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Constant lethargy and fatigue after mid day
Aug 8, 2010

I was diagnosed at the age of 20 in 1996, but did not start combo therapy until 2008. This was at a time that I had caught opportunistic TB. I recovered after 3 months in hospital and the HiV medication took my CD4 up to >1200 with an undetectable VL. I finished TB medication in May 2009 yet I have continued to for severly fatigued in the early afternoon until early evening.

I have tried exercise, I eat a balanced diet, and am happy at home. I try taking Pro Plus and other caffinated drinks but with no effect.

I scan the web and have seen some information about a drug used to treat ADHD but other than that, very little. My HIV doctor has had me tested for all of the common tirdnes tests but have not presente any answers. I can be on the brink of faling asleep at my desk on some occasions.

I look forward hopefully to your reply..

Many thanks


Response from Dr. Frascino

Hello Paul,

If indeed your HIV physician has done a complete evaluation for HIV-associated fatigue and you remain "on the brink of falling asleep at your desk," I would suggest:

1. you read through the archives of this forum, particularly the chapters on the diagnosis of HIV-associated fatigue and the treatment of HIV-associated fatigue, just to see if anything may have been overlooked in your evaluation. If so, talk to your doctor about it.

2. you consider a trial of Provigil, if you have no contraindications. You can read more about this drug in the archives as well.

Good luck.

Dr. Bob

health care provider with surgery

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