Both men and women have that famous hormone testosterone—known in the biz as T. If you don’t have enough of it, life gets rough: You can develop fatigue, wasting, depression and flagging libido. It’s hard to determine how prevalent low testosterone is among people with HIV, but it’s common enough that you should get screened if you’re feeling fatigued.
For men, the fix is easy: supplemental testosterone in a shot, gel or patch. For women, it’s trickier. Even though low-dose testosterone is safe and effective, it can cause hair growth and deepen the voice—in that case, switching to an even lower dose can help. Testosterone therapy works best, along with exercise, for people with low natural levels. There’s no evidence that “supraphysiologic” doses (higher than the normal range) provide extra benefits, and they may even be harmful.
Testosterone isn’t the only hormone you need to feel energized. Low levels of hormones produced by the adrenal and thyroid glands can also leave you listless. Luckily, both are easy to treat once your doc figures out the problem: synthetic steroids called corticoids (like hydrocortisone) for flagging adrenal hormones and daily thyroxine pills for low thyroid levels.
Screen It and Treat It
Screen It… • To find out if you have low T, your doc will measure your total and “free” testosterone. “Free,” or active T, is key. • To check up on your adrenal glands, your doc can do an ACTH stimulation test. It measures how adrenal glands respond to the hormone cortisol. • Hypothyroidism (underactive thyroid) or hyperthyroidism (over-active thyroid) can both cause fatigue. Thyroid tests measure three hormones produced by the thyroid gland.
...and Treat It • You can take additional testosterone via shot, gel or patch, which stimulate red-blood-cell production and improve energy. Aspiring he-men be warned: Big doses can be harmful—follow your doc’s guidance. • If adrenal glands are the reason you feel like you have no gas in your tank, your doc may give you synthetic steroids in pill form. • If low thyroid levels are the cause, you may need daily thyroxine pills.