I have been going to the doc for fatigue, and all the test have come back good, (blood,mri,cardio) I have an undectable viral load and 200 t count. I have been told since all phyical test came back neg. It is depression thats the cause, I was given provigil 200mg and wellbutrim 150mg, I also take Valcyte, Atripla, and Bactrim for my PCP infection I had a year ago. - with my PCP i had a lung calapsed and blood clot to the same lung. I still have no change in my fatigue. I have been taking all the med for a year now and my provigil for a month and a half and my wellbutrim for 3 weeks. What should I do next?

Hello,

HIV/AIDS-related fatigue is often multifactorial in nature. That means there is often more than one underlying cause working in tandem to drain your energy batteries. Diagnosing all the potential underlying conditions can be challenging and will require some cooperative detective work from you and your HIV specialist. Take a read through the archives of this forum to learn more about the common and not-so-common potential causes of HIV-associated fatigue. Make a list of these and discuss them with your HIV specialist. For instance, did your "blood" workup include an evaluation for possible hormonal abnormalities, such as hypogonadism, adrenal insufficiency and hypothyroidism? Are you paying enough attention to basic health issues, such as optimizing your nutrition and exercise routine and getting adequate sleep? You mention you are on Atripla. Often the Sustiva component of that drug can cause sleep disturbances, which can lead to impaired sleep and ultimately daytime fatigue. These are just a few of the many possibilities you should explore with your HIV specialist.

Good luck.

Dr. Bob