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Fatigue and AnemiaFatigue and Anemia
           
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VERY FATIGUED AND DON'T KNOW WHAT TO DO
May 9, 2000

I am a 36M HIV+ since '88 and on a cocktail of Viramune, Epivir, Zerit & other antibiotics for CMV, MAC. I was taking B12 I'm every two weeks but didn't seem to give me much energy I need to function on my job or everyday activities. I just don't want to get out of bed sometimes, or just go out. Just bought a house, but sometimes find it hard to push myself to keep up. Is is safe to take the B12 I'm more often, like every week or increase the dosage? Is there any other drug to increase energy. I have discuss this w/my doc and has no other suggestions. I am at a loss and too tired to seek answers. I heard of CNS stimulants ... ie, Ritalin and Dexedrine. Are these safe to take?

Thank you for you answer.

JAH

Response from Dr. Frascino

Dear JAH,

Lack of energy is an extremely common complaint for all of us that are HIV-positive. Since your HIV disease is longstanding, you should certainly be checked for anemia. You mentioned that you are taking antibiotics for CMV and MAC. Was this for prophylaxis (prevention) or treatment? If you have MAC, this opportunistic infection is frequently associated with anemia as well.

Vitamin supplementation can be helpful if you are deficient. Have your physician check your B12 blood level prior to one of your injections to see if your level is low. If so, increasing the dose or frequency of the B12 might be helpful.

I would certainly continue to search for the cause of your fatigue before resorting to a trial of stimulants. It's always better to treat the cause than cover up the symptoms.

In conclusion, I would strongly recommend that you check your hemoglobin level. Treatment of even mild decreases in hemoglobin in the setting of HIV disease or cancer has been shown to significantly increase energy level and quality of life.

Good luck.

RJF


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