Fatigue

Fatigue is tiredness that doesn’t go away even with rest. It can be physical fatigue that makes it hard to do things. It can also be psychological fatigue where it is hard to concentrate or be motivated to do things.

Fatigue, like pain, is a warning signal from the body. Fatigue often creeps up slowly. People don’t notice how much it has changed their lives. People with HIV and fatigue together tend to get sicker than if they didn’t have the fatigue.

Symptoms

Signs of fatigue tend to be general. They include:

• Being less active
• Difficulty falling asleep or staying asleep
• Having a hard time concentrating
• Losing a sense of well-being
• Losing interest in daily activities or hobbies
• Muscle soreness
• Not feeling rested
• Shortness of breath
• Sleepiness during the day

Causes

Many things can cause fatigue, including:

• Active HIV infection. When HIV multiplies rapidly, the body uses a lot of energy to fight it. Taking antiretroviral drugs can help bring back energy.
• Anemia. With anemia, the body has to work harder to get the same amount of oxygen to the cells. As many as 80% of people with HIV infection have anemia.
• Depression, which saps the energy. This sets up a cycle of not wanted to be active or social, which means less stimulation for your mind and body.
• Not getting enough sleep
• Pushing the body further than it can go
• Too much caffeine or alcohol, especially close to bed time
• Infections. Even if there are no signs of infection, the body maybe fighting parasites, bacteria, viruses or allergies. With treatment, energy should improve.
• Lack of exercise. Being physically active may seem like the last thing a person who is fatigued wants to do. Often it is precisely the thing that brings back a person’s energy and liveliness.
• Low hormone levels. Especially in men, low levels of the sex hormone testosterone can cause fatigue. Low levels of other important hormones such as DHEA, cortisol or thyroid can also cause fatigue.
• Poor nutrition. Because people with HIV are fighting an infection, they need more energy than healthy people. Some anti-HIV drugs can cut the amount of some vitamin and minerals the body takes in. It’s important to eat enough of the right foods. Sometimes supplements may be needed.
• Smoking 

Prevention

Getting enough sleep, exercise and a balanced, healthy diet helps prevent fatigue. 

Diagnosis

Fatigue is a common for people with HIV. It is important for a doctor to have as much information as possible about the fatigue to make an accurate diagnosis. Blood tests can identify causes such as anemia. Other possible causes are more difficult to find. 

Treatment

Untreated fatigue can make HIV disease progress faster. If the cause can be found – anemia, infections, low hormone levels, etc. – it should be treated.

In some cases (such as with anemia), it may be necessary to change antiretroviral drugs. AZT, for example, can cause anemia. Changing to a different combination of drugs may get rid of the fatigue.

Managing lifestyle issues can help reduce fatigue and strengthen the body’s ability to fight infections and HIV. This can include:

• Eating properly. Well balanced diet with enough calories, protein, vitamins and minerals is important.
• Taking supplements if necessary. These might include vitamins and minerals that may be lost because of antiretroviral therapy.
• Getting enough sleep. Avoid drinking a lot of caffeine or alcohol, which can disturb sleep.
• Getting support for emotional issues of things that are worrisome.
• Getting enough exercise. This will improve sleep.