NAPWA

Symptoms

Considerable tiredness and ongoing lack of energy.

Causes

Fatigue may be a drug-related side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. of antiviralA medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. therapy or may be due to HIV disease itself. Fatigue can sometimes be caused by anaemiaA lower than normal number of red blood cells., but this is not the only cause of fatigue.

Other causes include:

• Inadequate diet along with gut disturbance problems which affect the absorption of nutrients for energy.
• Lifestyle, sleeping habits (insomnia) and lack of exercise.
• Depression and anxiety.
• Infections such as Mycobacterium Avium Complex (MAC), cytomegalovirus (CMV), or candidiasis.
• LiverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. problems, and adrenal and thyroid gland problems.
• Sensitivity to environmental toxins or allergies.
• Excessive use of alcohol.

Complementary & Supportive Therapy

Dietary supplements: B complex vitamins, Royal jelly, Panax ginseng and Coenzyme Q10.

Sleeping and lifestyle patterns: If insomnia or other sleeping problems are the cause, try to establish a routine for going to bed at a regular time, and include relaxation exercises before bed, or when you get into bed, as part of this routine. Establish healthy life habits, a balanced diet, and recreational and social activity.

Diet: Low glycaemic index (GI) foods may be included in every meal to promote a sustained source of energy for the body to use (eg. multigrain breads, high fibre cereals, certain rice types like Basmati and Doongarra, pasta, fruit, vegetables and dairy products.) Accept offers from friends and carers to help prepare meals if fatigue stops you from having the energy to cook. Prepare bulk meals and freeze for later use. Stock up on easy to prepare food, and keep high calorie snacks on hand such as dried fruit and nuts.

Medical & Drug Treatment

Medical and drug treatment depends on identification of the underlying causes.

Special Precautions & Considerations

• Panax ginseng is broken down in the liver by the same pathway used by protease inhibitors. This may result in high blood levels of protease inhibitors. Check with your doctor before using Panax ginseng if you are being prescribed protease inhibitors.
• Panax ginseng may, in some cases, increase blood pressure and should be used under supervision in consultation with your doctor, health care provider or professional herbalist.

Managing side effects