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Fatigue and AnemiaFatigue and Anemia
           
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major fatigue
Oct 12, 2001

dr. My last few rbc's have been running between 3.8 and 4.0(refer. range 4.7-5.7) My My hgb is 12.7-refer range 14-17. I am so exhausted and many time feel out of it. I am taking neupogen for white count would you recommend procrit for my red count. This fatigue is taking away any my zest for life-all i want to do is sleep-please help

Response from Dr. Frascino

Hi,

Since you quote 14-17 as the reference range for hemoglobin, I'm assuming you are male. Your hemoglobin is 12.7. Yes, you are anemic. The question is: Is that what's causing your exhaustion? Generally speaking, "exhaustion" is usually associated with more severe anemia, i.e. lower hemoglobin levels. However, as I have often said, fatigue in the setting of HIV disease is often multifactorial and your mild anemia may be contributing somewhat. Check your old lab slips. Has your hemoglobin been dropping for some time? Does the drop correlate time wise with the onset of your fatigue? You mention that you are taking neupogen to stimulate your white blood cell count. Why is your white count low? Is your bone marrow suppressed? Perhaps your hemoglobin has dropped even more since your last blood test. You should also check out other factors, which might also be contributing, i.e. low testosterone or thyroid hormone production, adrenal insufficiency, medication side effects, depression/anxiety, unrecognized opportunistic infections, and adequacy of diet, sleep, and exercise. Should you take Procrit? Well, once you've evaluated and attended to as many possible-contributing factors as you've been able to identify, if you're still fatigued and your hemoglobin is still below the normal range, sure, give Procrit a try. It has virtually no side effects or drug interactions. Treatment of even mild to moderate HIV-related anemia with Procrit has been shown to improve energy level and quality of life, and to be associated with improved survival. OK, sleepy head, time to cut the zzzzzz's and get up and find out why your zip got zapped and hopefully, your zest will return with your zapped zip. Just how many "z's" can I use in one run-on sentence?

Dr. Bob


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