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Lipodystrophy and WastingLipodystrophy and Wasting
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B.I.A. testing
Sep 24, 2002

Dear Doc,

I have been having B.I.A.testing done for some years. The phase angle numbers were in the 7 range 7.4, 7.6, 7.9. I have experenced some recent GI problems and I believe I have wasted and lost weight. I did a B.I.A. test today and the phase angle was a new low of 6.9. I will repeat in a couple of weeks but if it is not back in th 7 range, I think I will discuss with my doctor some kind of short course of steroid use.

Should I use anything other than testosterone? Is there a preferred short course of intervention that I could discuss with my Dr. Thank you for your insight,

Getting skinny in Toronto.

Response from Ms. Fields-Gardner

Dear Getting Skinny,

While a lot of people put store in the phase angle calculation that is provided on many BIA reports, it means little when it comes to evaluating you as an individual and even less when it comes to deciding what kind of therapy to choose.

Phase angle is a ratio. This is a problematic evaluation for an individual because it can go up for both "good" and "bad" reasons and can go down for both "good" and "bad" reasons.

If your phase angle goes down, it can happen for one of three reasons:

1. muscle is down 2. hydration is up 3. fat is up

While we are not thrilled with muscle decline, the amount it declines on your BIA report to drop your phase angle by 0.1 points is not enough to even say that it has truly changed... the range of error is greater than that.

If hydration is up because you have an infection, then treatment for the infection is the right thing to do, not necessarily going for metabolic treatments. If you were dehydrated before and you did a good thing in getting hydrated, your phase angle will drop a bit... but it is not a bad thing!

If fat is up, the interpretation depends on the movement of other compartments and weight. If it is up because you have gained a little bit of weight, that is pretty normal. If you needed to gain some fat, you would consider it a good thing even though phase angle will drop.

I am not saying that you don't need metabolic treatment in your case. What I am saying is that you cannot base that decision on the change in a phase angle, particularly not such a small one.

Have someone interpret your report who is familiar with appropriate equations to estimate body compartments of body cell mass (BCM), extracellular mass (ECM), and fat. Make the decision on the amount of each of these compartments compared to appropriate goals for you.

As a final note, phase angle is valuable when evaluating larger groups of people or when getting an "eyeball view" of some significant change. You will still need to find out why phase angle has changed before you can connect it to a clinical decision. It is likely that there will be some problem if the phase angle is quite low (for men it means that it is less than around 4.5), but phase angle alone won't adequately characterize the problem and won't adequately point to a solution. Rather than make the wrong choices based on phase angle, you will have to find out why the changes have happened.

Best wishes!

Weight gain and muscle loss
Megace and Fat Gain

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