So Tired

[Brooke P.]

Ok,  does anyone have any suggestions for my constant fatigue?  I seem to never get enough sleep.  I go to bed every night around 9:30 and I'm up at 5:30am.  I can't seem to put the blame on any one thing.  I've been on Atripla since October but I was having this problem before then.  I was blaming it on my weakened immune system but now that it seems to be a lot better I'm still tired all the time! Any suggestions as to what I can do to help my continual tiredness?

[sdguyloveslife]

Could it be depression?  Or anemia?  (you would need to see your full blood labs to find anemia)
I've also heard of people taking vitamin B supplements (orally or injected) and they seem to improve energy levels. 

[leatherman]

have your testosterone level checked too

[tednlou2]

leatherman, were you joking about the testosterone levels..lol?  Brooke is female.  Although, I think I remember from biology class that females do have some testosterone and men have some estrogen.  So, maybe you're right.

Brooke, besides all the lab stuff, maybe your internal clock is off.  Maybe 9:30 to 5:30 is not the right sleep pattern.  I know I've heard 10pm to 6am is best for most people, but I've also heard that some people sleep better at other hours.

[leatherman]

no joking.

testosterone is a hormone that both sexes have, even though it's considered the "male" hormone. A deficiency of either hormone in either sex can cause issues. Just because we tell all the men on this board who are complaining of fatigue to have their testosterone level checked doesn't mean the same advice shouldn't be given out to females too. 

Symptoms of low testosterone in women include loss of sexual desire, lack of sexual responsiveness and weaker orgasms. Other manifestations are lack of energy, decrease in strength and endurance, and diminishing ability to perform work. It can also cause the bones to weaken and heighten the risk for developing osteoporosis.
http://ezinearticles.com/?The-Truth-About-Low-Testosterone-In-Women&id=158936

healthy young women produce approximately 300 microg of testosterone per day, of which about half is derived from the ovaries and half from the adrenal glands. In women, as in men, testosterone is thought to influence pubertal development, sexual function, bone density, muscle mass, erythropoiesis, energy, cognitive function and mood. Testosterone deficiency in women may result from a variety of conditions, including oophorectomy, adrenalectomy, adrenal disease, pituitary disease, HIV infection, premature ovarian failure, Turner's syndrome, and the use of high-dose corticosteroids and some estrogen preparations. Simple aging and natural menopause may also contribute to testosterone deficiency in some women. A consensus view of the diagnosis of female androgen deficiency syndrome (FADS) is currently being developed, and is summarized in this article, as are current approaches for treating testosterone deficiency in women.
http://www.ncbi.nlm.nih.gov/pubmed/11991434

[GNYC09]

What is the quality of your sleep like?  Do you wake up a lot?  Toss and turn?  Nightmares?  Just exploring what else could be influencing this...

[Miss Philicia]

What is the quality of your sleep like?  Do you wake up a lot?  Toss and turn?  Nightmares?  Just exploring what else could be influencing this...

Indeed.  A decade ago I thought I had HIV fatigue, often to the point of falling asleep quickly on the short 20 minute subway commute home and missing my stop.  Ended up that I had sleep apnea, which nobody guessed  because I was so skinny.

[skeebo1969]

  Have you mentioned any of this to your doctor?  You may also want to have your thyroid checked along with what everyone else suggested.

[wow1969]

i don't think there is just one cause for fatique ... i can tell you what has worked for me ...

first, i had to realize that i had lots and lots of energy before HIV and that when HIV came into my life, i went from lots and lots to just lots ... i still have energy, just not as much as i used to ...

second, once i realzied that i still had energy, then it became a job to figure out what i wanted to do with my energy ... where did i want to invest it ...

third, i started looking at the people and events in my life ... those people who sucked the energy out of me have been neutralized, or in some cases, totally removed ... the events in my life have also been scrutenized ... i use the following formula ... if it isn't something i really want to do, if it doesn't enrich my life, if it isn't helping, then, it needs to go ..

fourth, i now have more than enough energy to do what i need to do ... i will never have what i had before HIV but what i do have is sufficient ...

so, look for energy leakages ... i realized that i can't blame everything in my life on HIV ... it doesn't rule my life nor is it the total of my experience ... it is a part of my life and needs to be integrated ... think of it this way, if you are short, you are short ... not really gonna change so you have to compensate for it ... HIV is the same, you just gotta take into account what is going on ...

after i identified the leakages it took about a week before i felt rested and ready for life again ... it's now a month later and i'm pretty much good to go but i guard and protect myself ...

i think the real issue is that unlike being short which a person deals with their entire life, HIV hasn't been with us our entire lives so we have to adjust ... which is hard at times because we remember how we used to be ...

remember, it is just a virus, nothing more ... it's not a moral judgement ... it's not all of who you are ... it's a virus ... as a species, we beat virus's everyday ...

