Bone Health

Bone is a living organ. Throughout your life, the body removes old bone and replaces it. As you get older, the body is less able to do this, leaving bones thinner and weaker. Other things can also weaken bones, like smoking, low vitamin D levels, medication side effects, and having HIV. Osteoporosis means that the bones become porous, brittle, and subject to fracture. Osteopenia is a lack of bone minerals that can lead to osteoporosis.

HOW DOES HIV WEAKEN YOUR BONES?

HIV causes the body to remove old bone more quickly than normal and slows down the creation of new bone. In addition, certain HIV meds can weaken bones.

WHAT HAPPENS WHEN BONES WEAKEN?

When bones are weak, even a light fall can break them, leading to a major loss of function. For example, people with hip fractures have hip pain and cannot walk until they have surgery. Even after surgery, some people cannot walk as well as they used to. Broken bones can also lead to other health problems, and to death.

What you can do with your doctor

ASK IF YOU SHOULD GET YOUR BONE HEALTH CHECKED

People with HIV over 50 should get checked for weak bones, since they may not have any symptoms until a lot of damage has been done.  A bone density scan, sometimes called a DEXA scan, is a painless way to check your overall bone health. Even if you have little bone damage, getting a bone scan or other tests may be a good idea since they can give you a baseline to look at as you age.

 ASK IF YOU NEED TREATMENT

There are medications that can slow down bone loss and help the body build bone faster. Your doctor may also prescribe calcium and vitamin D, which the body can use to build new bone.

TAKE PILLS CORRECTLY

If your doctor recommends medications for bone health, take them as prescribed.

Bone treatments will not work if not taken correctly. Also, the lower your HIV viral load, the stronger your bones will be.

What you can do yourself

EAT A HEALTHY DIET

Our body uses calcium and vitamin D to build bones. A good diet can usually provide all your bones need to stay healthy. If you’re not sure your diet has enough calcium and vitamin D, ask a nutritionist.

EXERCISE

Exercise strengthens bone and lowers the chance of accidents and falls. Even a little bit of exercise helps, so any exercise is better than none. Simply walking and using stairs instead of elevators can help. Load-bearing exercise, (lifting weights or using weight machines) often called resistance training, has been shown to be particularly effective at improving bone strength, even in people over 70. If you are not sure where to start, see a physical therapist – don’t just join a gym without getting some training first.

DON’T SMOKE CIGARETTES OR DRINK TOO MUCH ALCOHOL

Smoking and too much alcohol weaken bone and cause many health problems. Too much alcohol is unhealthy.  People with HIV should have no more than one drink a day.  “One drink” means a bottle of beer, a glass of wine, or a shot of liquor, like gin or vodka.

It’s important to be honest with your doctor about how much you drink. Ask if that amount is right for you and be sure to drink safely (never while driving or using machinery). Also, ask if alcohol will interact with any of your meds.

A Sangarlangkam MD, R Havlik MD, S Karpiak PhD, J Appelbaum MD. Staying Healthy with HIV as You Age (2016). Published by the AAHIVM HIV Aging Consensus Project.

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