Author Topic: Unexplained fatigue - should I go on meds now even with good lab numbers ? (Read 6779 times)

madbrain · « **on:** June 21, 2007, 10:26:03 pm »

Hi,

Since mid-may, I have had unexplained fatigue. About 2 to 3 times a week, I become suddenly very weak. I become very hungry and nearly faint. I don't lose consciousness, but I definitely need to sit or lie down. This states usually lasts at least a few hours. After that, I am usually better. It has happened doing random activities such as sitting at the computer, playing the piano, pushing the cart at the grocery, driving.

I have also had some diarrhea several times a week, which is very rare for me. My primary physician who is an HIV specialist has run many blood tests and urine tests. So far, nothing has come back unusual. I haven't changed my diet or sleep patterns, though they have never been the healthiest. I get an average of 8 - 9 hours of sleep, though the actual number varies between 3 and 15.

On some days I am just fine. And sometimes, the next day I feel like shit, literally. Even if I don't faint, I have days where I am very sleepy/tired even after getting a good nights rest and proper food.

I only work 3 days a week at this time, so I am definitely not overworked. But even so, I am having a hard time functioning.
My latest labs from april 30 are 738 tcells and 2400 VL. They have been pretty stable since I tested poz. I am not due for the next labs until early august. I am not on HIV meds at this time. I tested poz last nov and have probably had the virus for about a year (last neg test june 06). My doctor only has 2 remaining theories - one is that the fatigue is a side effect of my depression, and the other is that the fatigue is HIV related, which he says can happen even with good numbers.

I am bipolar and have been depressed many times in my life, and I know I have never been this tired before, and certainly never experienced the sudden energy drops that I have lately. This is really debilitating. I tried energy drinks but it doesn't help. I just turned 31 a couple days ago and it's been nearly 6 weeks since this started.

My doctor offered me to go on HIV medication last week. But he said once I start, there is no going back and stopping them. This is somewhat of a bet for me to take at this point because I am not sure they will help. I am giving myself a few more weeks to decide. I am not about worried about meds cost or obtaining them. I am more worried about the short-term and long-term side effects. I saw my bf get more fatigued on atripla than without - he is in the process of changing meds, the doc said it was due to the sustiva component. Our virus is the same and has no resistance to any drugs, so we both have all medication options available.

What would you do in my shoes ? Go on meds now ? Wait it out ? Or look for some other cause?

RapidRod · « **Reply #1 on:** June 21, 2007, 11:08:48 pm »

I would go with the response from your doctor since your CD4 are still in the normal range.

sweetasmeli · « **Reply #2 on:** June 22, 2007, 01:35:39 am »

From my understanding, with a CD4% like you have, you shouldn't even be considering meds at this stage.The fatigue could be down to a number of things totally unrelated to HIV and with a % of 40 it most likely is. So if I were you I would, as you put it yourself, wait it out and look for some other cause.

Melia

milker · « **Reply #3 on:** June 22, 2007, 11:02:07 am »

With numbers like this I wouldn't go on meds. Like your doctor said, once you start, it's for life, so I would wait..

Have you checked your testosterone levels?

Milker.

madbrain · « **Reply #4 on:** June 22, 2007, 11:07:12 pm »

Milker,

Yes, the doctor had the testosterone level checked and it was normal.

Robert · « **Reply #5 on:** June 23, 2007, 01:46:59 am »

Quote from: madbrain on June 21, 2007, 10:26:03 pm

I have also had some diarrhea several times a week, which is very rare for me. My primary physician who is an HIV specialist has run many blood tests and urine tests. So far, nothing has come back unusual.

YOu say your Dr has run lots of tests? Ask him specificaally about your iron levels. Along with this diarrhea have you had any blood with your stools? Hemoroids? I had that problem and it turns out I was very, very aenmic due to loss of blood. A year ago I couldn't walk up from the garage.

Maybe that's the problem.

robert

bimazek · « **Reply #6 on:** June 23, 2007, 02:39:50 am »

when i get fategue i take extra multi vitamins and so far it seems to work
but i am new
i take 2 to 3 x the daily dose or more
definately helps in my opiinion

RapidRod · « **Reply #7 on:** June 23, 2007, 05:38:15 am »

bimazek, Flintstone vitamins don't count. Don't ever take more vitamins than what is suggested without first contacting your doctor.

sweetasmeli · « **Reply #8 on:** June 23, 2007, 05:56:42 am »

Quote from: RapidRod on June 23, 2007, 05:38:15 am

Don't ever take more vitamins than what is suggested without first contacting your doctor.

And a suitably qualified nutritionist.

