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Fatigue and AnemiaFatigue and Anemia
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Jun 23, 2005

Doctor, I am +, T cells of 570 viral load under 47,000. I am not on any antiviral meds my testosterone was like 270. My doctor gave me Andogel to help with my energy but has done nothing but make me very aggitated. If I continue Androgel will I make testosterone of my own? Or will I need to always supplement? Honestly I have not used it in 2 weeks and feel better emotionally but still have no energy. I dont feel i need to start antivrals and begin a whole new set of symptoms. I have no appetite and take marinol and am afraid antivrals will just make my appeite worse. I am in constant pain all over my body and nothing works. I am afraid nothing ever will.

Response from Dr. Frascino


". . . nothing works. I'm afraid nothing ever will???" Isn't that being just the tiniest bit pessimistic?

I agree you do not need to start antiviral therapy at this time (CD4 570 and viral load 47,000).

Hypogonadism (low testosterone) is the most common hormonal energy-zapper in HIVers. It can lead to loss of energy, appetite, weight, muscle and bone mass, sex drive and even your rosy outlook on life. Between 25 and 45 percent of us "virally enhanced" men develop low testosterone. The normal total-testosterone range for guys is between 300 and 1100; however, different laboratories may have different normal ranges. AndroGel or other replacement therapy can be very helpful in ameliorating the symptoms associated with hypogonadism. The dose can be adjusted if you are experiencing side effects. If you are already hypogonadal, you shouldn't worry about making your own testosterone in the future, as you already aren't making enough for your body right now!

There are other causes of low libido, anorexia and generalized discomfort that you should consider. Depression, for example, can be associated with all of these symptoms. Talk to your HIV specialist. The cause of HIV-related fatigue often turns out to be multifactorial in nature. You can review detailed information about the common causes of HIV-related fatigue in the archives of this forum.

Good luck, and do realize the proverbial glass can be at least half full as well, OK?

Dr. Bob

Window Period
Procrit and Jim, Johnny, and Jack

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