Nelson Vergel
Founder, ExcelMale.com
Belly fat is out of control within the last two months
Hello,
I have been on Epzicom/tivicay for about 3 months and within the last month I have been bloated and constipated. When I eat anything my stomach blow up and I am unable to make a bowel movement. My ID doctor suggested some over the counter laxatives and prescribed me two different ones. Nothing seem to work and it is starting to look like I am 6 months pregnant. I have an apt 4 months from now with a GI doctor but what else can I until then. I have already tried switching from Epzicom to Truvada since I believe it's Epzicom but the Truvada and Tivicay wasn't a good fit for me.
Response from Mr. Vergel
This is one of the least talked about but very real side effects of starting integrase inhibitors. I have had this side effect as well as several of my friends when we started raltegravir (Isentress).
Luckily, it slowly resolves with time.
I was very bloated and gassy no matter what my diet was.
Merck listed gas as a side effect in their first phase 2 reports of raltegravir to later erase it from phase 3 reports. I am not sure why they did that.
I speculate that integrase inhibitors penetrate the intestinal tissue and gut associated lymphatic system (GALT) very well and this could create some sort of inflammatory response that slowly gets better as time goes by and homeostasis occurs. There may also be a shift in gut bacteria. However, these are my speculations since I have seen nothing on the subject.
I ate smaller meals, eliminated any milk products, eat more meat and fewer carbs (beans and broccoli would worsen bloating). I also took probiotics. My bloating lasted for 3 months. Friends have had the same experience.
Hang in there. Tivicay is probably the best HIV drug out there and is one that makes it worth it riding this side effect.
Even when raltegravir was used in HIV- people as PrEP, bloating was listed as a side effect:
"The most commonly reported symptoms among the volunteers receiving Isentress plus Truvada were nausea and/or vomiting (27 percent); diarrhea (21 percent); headache (15 percent); fatigue (14 percent); abdominal discomfort, including pain, gas or bloating (16 percent); and/or bone or muscle pain (8 percent)."
Hang in there. It is not easy to feel bloated since it gets in the way of any enjoyment of life and social interactions.
Nelson