[hotpuppy]

Brooke,
  Sorry to hear you are tired..... it sucks to be worn out all the time.  Have you sat down with a nutritionist?  Sometimes a nutritionist can give you specific advice about supplements or vitamins that may help.  Another avenue to check is exercise.  It seems counterproductive, but exercising may help you get a better night's rest giving you more energy in the end.  You don't have to run a marathon, but something as simple as going for a walk can help.  It's always more fun with a friend.

Another area to look at is Caffeine and Alcohol.  If you consume much of either they can mess with your sleep cycle and so you may want to evaluate how much of either are right for you.

Good luck and keep us posted on your progress. 

[rmgjunk]

Hi,

I found out recently that a cup of chamomile tea at night makes me feel better the other day.  Probably because it's a mild sedative and reduces anxiety.  Heck, even if it's because of the placebo effect, I don't care :-)

Hope you feel better soon,
Roger

[tednlou2]

Brooke, I was thinking about ya today at the doc.  First, thanks to leatherman and my doc I found out testosterone is an issue in women.  Second, I had made a posting about having a lot of fatigue after the holidays.  I went to the doc and they did bloodwork. 

I got results today.  My hemocrit, on a few occasions, has dropped just below the normal range.  I get different opinions whether just a small dip below normal would cause fatigue.  I couldn't get an answer to the difference of being on the low end of the normal range and being at the high end--not just hemocrit but most things.  I would assume I should feel better at the high end of it. 

They also checked my thyroid.  It is in the normal range, but at the low end.  They checked testosterone and free testosterone.  The normal range for testost is 250-1100 at my lab.  Mine was 288.  Would I feel more energized at 1100?  Seems like I would, but I don't know.  Free Testosterone was 55.6.....normal is 35-155.  Seems like I'm on the low end on that.  Everything else was normal...except for total protein which is usually high in HIVers.

I guess what I'm saying is that I agree that it is hard to pinpoint these things.  Would testosterone therapy help me?  Would starting HIV meds get the hemocrit up higher?  I've been reading I should have vitamins checked...like Vit B12, D, Folate.  It would be interesting to see your labs if you don't mind sharing them. 

I wish ya some good zzzzzzzzzz and more energy.  Everyone keeps telling me the importance of serotonin and taking depression meds if you feel you need them.  A new study just came out about Lexapro.  I think it said it gave people more energy and helped brain function.

[Brooke P.]

Thanks you everyone for the great suggestions!  I go back to the doctors on the 25th so I'll ask him to check some of this for me. 

I do seem to sleep very deeply.  Although I have a 4year old so sometimes I am awaken in the middle of the night but that doesn't happen but maybe once every 3 weeks or so. 

Caffeine or alcohol.  I don't drink any caffeine after lunch, after that it's water and milk with dinner.  Alcohol, maybe once a month but usually on the weekend.

Unfortunately I can't really change my schedule because of work.  I have to get up at 5:30 in order to get my son up and be ready to leave the house by 7. 

Stress may have a little to do with it.  I work for AT&T (now) which took over Bellsouth about a year or so ago.  I've been with the company for 11 years now and don't really want to change my job.  Mainly because I have the best benefits around.  Amazingly my Atripla only costs me $20.00 for 30 days worth.  Can't beat that!


I'll keep everyone posted on what I find out at the docs later this month.

[franfrog]

Brooke
I think everyone has had some good insight.  I know that since my diagnosis I have realized my fatigue level has gone beyond where I was.  Always had fatigue due to anemia.  Since on meds my anemia has been fixed but always seemed fatigued.  I did come to find I was suffering from depression and recently bipolar.  So far the meds seem to be working, I sleep horrible at night but do seem to be more energized in the morning and through out the day.  May want to look into that after speaking with your Dr. about other possabilities.

[tommy246]

Im on atripla and wasnt getting the quality sleep i used to i think the dreams seem so real  i wake up exhausted and toss and turn alot. So lately ive been exercising a little then taking a hot bath or shower and a relaxation herb tea before bed and am getting a sort of deeper better quality sleep.