Could you please explain whether "asymptomatic" increase in lactic acid due to HIV drugs can become symptomatic as a result of exercise? I have a problem with extended stamina during exercise. I'm 50 and taking Kaletra, Epivir, Zerit for four years, T cells around 300, undetectable VL. I weigh 154, 5'9", and have moderate fat loss in limbs and fat gain in belly. I have a problem with stamina - already use 7.5 grams Androgel and am also taking synthroid. I get pretty complete workups monthly. I'm sure some of the fatigue I have is the result of th/e drugs (Kaletra especially), but I used to feel invigorated by exercise - now after years on these drugs, exercise makes me feel washed out, takes an hour or more to feel ok after 20 minutes on a bike. Could this be due to abnormal lactic acid buildup?

Possibly with D4T the most common drug involved with that phenomenon. Lactic acid levels are high in many persons afer exercise then clear. In persons on drugs which cause mitochondrial toxicity the clearance may be slowed and muscle function/recovery may be impaired. Details about that are not complete since the usual approach to stop the offending medications and then observe what happens. KH