Downsides to testosterone replacement therapy include the potential for liver toxicity and, when used by women, masculinizing effects. Synthetic forms of anabolic steroids are also available. These therapies have been studied in both men and women, although little is known about their effects on people with HIV disease or on HIV replication. However, the preliminary results have been encouraging enough that these agents are being prescribed for people with low levels of testosterone as well as people who are suffering from unexplained weight loss. Side effects and toxicities associated with long-term use of synthetic steroids include liver toxicity, liver cancer elevated triglyceride levels and heart disease.
Synthetic steroids can also cause masculinization in women.
Psycho-stimulants are other medical approach to treating fatigue. Ritalin, Cylert and dexedrine are amphetamines that are used principally to treat attention-deficit disorders and are also being studied for the treatment of fatigue. Insufficient amounts of certain vitamins and minerals, as well as proteins and calories can lower energy levels. Low levels of vitamins B-12, A, C, folate, beta carotene and the mineral zinc are often associated with fatigue. In people with HIV disease, the level of these nutrients are often below normal.