anabolic steroids. I asked about Procrit and didn't get much of a response. Is Procrit an anabolic steroid? I asked my what the diference was between Procrit and anabolics and he said "not much". Is that true? What do you think of my PA? Any time you want to move to to the beach -- you're welcome to stay here. Thanks for your wit, wisdom, and twisted humor. You are our best medicine! xoxxoxo PJ

Response from Dr. Frascino

Hey PJ,

Well, I don't know how "straight" my answers are, but I'm glad you enjoy them. Combining Miss Manners with Carrie Bradshaw? Hmmm . . . now there's an entertaining thought. Snappy sexual etiquette advice while wearing haute couture and 3-inch stilettos?

OK, on to your questions. Is Procrit an anabolic steroid? No, definitely not. Procrit is identical to a substance your body produces naturally called "erythropoietin." Erythropoietin is not an anabolic steroid. It's a hormone that stimulates the bone marrow to make new red blood cells.

Is there a difference between Procrit and anabolics? That's like asking is there a difference between Carrie Bradshaw and Dr. Laura Schlesinger! Hell yes, there's a difference. Anabolics have been used to treat some types of anemia, but published clinical trials data supporting its use in HIV-positive folks are lacking. Anabolic steroids (androgens) are associated with a significant number of potential side effects - virilization in women, acne, elevation of blood lipids (cholesterol and tryiglycerides), and significant liver problems just to name a few. Anabolics do have their place in treating some HIV-related conditions, such as wasting, but as a treatment for HIV-related anemia, it is risky, especially compared to Procrit. Procrit has essentially no drug interactions, no side effects, and has been used for more than a decade. Numerous clinical trials have demonstrated its safety and efficacy in treating HIV and cancer/chemotherapy-related anemia. Procrit has been shown not only to improve energy levels and quality of life in anemic HIV-positive patients, but it is also associated with improved survival.

Move to the beach? Really? Is my room ready? Get the sun tan lotion ready and start making one of those umbrella drinks for me. I'm on my way. Oh, you're last question: What do I think of your PA??? Well, to quote him, "NOT MUCH!"

Stay well, PJ.

Dr. Bob


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