Visceral Fat Increasing on Isentress+Prezista+Intelence

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This is an email someone sent me...with my reply in color

I am writing to ask you a question. As you might remember, I have been poz for 20 years now. I have been resistant to every drug for 6 years now, and then became resistant to fuzeon as well. I was very sick last year for the first time (but my t-cells were near zero for 5 years so I was lucky before that). For the entire year of 2007, I had stomach problems where everything turned to diahrrea and I went from 180 pounds (which was overweight for me, male at 5'6") to 130. About 6 months ago I started on Prezista, Intelence and Insentress (with boosters of Norvir and Reyataz for the Insentress) plus Truvada (which I am resistant to). I have never had fat re-distribution before.After 2 months, my t cells started climbing and after the 3rd month I became undetectable for the first time in all my 20 years being poz. My t-cells now are about 210 (after 6 months). After my t-cells went up from zero to about 80 and my diahrrea went away, I started eating like a pig, and I mean so much that my stomach was sore and still I craved even more food (and usually ate it). Within the last 6 months since starting on these meds I went from 130 and am now at 216 pounds. I feel so fat. About 2 months ago, I started sweating heavily (all the time after eating but other times too after anything strenuous and sometimes for no reason at all), started getting a buffalo hump (first time ever) and as I said have gained a ton of weight. Now this last week I have notice small lumps under my skin (you cannot see them only feel them). On the legs, right above the knee-front of the leg (about 1") and bear the bi-cep (about 1/2") same place on both the right and left side.I also started getting a terrible pain in my left leg, the upper part above the knee to the crotch area and sometimes foot cramps. This started a week ago and I am limping now and it can be very sore, some days better than others. I know these MAY not all be related and some, like the leg soreness, could be from twisting a muscle.

Are you still eating a lot? Your problems sounds like increased appetite, immune reconstitution and possibly increased insulin resistance and production. Are you exercising? What is your weight and height, and waist size? I do not know much about your pain issue, but I would see a neurologist for sure.I am very afraid what is happening to me. I see Dr. Henry in Minneapolis and he basically tells me not to worry it's probably immune reconstitution, I saw another HIV specialist in Duluth who considered it might be Cushing's disease but thank God that turned out negative. My cortoid urine readings are fine, but my ACTH was lower than minus -5, which is not detectable ...so I am not producing any. Dr. Henry perscribed a very low dose cortisone pills for me (10 mg in morning, 10mg in aftenoon) because of the low ACTH, but I looked it up and it causes weight gain and sweating, which are 2 of my main symptoms so I did not start them yet. I have wondered about testosterone????

I would be careful about the corticoid steroids. Get your free testosterone, estradiol and thyroid function checked also. Normalizing your low ACTH may be a good thing but if you dose cortisone over what you need, you will get more bloated and fat, and may lose bone density also. You could also wait until you lose some weight by going on a diet and may be taking an appetite suppressant.

Also talk to your doctor about doing a glucose tolerance test on you. I would not be surprised if it comes back irregular.

I felt extremely hungry when I started Isentress and also got very bloated, but it all got better after 8 months or so.Can you offer any suggestions on what to do or what this all might be? It seems strange that the buffalo hump and fat redistribution would come now because I never had it after taking almost every other HIV pill for 19 years. I fear if this keeps happening I will look even more awful, not to mention what is happening to my body. Unfortunately I have no alternatives to drugs as these are the newest, but I can't let this situation get much worse. Thanks for your time, , I am very scared right now. The sweating is awful, the weight keeps going up, the hump is disgusting looking, and now the 4 small lumps and cramps in foot and leg pain (feels like a very bad twist). My weight is getting so much that I don't have the energy to do anything and even getting up from a chair seems harder. My doctor also perscribed Zoloft and I have been on it for about a week and a half and some of my energy is returning, that part may have been due to some depression. Any thoughts you might have would be greatly appreciated.

Are you taking any medications like diuretics for blood pressure? That can cause cramps associated to lower potasium levels.

Hopefully Zoloft will start normalizing your appetite (SSRIs tend to lower impulsive eating in many patients).

In summary, I would concentrate first on losing weight and normalizing your appetite. Go see a neurologist for the pain issues. Get the mentioned hormones tested.

If everything else fails, you may want to see if you can get a prescription for low dose growth hormone to decrease your fat. Sincerely SiegelMinnesota

Regards, VergelDirectorProgram for Wellness Restorationpowerusa dot orgLooking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos.