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Fatigue and AnemiaFatigue and Anemia
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Jul 3, 2001

Hey Dr. Bob, I've been reading your forum for a while now. I've learned more from you than from my doctor! I've been tired for as long as I can remember but never really complained much about. After reading your responses to others I reviewed my labs with my doc. My hemoglobin was 10. I asked why my doc didn't tell me I was anemic. He said it was mild and he was waiting to see if I developed any symptoms. If it weren't for you he'd still be waiting! When we actually discussed how tired I always feel he said "why didn't you say so" --like it's my fault! So I had my first dose of Procrit last week. I'm scheduled to get my next one on Monday. So far I don't really feel any better. Is Procrit not working for me or do I have to be more patient. I talked to the nurse yesterday who said maybe I should take Procrit 3 times a week rather that just once so it would be more effective. Is this true? I don't mind needles but once a week is sure more convenient. Well that's it. Hope you'll find time to answer my question but I know you must be swamped by lots of requests. I just want to say thanks for your compassion and wit ... it's comforting knowing you are one of us and living well. OZ Man on Manly

Response from Dr. Frascino

Hey OZ Man on Manly,

Manly Beach in Sydney? I've spent some fine summer days on that beach trying to learn how to surf!

Thanks for your comments and the question. Hemoglobin of 10? Yes, you're anemic. I'm also assuming you're HIV positive and your physician ruled out causes of anemia that are easily correctable such as iron, B12 or folate deficiencies. Assuming you have HIV-related anemia of chronic disease (the most common type of anemia in us HIV-positive folks), then Procrit is the correct therapy. Regarding dosing schedules, preliminary studies have shown the once-per-week schedule to be as equally effective as the old 3-times-per-week schedule. The standard dose of once-per-week administration is 40,000 units. So assuming all that is correct, is Procrit working for you? Well, it's too early to tell. The effect is not immediate. Procrit stimulates your bone marrow to make new red blood cells, and that takes a bit of time - generally at least 2-6 weeks before the hemoglobin will start to rise. The speed of the response is somewhat variable from person to person. I would suggest that you stay with your once-per-week schedule and check your hemoglobin every 2-4 weeks until it's stable. Remember to store your Procrit in the refrigerator, but not in the freezer.

Good luck and g'day mate!

Dr. Bob

I think you look great!!!
quality of life

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