Hello Dr.Bob, First I would like to say thank you for being here!! 1 month ago I expressed my concern to my doc about the fatigue and low sex drive I have been battling. He said my testosterone was only slightly low and suggested I try Oxandrin. I have put on 19 lbs, and Mr.Happy is back but I still feel very tired all the time. I am working out 2-3times perweek,eating good etc.etc. Any suggestions??What's next? All my lab's are good VL 97, CD4 421, HCV VL 850,000.Med's Viread,Viramune,Epivir, and Oxandrin. I am just very tired of being tired all the time!!!Any of your time would be greatly appreciated.

Thank You, Rich

Hello Rich,

A couple of thoughts come to mind. First off, Oxandrin is primarily an anabolic steroid (muscle building). It can be very effective in treating HIV wasting. Your 19-pound weight gain is testament to that! However, Oxandrin does not have a lot of androgenic (male hormone) potency. Thats why it can be used in women as well as men. It could be that your testosterone is still not where it should be, even though Mr. Happy is once again winking his one eye! Have your doctor check your "free" testosterone level to see if testosterone supplementation is needed in addition to your oxandrin (or perhaps in place of it, as testosterone has both anabolic and androgenic properties).

Next, your Hep C viral load is 850,000. How are your liver enzymes? Elevated liver enzymes would indicate the liver isnt functioning as well as it should. Have you had a liver biopsy to check for inflammation and/or scaring?

Aside from these 2 causes of fatigue, other common causes would include:

1. Depression 2. Unrecognized infection 3. Drug side effects 4. Psychological causes anxiety, stress, depression, etc.

Check these possibilities out with your HIV specialist and write back if youre still having difficulties, OK?

Good luck.

Dr. Bob