Melia

Matty the Damned · « **Reply #9 on:** June 23, 2007, 06:39:32 am »

As always Roddles and Miss Melia are quite correct. Supplements are only of any value when one's diet is deficient in vitamins and minerals.

Indiscriminate and carefree use of vitamin supplements can be harmful. For example, vitamins such as A & D can be quite toxic when used to excess. So are things like selenium.

The wisest way to ensure an adequate vitamin and mineral intake is through a sensible balanced diet and if you need advice about such things then as Melia suggests it's best to consult an appropriately qualified nutritionist/dietician. Ask your doctor for a referral.

Regards,

MtD

jordan · « **Reply #10 on:** June 23, 2007, 06:51:26 am »

I was diagnosed in February 2006 and immediately started a HAART regimen. One of my complaints was fatigue.......I had my testerone level checked - came back normal.

I was eating normally, working and getting enough rest.....so I don't know why I was fatigued. Then I started therapy to help me cope with all of the shock of being diagnosed and adjusting (I don't see a therapist anymore) and shortly thereafter I started feeling better.

So in my case my fatigue was psychosematic (i.e., was caused by my depression from being diagnosed and thinking my life was over). I felt like life wasn't worth living and then I came to realize that I can still do everything I've done before and more

Therefore, in my case, it was accepting myself and dealing with shame issues that I had. I haven't had fatigue since and the only thing I changed was my attititude

Peace,

Jordan

J.R.E. · « **Reply #11 on:** June 23, 2007, 02:15:02 pm »

I would continue to bring this, to your doctors attention. Ask your doctor what further blood test can be done.

Have any of these been checked ?----Check your testosterone, Check your Iron levels for anemia, Check for diabetes ?

EDITED : You should probably avoid those energy drinks. They may help you a little, but then they end up zapping your energy

Ray

J.R.E. · « **Reply #12 on:** June 23, 2007, 02:19:32 pm »

Forgot to add this. From the lessons ;

http://www.aidsmeds.com/articles/Fatigue_7533.shtml

Ray

otherplaces · « **Reply #13 on:** June 23, 2007, 03:34:50 pm »

You don't mention an exercise regimen. It's worth considering before you take the meds plunge. Your numbers are so good I'd personally investigate some other options before starting meds. Fatigue can be a vague head game. It could be the virus, but also just knowing you're fighting the virus could counter the fatigue. For me, running and lifting weights has done alot to counter fatigue and depression.

Just a thought.

brian

madbrain · « **Reply #14 on:** June 25, 2007, 11:14:10 pm »

Quote from: Robert on June 23, 2007, 01:46:59 am

YOu say your Dr has run lots of tests? Ask him specificaally about your iron levels. Along with this diarrhea have you had any blood with your stools? Hemoroids? I had that problem and it turns out I was very, very aenmic due to loss of blood. A year ago I couldn't walk up from the garage.

Maybe that's the problem.

robert

I was checked for anemia through hemoglobin levels rather than iron levels. I haven't had hemorroids recently, although I have them once in a while.

madbrain · « **Reply #15 on:** June 25, 2007, 11:23:17 pm »

Hi,

Quote from: bimazek on June 23, 2007, 02:39:50 am

when i get fategue i take extra multi vitamins and so far it seems to work
but i am new
i take 2 to 3 x the daily dose or more
definately helps in my opiinion

I have been on a vitamin and supplement regimen for a while, which is being supervised by my doctor. Nothing changed in that regimen in the last few months.
- centrum . This was the daily multi recommended by the doctor.
- 800 IU vitamin D . I have a vitamin D deficiency so I need some extra.
- 1g calcium. It is needed to absorb the vit. D. And I don't get much from my diet.
- 2400 mg omega-3 . Helps with mood and cardiovascular
- 300mg magnesium. I get very regular constipation a lot and this is supposed to help. I have been on it for 4 months. It could be the cause of the diarrhea. Haven't tried stopping it.
- selenium 200 mcg. This is because of the studies that came out about the benefits on lowering VL for HIV positive people.

madbrain · « **Reply #16 on:** June 25, 2007, 11:24:18 pm »

Hi,

Quote from: J.R.E. on June 23, 2007, 02:15:02 pm

I would continue to bring this, to your doctors attention. Ask your doctor what further blood test can be done.

Have any of these been checked ?----Check your testosterone, Check your Iron levels for anemia, Check for diabetes ?

EDITED : You should probably avoid those energy drinks. They may help you a little, but then they end up zapping your energy

Ray

Testosterone was checked, anemia through another test, diabetes too.

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Author Topic: Unexplained fatigue - should I go on meds now even with good lab numbers ? (Read 6779 times)