Question
How do I know if my meds are causing bone problems?
1 July 2011. Related: All topics, Living with HIV long-term, Side effects, Supplements and herbs.
I am HIV + on treatment, and have been exercising at the gym for a few years. I have recently noticed pain in my hip and wondered if this could be down to the meds. I have not been working out any harder than usual, in fact i have been toning down my sessions. I’m worried about the impact of ARVs on my bones.
I wondered whether it might be an idea to start taking a calcium supplement and whether this would have any impact on the meds?
Answer
Without knowing your age and other risk factors it is difficult to comment on whether you are likely to have bone problems or whether this is just a normal injury that will clear up in a few days.
Lots of things are related to bone health, including HIV, but one of the most important ones is age. In the general population the risk of fractures increases with age (especially over 65). For HIV positive people, bone loss seems to happen earlier (perhaps increasing after 50).
A higher proportion of HIV-positive people have bone disease (defined by low bone mineral density) than HIV-negative people, but this is also common in the general population.
Bone disease is more rare in younger people (under 30) unless they have been HIV positive for a long time.
Also, weight-bearing exercise, running and walking all help your bone health because the pressure on the bones causes more new bone cells to be produced. So your bones may be stronger than you think. Calcium levels are easy to test and may already be done routinely at your clinic. your doctor may already have this information as there is no point taking supplements if you don’t need them.
Speak to your doctor who knows your medical history and who can decide whether you need other tests, or supplements. This is always recommended for any symptom, and certainly anything that causes prolonged discomfort or pain. If you do need calcium supplements, they will not interact with your HIV drugs.
This link has more information about bone health and HIV, including other risk factors.
This study indicated that HIV meds in general (all drugs, all combinations) improve nearly every part of your health except your bones.
Again though, in general, this is something that can be picked up by a lab tests but may be too small to be clinically relevant – meaning it doesn’t related to having worse day-to-day risk of bone breaks of fractures.
This link includes recent studies that reports higher risks in HIV-postive compared to HIV-negative people, but luckily, the fracture risks were still low in both groups, and may only become apparent in older HIV-postive people.
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