 
Up, Up and Away
There's no need to let HIV-related fatigue hold you down.
We all feel drained from time to time, but there's
a difference between feeling a little tired and the
condition known as fatigue. "Normal tiredness is what you feel after
walking half a mile if you're not used to it," says Lisa Capaldini, MD,
of the University of California at San Francisco. "Fatigue
is like the rug is pulled out from under you. You do
a minor activity, like shaving or packing your kids'
lunch, and you need to lie down."
Fatigue is no joke: It affects at least a third of people with HIV and
can interfere with work, relationships—even your ability to adhere to
your HIV meds. Everyone is at risk, from the just-diagnosed to HIV
veterans, but many people are reluctant to tell their doctors about
fatigue, thinking it's not that big a deal. Some misinformed docs
agree, saying it just comes with the HIV territory.
So what causes you to lose your juice? Likely culprits
are a blood condition called anemia, low levels of
the hormone testosterone and depression. But there
are many causes: opportunistic infections, poor diet,
physical inactivity, alcohol or recreational drug use,
lack of sleep. Plus various causes can interact. "Sometimes it's very difficult to identify a single culprit," says
Edwin DeJesus, MD, medical director of Florida's Orlando
Immunology Center.
The good news is that there are many effective fatigue treatments, from
potent meds to simple lifestyle changes. This last of our three-part
series on the evolution of HIV therapy explains fatigue's causes, its
treatment and how to keep your energy lifting you higher and higher.
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