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Author Topic: Osteopenic or Osteoporosis?  (Read 6162 times)

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Offline Bunny

  • Member
  • Posts: 121
Osteopenic or Osteoporosis?
« on: July 17, 2012, 01:38:46 am »
Dear Friends,

I did a DEXA scan for my back pain. Reports reads as below.

The BMD measured at Femur ( Mean ) is 0.774g/cm2 with a T-Score of -2.3. This patient is considered osteopenic according to world Health Organization (WHO) criteria. Bone Density is 20-30% below young normal. Fracture risk is moderate. Please note the Lowet site Left Torochanter is -Osteoporotic  (Lt Troch) with T-Score -3.1 and BMD is 0.576 g/cm2


My next appointment to my doctor is on 21/07/2012.What care should I take to avoid fractures.

Please suggest me effective treatment to improve my bone density? I am from INDIA. I am on AZT+3TC+NVP. Is this caused due to my HIV medications or anything else.

Whom can I consult for this HIV Doctor or Ortho?
« Last Edit: July 17, 2012, 01:52:37 am by Bunny »
March 2019 - CD4 - 863

Offline spacebarsux

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  • Posts: 1,350
  • Survival of the Fittest
Re: Osteopenic or Osteoporosis?
« Reply #1 on: July 17, 2012, 02:49:47 am »
Please suggest me effective treatment to improve my bone density? I am from INDIA. I am on AZT+3TC+NVP. Is this caused due to my HIV medications or anything else.

Whom can I consult for this HIV Doctor or Ortho?

Hi Bunny, in such situations, I think it's best to first speak with your HIV doctor and perhaps get a referral off him to see an orthopedic specialist.

Best
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline friskyguy

  • Member
  • Posts: 109
Re: Osteopenic or Osteoporosis?
« Reply #2 on: July 17, 2012, 05:50:12 am »
No need to worry as bone mass decline is gradual and I noticed you will be seeing your HIV doctor later this month. Remember you have osteopenia only and not the more serious osteoperosis which requires more urgent attention.

I recently had a DEXA scan and was diagnosed as having osteopenia as well. This is very common in HIV patients currently on meds and those who have yet to start treatment.

I was advised by my doctor to continue to get enough VitD3, calcium and weight bearing exercise and follow up with another DEXA scan in 2 years time. Blood tests will determine if you are deficient and if supplements are warranted.

Thebody.com has some uselful information on low bone density in HIV patients and is worth reading. You can also do some investigation on the internet as to whether your current meds may be contributing to the problem and/or ask your HIV doctor at your next meeting. Truvada can be a contributing factor.

Good luck
Sero converted Sept '10 / Confirmed + Dec '10
Jan '11, VL 9,500 / CD4 482 (32%)
Feb '11, VL 5,800 / CD4 680 (37%)
start Atripla
Mch '11, VL UD / CD4 700 (42%)
Jun  '11, VL UD / CD4 750 (43%)
swap to Kivexa and Efav. due to osteopenia diag. (DEXA) / kidney issues ( decline in eGFR to 77 )
start supplements - Vit D3 / Omega 3 / multivitamin / mini aspirin
Dec '11,  VL UD <20 /  CD4 670 (49%)  / CD4:CD8 = 1.4
all labs now within normal ranges
Mch '12,  VL UD / CD4 600 (51%)
Sep '12,  VL UD / CD4 810 (51%)
Mch '13   VL UD / CD4 965 (56%)
Sep '13   VL UD / CD4 (not taken)
Dec '13   VL UD / CD4 901 (35%) / CD4:CD8 = 1.1  /  eGFR > 100

Offline BT65

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Re: Osteopenic or Osteoporosis?
« Reply #3 on: July 17, 2012, 07:37:31 am »
Osteopenia is like a precursor to osteoporosis, which is what I was diagnosed with.

Usually, calcium w/ D is what doctors recommend.  I was prescribed something, but am taking so many meds now, I decided to just stick with the calcium w/ D.  My doctor told me to take it twice a day.

