I'm always tired and fatigued no matter how much or little or sleep i get. I feel ill a lot and run down, I've been starting to get cold when usually I'm not, and very thirsty.
I am sorry that you feel tired. I have dealt with this issue since the start of my infection 34 years ago. Fatigue can be caused by many different factors. I suggest that you discuss these ones with your doctor:
Active HIV infection. When HIV multiplies rapidly, your body uses a lot of energy trying to fight it. Most people have more energy after they start taking HIV medications to achieve undetectable viral load.
Other active infections. Other infections can tire you out, even without obvious symptoms. Parasites in your digestive system, bronchitis, other infections or allergies can cause fatigue. If these infections are treated, your energy should improve.
Poor nutrition. People with HIV need more energy than healthy people. If you are not getting enough nutrients, your energy level will be low. Diarrhea can rob your body of nutrients and cause fatigue. If possible, meet with a dietitian who knows about HIV disease to discuss your eating habits. For some people, vitamin B12 supplements or better nutrition can eliminate fatigue.
Anemia . The main job of the red blood cells is to carry oxygen from the lungs to the rest of the body. If you don't have enough red blood cells, or if they aren't carrying enough oxygen, your fatigue may be caused by anemia. A simple blood test will show whether you have anemia.
If you do, your health care provider will determine what is causing anemia. It could be due to blood loss, damage to your bone marrow caused by anti-HIV medications or vitamin deficiencies, or by a low level of the hormone erythropoietin which helps make red blood cells.
Low hormone levels. Especially in men, low levels of the sex hormone testosterone can cause fatigue and lack of interest in sex and other normal activities. Low levels of other important hormones such as DHEA , cortisol or thyroid can cause similar problems. Hormone levels can be checked with blood tests. Pills, patches, creams, or injections can restore hormone levels to normal.
Depression. This is more than just feeling sad. Chemical changes in the brain can cause fatigue and a lack of interest in daily activities. There is no blood test for depression. The chances that you are depressed are higher if you have previously been diagnosed with depression, if you have a history of heavy alcohol or recreational drug use, or if you have a family history of emotional disorders. Depression can be treated with medications. However, some antidepressants can cause problems with sexual functioning. Also, some antidepressants interact with some HIV medications, so they must be used very carefully. Also, one HIV medication in particular (Efavirez) has been linked to increased depression in some patients.
Obstructive Sleep apnea. Some people may have respiratory blockage for portions of a minute while they sleep due to sinus or throat related blockage at night. This blockage can starve the brain of oxygen and cause daytime fatigue. A sleep study to diagnose apnea is important. If apnea is found, doctors prescribe the use of a continuous positive pressure air mask to facilitate proper breathing and oxygenation.
Lifestyle. Getting enough sleep is important. Habits like smoking or drinking a lot of coffee can make it harder to sleep. Regular exercise can make it easier to sleep. Lowering stress by using relaxation techniques like deep belly breathing and mindfulness can help.
Medications. Efavirenz, a popular HIV medication, can cause sleep disturbances and fatigue.
We have a lot of good information about fatigue at TheBody.com
Here are some good articles on fatigue
I hope this information helps you to discuss potential solutions with your healthcare provider. I hope you feel better soon!