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Fatigue and AnemiaFatigue and Anemia
           
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Bruising ,Fatigue, etc.
Sep 30, 2003

Hey Dr. Bob,

First off, thanks for all wisdom you share with us! I really appreciate you taking the time to read my question.

I'm 34 and seroconverted about 14 months ago. Other than fatigue I've done very well and my last set of #s had my viral load down to 96K and my CD4 up to 994. I haven't been on any meds and do my best to stay more educated and optomistic than "pozitive".

I've been bruising very easily lately. My forearms for the most part will get bruises as small as the size of a quarter and up to the size of and egg and I have no idea what causes them, they just show up. On my walks to work I've been short of breath (25 minute walk), sometimes my fingers tingle after exercise, I get headaches and a starry tunnel vision occasionally and the fatigue is still consistant. I don't do drugs other than exedrin for a headache now and then and I will have one or two drinks once or twice a week (I know, bad bad bad). For the most part I eat well-rounded and healthy food.

My question is this whether or not this is anemia? I have a tendency to down-play these little issues. My father and I were talking about my status recently, he noticed the bruises and said that my mother had similar symptoms that he remembers and that perhaps it's something I inherited?

Well, any help or suggestions are very much appreciated. Thanks again and have a great day!

-Scott

Response from Dr. Frascino

Hi Scott,

Anemia means you have a shortage of red blood cells. Red blood cells contain hemoglobin, a key protein that carries oxygen from our lungs to every part of our body. Anemia can be diagnosed easily with a simple blood test. The "hematocrit" level is the percentage of red blood cells in the plasma. A more accurate test is the hemoglobin level. The normal range for hemoglobin is 14-18 g/dL for men (12-16 g/dL for women).

Symptoms of anemia can include fatigue, shortness of breath, rapid heartbeat, paleness, headaches, exercise intolerance, decreased sex drive, and inability to concentrate!

So what about your symptoms? Certainly the fatigue, shortness of breath, and headaches you mention could be indicative of anemia.

The easy bruisability, on the other hand, would be more suggestive of low platelets (another type of blood cell), rather than low red blood cells. Low platelets (thrombocytopenia) can be related to HIV and a wide variety of other conditions as well. Could it be inherited? Yes, it's possible. Could you have both low platelets and low red blood cells? Yes, that's possible too.

Next step Scott is to see your doctor. A very simple blood test will answer all these questions. Once we know what you've really got, we can then work on finding the cause and institute the proper treatment. There are a variety of treatments for low platelets, such as intravenous gammaglobulin for ITP (idiopathic thrombocytopenia purpura), and very specific treatments for various types of anemia as well, such as Procrit, a medication that stimulates the production of additional new red blood cells.

Write back when you get the results of your blood test if you need additional advice, OK?

Good luck.

Dr. Bob


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