I'm sure your doctor will have recommendations for you.  Try not to worry.
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Offline Mishma

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  • Posts: 234
  • HIV drugs are our Allies but hardly our Friends
    • Marquis de Vauban
Re: Osteopenic or Osteoporosis?
« Reply #4 on: July 18, 2012, 02:27:53 pm »
I can empathize with you. About 10 years ago I had osteopenia so bad I had to crawl to the bathroom it hurt so bad to walk. It hurt to lie in bed and it hurt when I sat down. My wife felt so sorry for me she bought me a lounge chair-which she hated (the chair that is).

My osteopenia was due to years of high dose predisone for autoimmune thrombcytopenia and hemolytic anemia. I can't remember the protease inhibitor or NRTIs I was on at the time.


My doc had me eating Tums for the calcium. Weight bearing exercise is still one of the best ways to keep your bones strong (and it is free). Good luck I hope it resolves soon.
« Last Edit: July 18, 2012, 02:30:42 pm by Mishma »
2016 CD4 25% UD (less than 20). 30+ years positive. Dolutegravir, Acyclovir, Clonazepam, Lisinopril, Quetiapine, Sumatriptan/Naproxen, Restasis, Latanoprost, Asprin, Levothyroxine, Restasis, Triamcinolone.

Offline dpb

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Re: Osteopenic or Osteoporosis?
« Reply #5 on: July 18, 2012, 08:12:51 pm »
Last year, I too was diagnosed with osteopenia.  It came as quite a surprise being that I was only a 23-year-old male. 

I currently take a Calcium/Vitamin D (600MG/400IU) supplement twice daily with food, and a 50,000 IU Vitamin D supplement once weekly.  I am no longer Vitamin D deficient and now have normal levels. As other posters have noted, weight-bearing exercise is also very important for bone health (in addition to muscle strength, coordination, balance, and overall health).  I just started again a few weeks ago and I'm glad I did.
Date        CD4    %    VL
1/15/11    Diagnosed
3/1/11    525    18    168,518
5/12/11    558    16    331,791
5/16/11    Started Atripla
5/31/11    NA    NA    1,200
6/15/11    721    21    330
7/15/11    649    23    231
8/15/11    569    25    UD
11/17/11  752    26    UD
3/1/12    634    27    UD
7/2/12    594    26    UD
2/13       676    30    UD
9/13       662    31    UD

Offline Common_ground

  • Member
  • Posts: 292
Re: Osteopenic or Osteoporosis?
« Reply #6 on: July 19, 2012, 07:53:02 am »
Last year, I too was diagnosed with osteopenia.  It came as quite a surprise being that I was only a 23-year-old male. 

I currently take a Calcium/Vitamin D (600MG/400IU) supplement twice daily with food, and a 50,000 IU Vitamin D supplement once weekly.  I am no longer Vitamin D deficient and now have normal levels. As other posters have noted, weight-bearing exercise is also very important for bone health (in addition to muscle strength, coordination, balance, and overall health).  I just started again a few weeks ago and I'm glad I did.

dpb, did your doc mention why you developed osteopenia?

Did you find out by looking at blood/urine samples or xray bone scan?
2011 May - Neg.
2012 June CD4:205, 16% VL:2676 Start Truvada/Stocrin
2012 July  CD4:234, 18% VL:88
2012 Sep  CD4:238, 17% VL:UD
2013 Feb  CD4:257, 24% VL:UD -viramune/truvada
2013 May CD4:276, 26% VL:UD

2015 CD4: 240 , 28% VL:UD - Triumeq
2015 March CD4: 350 VL: UD

Offline dpb

  • Member
  • Posts: 89
Re: Osteopenic or Osteoporosis?
« Reply #7 on: July 19, 2012, 10:15:50 am »
dpb, did your doc mention why you developed osteopenia?

Did you find out by looking at blood/urine samples or xray bone scan?


