General Fatigue Questions

• What Exactly Is Fatigue? Are there Different Types with Different Causes?
  I know that "fatigued" means tired, but are there any other symptoms that fall under the term fatigue? Are there different kinds of fatigue that require different treatment strategies?
  Response from Bob Frascino, M.D. (January 2, 2007)

• Is My Fatigue AIDS-Related?
  I was recently diagnosed with HIV. My CD4 count is 34 and my viral load is 57,700. Though I am not ill and I continue to go to the gym daily, I find myself drained at the end of the day. What's going on? Is HIV responsible for my nighttime exhaustion?
  Response from Bob Frascino, M.D. (February 12, 2007)

• Why Is an HIVer with an Undetectable Viral Load Feeling So Tired?
  An HIV-positive friend of mine with an undetectable viral load and a CD4 count of 400 is suffering from intense fatigue. She has her HIV under control, so why does she feel so poorly?
  Response from Bob Frascino, M.D. (February 21, 2005)

• How Should I Handle the Fatigue I've Been Feeling Since I Started Taking ART?
  I have HIV and hepatitis B and began taking Sustiva [efavirenz, Stocrin] and Truvada [tenofovir/FTC] two months ago. Lately, I have found myself sleeping more and exercising less. Where has my energy gone? Should I try to ignore how tired I feel and exercise more, or should I take it easy until my energy level recovers?
  Response from Bob Frascino, M.D. (April 22, 2007)

• Do HIVers Take More Time to Recover After They Push Their Bodies Hard?
  I don't usually suffer from fatigue, but on a few occasions I've found myself feeling run-down and exhausted for a number of days after I pushed my body hard. Should I assume that feeling this way once in a while is normal for people with HIV, or should I get myself checked out?
  Response from Bob Frascino, M.D. (March 15, 2007)

• The Nightly Sleep Quota
  How many hours of sleep should people with HIV aim for?
  Response from Bob Frascino, M.D. (January 22, 2004)

Hypogonadism (Low Testosterone) and Fatigue

• Is Taking Testosterone for HIV-Related Fatigue Dangerous?
  I have HIV and hepatitis C and suffer from chronic fatigue. I'd like to try testosterone supplementation to address my fatigue, but my doctor refuses to prescribe it, arguing that it might reduce my life span. What do you think?
  Response from Bob Frascino, M.D. (April 8, 2007)

• How Can I Get Enough Testosterone to Avoid Fatigue Without Getting Other Side Effects?
  I'm HIV-positive. For the last six months, I have been receiving testosterone injections for fatigue. The trouble is that a low dose only makes me feel more energetic for a few days, but a higher dose makes my head explode and my libido shoot off like a rocket. How can I find constant relief of my fatigue without powerful side effects?
  Response from Bob Frascino, M.D. (August 23, 2006)

• What Is Adrenal Insufficiency?
  My doctor tells me that I have developed adrenal insufficiency. What does that mean, and what should I do about it?
  Response from Bob Frascino, M.D. (August 12, 2006)

Anemia and Fatigue

• Should I Blame My Fatigue on Anemia?
  My viral load has fallen to undetectable since I began taking Trizivir [abacavir/lamivudine/zidovudine], but I've been feeling really tired ever since. My hemoglobin levels have been falling below normal. I'm wondering if my exhaustion could be due to anemia. If so, what's the best way to resolve my anemia?
  Response from Bob Frascino, M.D. (July 3, 2001)

• Can Mild Anemia Cause Fatigue?
  Nine months ago I was hospitalized for an opportunistic infection. Now my CD4 count is 900 and my viral load is undetectable, but I've been struggling with fatigue. When I was in the hospital I was severely anemic. My last lab report showed that my level of hemoglobin is slightly below normal. Could that explain my exhaustion?
  Response from Bob Frascino, M.D. (September 22, 2006)

Depression and Fatigue

• How Can a Person Who Doesn't Have the Energy to Handle Life Get Back in Control?
  For some reason, I no longer have the energy I need to maintain my relationships and run my business. I'm not physically exhausted, but I don't have the mental energy to get much done. Neither my HIV specialist nor the counselor I see have has been able to help. What should I do?
  Response from Bob Frascino, M.D. (January 10, 2007)

• What Should a Lonely HIVer Fighting Fatigue and Depression Do?
  I've been HIV-positive for less than three years. Lately, I've been fatigued and depressed. When I get home from work I barely have enough energy to stand up -- let alone go to the gym! Six months ago I moved. No one here knows I have HIV, so I'm feeling pretty lonely. On top of that, I suffer from post-traumatic stress syndrome. Can you suggest a strategy to beat this case of "the blahs"?
  Response from Bob Frascino, M.D. (March 18, 2006)

• Fatigue and Depression: A "The Chicken or The Egg?" Problem
  I'm HIV-positive and suffering from fatigue. All my lab values are good: my testosterone levels aren't low and I don't have anemia. I am depressed, but I think my fatigue is causing my depression, not the other way around. So how can I figure out what's really wrong with me, and, more importantly, what should I do?
  Response from Bob Frascino, M.D. (October 22, 2006)

Medications and Fatigue

• Could Meds for Hepatitis C Be the Cause of My Fatigue?
  I've been very tired ever since I started taking Pegasys (a treatment for hepatitis C) in addition to Truvada [tenofovir/FTC]. Could this new medication be contributing to my fatigue?
  Response from Bob Frascino, M.D. (September 5, 2006)

• How Can I Prevent Sustiva Dreams From Tiring Me Out?
  Because I take Sustiva [efavirenz, Stocrin], I often have wild dreams and wake up exhausted. Is there any way to avoid that side effect without switching to a different medication?
  Response from Bob Frascino, M.D. (January 25, 2005)

For frequently asked questions on other HIV/AIDS topics, click here.