December 2002
Osteopenia / Osteoporosis

Osteopenia is mild to moderate loss of bone mineral density (BMD). This means that your body is breaking down and using your bone minerals faster than it is making new bone cells. This makes your bones weaker and more susceptible to breaking.

Osteoporosis is severe loss of bone mineral density. Causing bones to get very thin and lose their strength. This raises the risk of breaking bones not only from falls but also even from minor stress put on bones from everyday work and play.

Under normal circumstances old age, sex hormones and weight are the natural factors that influence these problems. But some diseases, medications and even bad habits can interfere with how our bodies break down and build the cells we need to build strong bones. Unfortunately HIV is one of these diseases. It is becoming evident that people with HIV are experiencing a lot more bone loss than HIV negative individuals. Some researchers have shown that up to 55% of HIV positive individuals could have bone density problems to some degree. In the past this problem was seen most often in post-menopausal women. This occurs in women when their bodies stop the production of estrogen, which helps protect our bones. But now we are seeing it in young women and even men who are HIV-positive. There is some evidence that people on HAART have more bone density loss than those not on treatment but other studies have found equal rates of bone mineral loss within the groups. Which indicates that the virus itself increases our risk of bone mineral density loss. Most often in our lower backs. It remains unclear what exactly is causing the bone loss in HIV patients. We do know that factors like PCP treatment, low testosterone or estrogen levels, alcohol abuse, weight loss and lack of exercise help to cause decreases in bone mineral density in all people.

There are things we can do to help prevent or minimize bone loss.

• Do weight-bearing exercises. (be careful of your back)
• Eat a good well rounded diet (not junk food, it doesn’t count except in fats and calories)
• Take vitamin supplements including calcium every day.
• Stop smoking and reduce excessive alcohol intake.

Since there are no symptoms that tell us we have Osteopenia or Osteoporosis most people are totally unaware they may have a big problem. There is a test that your medical provider can do to check your bone mineral density (BMD) it is called a DEXA scan. It is a non-invasive test that takes about 15 minutes. If the results show a problem providers can prescribe medications that can help treat the condition. Also we as pro-active participants in our own health (hint-hint) will have a better idea of the needs our bodies may have. We can make needed adjustments for better health and be aware of how careful we should be during work and play. (Nobody wants to be broken !)

Take care of your whole self my friends, be happy. Erica

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