I saw a nutritionist who tested my vitamin levels, and I believe that is when my primary care physician noticed I was Vitamin D deficient.  That led to a DEXA scan which showed I was osteopenic.  I don't recall my doctor stating exactly why.  I also discussed it with my infectious disease doctor to see if Atripla could be causing it or contributing, and the various tests she did came back as normal from my understanding.  Atripla may have an effect, but since taking supplements my vitamin levels are in the healthy range again.

When I was a boy, I remember seeing a chiropracter who off-hand believed I was Vitamin D deficient based on having very chapped lips, and prescribed me supplements.  My primary doctor believes I was likely deficient for some time and osteopenic for a while as well.  Several years ago I suffered a stress fracture at 18 during one of my first jobs (from no apparent injury).  Last fall I broke a finger wakeboarding (still not sure exactly how), and later routine X-Rays of my spine revealed a "stable, old T-11 compression fracture" which may have happened from a four-wheeler accident I was in several years ago.  I've always had a somewhat slender frame with 'smaller bones', and my diet, nutrition, and fitness growing up were very, very poor.

Thankfully, my diet has improved significantly.  I'm more health conscious now and eat better in addition to vitamin supplements and routine physical exercise.
« Last Edit: July 19, 2012, 10:18:14 am by dpb »
Date        CD4    %    VL
1/15/11    Diagnosed
3/1/11    525    18    168,518
5/12/11    558    16    331,791
5/16/11    Started Atripla
5/31/11    NA    NA    1,200
6/15/11    721    21    330
7/15/11    649    23    231
8/15/11    569    25    UD
11/17/11  752    26    UD
3/1/12    634    27    UD
7/2/12    594    26    UD
2/13       676    30    UD
9/13       662    31    UD

Offline Bunny

  • Member
  • Posts: 121
Re: Osteopenic or Osteoporosis?
« Reply #8 on: July 20, 2012, 02:09:51 am »

@dpb,@friskyguy,@Common_ground, Friends Thank you so much  for your comments....

@ Mishma...How is your health now? Do you able to walk now?

On my HIV Doctor's suggestion I have visited a referral doctor. He prescribed me some tablets.

osteofos 35 ( alendronic Acid ) - 35 mg ( with 200 ml water empty stomach weekly once for 8 weeks only Sunday preferably  )

tayo 60K ( choleclaciferol I.P 60,000 IU)- (weekly once empty stomach for many years Wednesday Preferably)

shelcal-HD ( Calcium 500mg+Vitamin D3-500IU) - (Daily once for many years  )

Besides my HIV medicines I am going to swallow these pills. Please can any one find out any interaction with my current HIV medicines or any other serious side effects will cause with these tablets as I already suffered so many side effects. If some one have any better supplements please suggest me.

And he suggested to Physiotherapist, but I am not afford all these, so I decided to stick my HIV+Osteo medicines and simple exercises like walking, running, jogging.
« Last Edit: July 20, 2012, 02:12:26 am by Bunny »
March 2019 - CD4 - 863

Offline Assurbanipal

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  • Posts: 2,177
  • Taking a forums break, still see PM's
Re: Osteopenic or Osteoporosis?
« Reply #9 on: July 20, 2012, 11:00:02 am »
Hi Bunny

There's a number of us with osteoporosis that are on the bisphosphonates (like alendroic acid) and taking the vitamin D and calcium supplements.  Most of the threads on it are in the treatment and side effects forum -- if you do a search on "osteoporosis" you'll find a number of us. ( My thread about finding out I had it was here http://forums.poz.com/index.php?topic=23815.0  It has some useful links in it.)

There's also a section in the lessons. https://www.poz.com/basics/hiv-basics/hiv-bones

Generally there don't seem to be a lot of interactions between the HIV meds and the osteoporosis drugs and supplements.  You need to listen to your own body, but try not to worry.  For me the main issue was in finding out about it and getting on the right drugs -- recently it doesn't seem to get in the way of much.

Be well
Assurbanipal

« Last Edit: May 07, 2019, 11:33:12 am by iana5252 »
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

 


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