hi keith

i've been HIV+ for 1 1/2 years and on reyataz/norvir/epzicom for 3 months. I have never lived such a clean and healthy lifestyle as i do now. I have eliminated all vices, added cardio/weight training, began working w/a nutritionist and take well reserched and dr approved supplements, all to conteract the damaging effects on my body.

Why is it that with a blood tests that indicate health (my T-cells have improved from 277 to 453 in just 2 months and now an undetectable V.L.)and a doc that says everything's looking even better than hoped, do i feel constantly fatigued and a general sense of "not feeling good"? Is this just something I'm gonna have to accept about my "new life" and the medications i take? Prior to March 08 I have never taken anything beyond antibiotics and felt pretty excellent 95% of the time. This may seem extreme but this is not how I'd like to spend the rest of my days and will try anything to feel well again.

any advice is appreciated.

Fatigue is common in the general population and in HIV+ persons +/- treatment. Most studies have noted overall increased quality of life (including less fatigue) when HIV+ take effective treatment. A wide range of non-HIV conditions can contribute to fatigue (such as hormone disorders like low thyroid or testosterone levels, sleep problems, stress, depression and many more). There is a lot of flux in your overall metabolic and immune status after starting effective treatment which could contribute to fatigue and might diminish once things have settled down with more time. Some patients will have an idiosyncratic reaction to a drug (unusual and uncommon) that can be hard to prove other than a carefully done switch off a drug to an alternative with observation. Increased exercise is often useful for decreasing fatigue as is a sleep and mental health assessment. KH