First off I see a doctor in the VA because it's my only option and don't feel really confident in the things he does or doesn't say. I have also had issues with weight loss by 15% in the past and is about a stable decline of 1% couple of months. Had not treatment for that, doctor said it was due to diarrhea. I have had a history of myalgias while on truvad, entarvine and raltegravir. My last CD4 was 380 and vl undetectable, this was my 8th different type of regiment. I also exhibited signs of tingling/numbness in arms and legs. They removed just the raltegravir. Now I still have issues with massive migraines and the tingling/numbness and muscle aches/weakness are still there just not as worse. I have gained 25 lbs in the last few months. Also I have had high Triglycride levels for over a year and HDL is lower than normal. In addition to all of that I have had two fistulaotomies in the last 2 1/2 years from unknown causes, they could not determine the cause after multiple testing. I am continuing to gain weight and bowel is normal now. So what does all this mean? How bad is the impact of the high Triglycride levels and HDL is lower than normal? I am more worried about the muscle weakness than anything else. It really interferes with daily life. Any suggestions?

Increased triglycerides (3G) can be due to a variety of conditions (including many non-HIV related) but are somewhat sensitive to diet/exercise levels. HIV infection often increases 3G levels as well as lowering HDL levels (some improvement with HIV treatment is sometimes seen). Muscle aching/weakness is a common complaint in the general population as well. Direct muscle irritation from medical conditions/drug side effects is sometimes present and can be assessed with blood tests and occasionally a muscle biopsy. Hormone abnormalities (including thyroid and testosterone) can contribute. Rarely patients might experience some mitochondrial toxicity from NRTIs which could effect muscle recovery from exercise. In many cases however no clear cause of muscle aches can be found which is frustrating but common. Physical therapy evaluation can be useful in some of those cases. KH