health info :: hiv treatment :: positive

Positive? How are you feeling?

January 2007 View PDF En español

Minding your body

Usually, your body tries to tell you when something is wrong. Paying attention to what it’s saying (or its symptoms) is the first step toward understanding the cause of what you’re experiencing. Then, you can identify ways to deal with symptoms and their causes and try to prevent them from coming back.

Some of the most common symptoms and problems of HIV disease are connected. For instance, feeling tired and losing weight can reinforce each other. Are you losing weight because you feel extremely tired or are you tired because you’re losing weight? Many symptoms can have the same cause, so once you find it they may all go away.

The next section explains these common conditions of HIV: fatigue, weight loss, diarrhea, cough, anemia, nausea and headache.

Everyday problems or something serious?
Weight loss, diarrhea, nausea, headache, cough—the list goes on. Some dismiss these as bothersome, everyday problems. Sometimes doctors do too. So even though they interfere with the day-to-day, it’s easy to fall into a routine where you just grin and bear it.

It’s important to get a handle on these conditions. If they persist or get worse, they could be signs of something more serious to come. They could also be side effects from your meds. Pay attention to these conditions. Monitor whether or not they get worse or happen frequently. You don’t have to feel bad all the time. Explore different ways to deal with problems like these. The first thing you try might not work, so don’t be discouraged and certainly don’t give up!

Fatigue
It’s not unusual to feel fatigued or have low energy, especially when life is hectic. But sometimes, fatigue is a symptom of weight loss, depression, malnutrition, hormone imbalances, lack of exercise, HIV itself, or anemia.

If you’re feeling more tired than usual, it’s important to figure out why. Fatigue can create a vicious cycle—the longer you stay in bed, the harder it is to get up. Sometimes fighting fatigue may involve taking small steps to be in bed less and be active more. Other times, the cause of fatigue can be more important and need more attention, as in the case of anemia.

Anemia
Anemia is low red blood cells. Those are the cells that deliver oxygen to different parts of your body. When your body is short on oxygen, you feel fatigued. Long-term or severe anemia can cause damage to your body.

Most people with HIV have anemia at some point. HIV causes it. So do many drugs used to treat HIV and hepatitis C. Lack of iron, vitamin B-12, or folic acid can also cause anemia. Problems with your periods can cause anemia, or problems with your periods can be a symptom of anemia.

Severe anemia can be life-threatening, particularly during pregnancy. However, even less severe anemia can feel just as bad so that getting out of bed can be a major chore.

It’s important to recognize symptoms of anemia. Blood tests can tell if your fatigue is due to anemia; if so, there are treatments to correct it. To monitor things like anemia, see a doctor and have regular blood work done at least every three months, even if you’re not using anti-HIV medication. Changes in daily diet and plenty of rest can ease symptoms of anemia and help you feel better.

Nutrition and other food tips

Fish, meat and poultry are high in iron and vitamin B-12, both of which lower risk of anemia.
Spinach, asparagus, dark leafy greens and lima beans are high in folic acid, another nutrient that lowers risk of anemia.
The BRAT Diet (Bananas, Rice, Applesauce and Toast) helps with nausea and diarrhea.
Keep easy-to-prepare foods on hand for times you’re too tired to cook.

Weight loss
Weight loss can be a serious problem in HIV disease. Unfortunately, even though symptoms can be obvious it’s not always seen as a problem. In fact, many positive women who lose weight because of problems due to HIV are praised and told they “look good.”

Losing weight can be a bad thing. If you’re losing weight, and it’s not because you altered your diet or exercise patterns for that purpose, it’s never a good thing. If you experience this, you should definitely talk to your doctor.

Nausea
Nausea, or feeling sick to your stomach, is common. Like diarrhea, it could be a drug side effect or indicate something else, like stress or an infection. Whatever the cause, it’s not easy to live with. If nausea happens a lot or lasts more than two days, tell your doctor.

While vomiting often accompanies nausea (and vice versa), they’re separate symptoms. If you experience one or both regularly, talk to your doctor. Anti-nausea drugs may help if you can’t find other ways to bring it under control. For more information on nausea, read Project Inform’s publication, Coping with Nausea, available through the National HIV/AIDS Treatment Infoline at 1-800-822-7422.

Diarrhea
Diarrhea is a common problem, even more common in HIV disease. In people with HIV/AIDS, it can be caused by infections like parasites or bacteria in the gut. It can also be caused by HIV itself, or by side effects from anti-HIV medications.

Aside from being annoying, the biggest concern is that diarrhea can make you dehydrated and lose weight. If it occurs regularly (for more than a week) or it’s accompanied by severe stomach pain, fever or your stools (poop) are black or bloody—or very pale and light—it’s important to let your doctor know immediately. It could be a sign of something serious.

Drinking lots of liquid like broth, water, or ginger ale when you have diarrhea helps prevent dehydration. Gatorade or Jell-O can also help. Avoid milk and fatty foods and try the “BRAT” diet (see Nutritional Tips). Any form of soluble fiber (foods that absorb liquid, like rice and oatmeal) can also be helpful.

Treating diarrhea without knowing its cause can do more harm than good. For example, diarrhea may be helping to eliminate an infection from your gut. In this case, taking medication to manage diarrhea may keep infections in your body longer. Anti-diarrhea medications like Lomotil, Leopectate, Immodium, or Pepto-Bismol can help ease diarrhea. So can bulking products like Metamucil. For more information on diarrhea, you can read Project Inform’s publication, Dealing with Drug Side Effects.

Headache
The most common cause of headache is tension, something most women have at some point! Medications, including anti-HIV drugs, can also cause headaches.

Mostly, headaches are just a pain and can be eased by over-the-counter painkillers like aspirin. They can also be helped and prevented by reducing stress. (If you have hepatitis or signs of liver disease, avoid using ibuprofen or the various brands of acetaminophen like Tylenol, as they can be hard on the liver.)

When headaches just don’t go away or become severe, it may indicate a more serious problem. Headaches with a stiff neck and fever can be a sign of a dangerous infection. Those that cause weakness or slurred speech can indicate a brain attack (stroke) and should be discussed with a doctor immediately.

Cough
We cough to get something out of our lungs that shouldn’t be in there or that is blocking normal flow of air, like toxic material from smoking or mucous from a cold or other infections. For normal coughs, lots of water can help. Over-the-counter meds can also help, as can breathing in moist air by taking a long, steamy shower or using a vaporizer.

Along with these typical causes of cough, people with HIV are vulnerable to certain lung diseases, like Pneumocystis carinii pneumonia (PCP). The signs of PCP include a dry cough that does not produce mucous, accompanied by shortness of breath and fever. Other serious lung infections that involve coughs are tuberculosis and bacterial pneumonia.

Got a bad cough?
You should see a doctor if any of the following occurs: