Fatigue Management

What is Fatigue?

Tiredness (fatigue) is the tiredness that does not disappear when you rest. It can be physical or mental.
With physical fatigue, muscles can not perform any activity as easy as before. We may notice this when you climb stairs or carry bags of groceries.

With psychological fatigue, we can not concentrate as before. If more severe, might not feel like getting out of bed in the morning and doing your daily work.

Is Fatigue That Important?
Fatigue is one of the two main ways the body warns you about a problem. Another way is to feel pain. We usually pay attention to pain, and stop whatever causes. But we do not consider fatigue as pain. One reason for fatigue to get worse gradually, so we do not notice it.

HIV and fatigue more quickly tend to become more ill than people without fatigue. Constant fatigue can also weaken the immune system. HIV-positive people should know what causes fatigue and how fatigue can be treated.

HOW DO I KNOW IF I HAVE FATIGUE?
A
Fatigue can start and increase very slowly. If you feel tired even after a break, we should talk to your doctor about fatigue. Provide maximum information to the doctor. This will make him know if you are tired, and why. Here are some questions to think about before we discuss our fatigue problems with the doctor:
* How long have you been tired?
* Compared to a few months ago, whether the level of physical activity we change?
* How do we feel when tired? Are we feel hard to breath? Sore muscles? Difficulty remembering or concentrating? Difficult to build attention for everyday activities?
* When are we tired? Was after a certain activity, like climbing stairs? Did we wake up tired?
* How do we sleep? How long do you sleep each night? How many times do we have to get up? Was it difficult to sleep or stay asleep because of itching, pain, or other problems?

What Causes Fatigue, Fatigue Treated and How?
Fatigue can be caused by diverse factors. We should work together with your doctor to determine the cause of fatigue and how best to treat it.

HIV infection is active: When HIV multiplies rapidly, your body uses a lot of energy to fight HIV. Most people have more energy after they started antiretroviral therapy (HAART).

Other active infection: Other infections can tire you out, even without obvious symptoms. Parasites in the digestive system, bronchitis, other infections and allergies can cause fatigue. If these infections are treated, your energy should go up.

Poor nutrition: people with HIV need more energy than healthy people. If we are not getting enough nutrients, your energy level will be low. Diarrhea can remove nutrients from our body and cause fatigue. For more information, see Fact Sheet (LI) of 554 diarrhea, LI 600 and LI nutrition of vitamin 601. If possible, meet with a dietitian who knows about HIV disease to discuss your eating habits. For some people, vitamin B12 or better nutrition can eliminate fatigue.

Anemia: (see Fact Sheet 552) The main task of red blood cells is to remove oxygen from the lungs to all parts of the body. If we do not have enough red blood cells, or if the red blood cells do not carry enough oxygen, fatigue may be caused by anemia. A simple blood test can show whether you have anemia.

If you have anemia, your doctor will determine what the cause. Anemia may be caused by loss of blood, bone marrow damage caused by anti-HIV or vitamin deficiency, or due to lack of the hormone erythropoietin that helps the formation of red blood cells.

Low hormone levels: sex hormone testosterone deficiency can cause fatigue and lack of sexual desire and other normal activities, especially in men. Lack of other important hormones such as DHEA (see fact sheet 724), cortisol, or thyroid can cause similar problems. Hormone levels can be checked with blood tests. Pills, patches, creams, or injections can increase hormone levels.

Depression: (see fact sheet 558) This is more than just feeling sad. Changes in brain chemistry can cause fatigue and lack of interest in daily activities. There is no blood test for depression. Possibilities are depressed are higher if previously diagnosed with depression, have a history of alcohol or drug use is heavy, or our families have a history of emotional illness. Depression can be treated. However, some antidepressants can cause problems with sexual function. Also, some antidepressants can interact with ARVs, so antidepressants should be used with caution.

Lifestyle: It is important we get enough sleep. Habits such as smoking or drinking lots of coffee can interfere with sleep. Regular exercise can help us sleep.