How Can I Fix Unintended Weight Loss?

Nelson Vergel


I am a sixty plus year old woman with HIV-1. I was diagnosed October 18,2001. Two years after starting my medication regime I was given Atripla and have been on it ever since. This year I began loosing weight intentionally but now over the last 4 to 5 months I have loss of appetite and have lost over 40 pounds. I think or to me it looks like I have wasting syndrome because I ma loosing muscle mass. Both of my physicians are out of town for the next couple of weeks. I had labs drawn last month but am unable to get the results to see how my numbers. Typically my numbers are great. HIV, undetectable and CD4 count 1000 yes one thousand. So far it's been going very well but now I'm afraid the Atripla is becoming ineffective. It's been a great run for me. Almost 14yrs. If I have to change meds what would you recommend? Although I am disabled because I was dx with COPD and was unable to run the halls as a RN I know the importance of taking your meds every day. My Doctor did put me on a drug holiday five years ago or so for one year until my numbers started trending upward. Like I said Atripla worked very well for me and the only side effect I am experiencing isPeripheral Neuropathy and I don't think that the atripla had much to do with it. I began having the symptoms in the beginning when he tried me on sustiva and, viread and epiveare. It is severe and I do have a pain management doctor that I see.

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Response from Mr. Vergel
I am sorry to hear about your unintentional weight loss, COPD and neuropathy.
It is not uncommon for patients with COPD to have unintentional weight loss.Atripla in it self is not known to decrease appetite or weight unless you are not sleeping well and fatigue gets in the way of your eating. If that is the case, you may want to talk to your doctor about switching you to an integrase inhibitor based regimen that may not have interactions with your COPD drugs.
The use of oxandrolone, an oral anabolic researched in men and women with HIV to treat unintentional weight loss, has been proven to be effective in improving weight in people with COPD: Reversal of COPD-associated weight loss using the anabolic agent oxandrolone.
Body cell mass repletion and improved quality of life in HIV-infected individuals receiving oxandrolone
It is covered by insurance in the United States with a pre authorization from a doctor. Talk to your doctor about this drug and let me know.
Another potential treatment for appetite gain is dronabinol (used to be called Marinol before it went generic). It is a prescription and legal drug that contains the main active compound in marijuana (THC). It increases appetite but can make people stoned like marijuana. But since you have COPD, smoking medicinal marijuana is out of the question. THC oil has been studied also in COPD with good results in appetite and wellbeing. (Source: Lecture by K-C Bergmann on 17 March 2005 at the Meeting of the German Society of Pulmonology in Berlin).
An Overview of Dronabinol
Concentrate in the mean while to eat high calorie foods like peanut or almond butter, nuts, cottage cheese, yogurt, cheese, meats, beans, sweet potatoes, etc
Please let me know how things go soon. Good luck and know we are here to help at
In health,
Nelson Vergel

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