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Fatigue and AnemiaFatigue and Anemia
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Fatigue timeline
Jun 24, 2002

Hi Dr. Bob. Sorry for the lengthy inquiry but wanted to give you plenty of material to deduce from. I am a pretty healthy 27 year old in NYC. 7 1/2 months ago I had unprotected insertive vaginal intercourse with a girl after a Halloween party. Told myself I would not freak out, but of course did at the first sign of symptoms 10 days later. I went on to have a pretty hearty and profound fatigue/malaise for about 5 weeks thereafter, more extreme at some times than others. Had some sore throat and was very stressed about the whole thing. 99 sure I was HIV+. Got tested at 7 weeks and was negative. . The Doc assured me I didnt need another test. The fatigue then disappeared less than a couple days later. I thought all was well but never got rid of the unsettling feeling I needed to be retested, specifically on those Saturdays where I would be unusually hungover and exhausted. Not to mention the recurring tingling in my fingertips and noticeable pulsing heartbeat all around my body i.e. fingertips, stomach, and scalp. However I just continued to write it off and was too scared and embarrassed to face my doctor with yet another HIV test request. Starting just a few days ago, almost 8 months later, and I have been experiencing overwhelming fatigue where I feel like a might pass out or vomit or both. It started with getting hives on my chest (which I am used to because of allergies but they seemed excessive) combined with noticeable hair thinning as of late, and some teeny tiny red dots/spots here and there on my torso. So I am totally freaked out again and have set up a doctors appointment but they cant see me for a week. My question is is fatigue this extreme common 7-8 months after initial infection? Does this sound like typical HIV infection symptoms timeline? Please answer me as I havent been able to focus on anything else especially knowing if I had just gone in once more for another test I could be in much better shape than I might be now both mentally and physically Thanks and keep doing what your doing.

Response from Dr. Frascino


OK, calm down and focus on this. Following that "Trick or Treat" Halloween adventure, you felt "profound fatigue/malaise for 5 weeks" when you felt 99% sure you were HIV-positive. These symptoms "disappeared" shortly after you got your negative test results at 7 weeks. Amazing coincidence, don't you think? OK, so now it's 8 months later and you are worried about feeling "unusually hung over and exhausted" on Saturdays (what did you do Friday night?), tingling, "pulsing heartbeat," and, once again, overwhelming fatigue. Any guesses what could be causing this??? Yes, indeed, these are classic symptoms of anxiety and stress and not at all suggestive of HIV on any timeline. Sure, go for your follow-up test. It will be negative. The odds are very much in your favor. Your symptoms will once again get significantly better when your fears are put to rest. If not, counseling or therapy for anxiety/depression may be very worthwhile. And remember to include some latex in your next Halloween costume!

Stay well.

Dr. Bob

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