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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Jun 11, 2001

Dear Dr., I have 3 questions.

1.Androgel applied to a buffalo hump. a.will this help in shrinking the hump? And are there any state of the art procedures being done? b.will this kind of testosterone worsen facial thinning?(you've mentioned this in prior posts,but you didn't specify androgel)

2.Swollen parotids. Any new ideas on how to eliminate them or reduce their size?(My regimen has always worked well-vl<50,cd4900,so a better regimen is prob. not the answer) I'd be afraid of radiation too. 3.I saw an ad in a mag for Niaspan,which is prescription extended release niacin.I remember reading an article that niacin is the real deal for lowering cholesterol. I take 40 mg of lipitor.I'd appreciate any feedback/comments on replacing lipitor with niaspan. Thank you for your response to these 3 diff subjects.Sincerely,Luke

Response from Dr. Boyle

Luke, you have a lot of very good questions. First, while an interesting thought, there is no evidence that androgel applied to a buffalo hump will help reduce it. Second, androgel may worsen facial wasting just like any androgen. Third, increased parotids can be due to many causes and these should be evaluated before considering therapy. If the enlargement is secondary to lymphoepithelial cysts they are best reduced using low-dose radiation therapy or surgical excision. Most of my patients prefer the radiation therapy which is very simple and generally achieves a pretty good result. Fourth, Niaspan can be used to lower cholesterol, but must be used with caution when it is combined with lipitor or other drugs in that class since there is a drug interaction that can cause problems. It is effective in lowering cholesterol, but does have niacin-like side effects including flushing and other symptoms. If you are not tolerating the lipitor or if you have not had a successful result, you should discuss a change of medications with your doctor. Good luck!

mushy muscles, part 2
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