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Is this bad news? (phase angle)
Dec 13, 2002

I finally have gotten a phase angle done. This was my first so there is nothing to compare it to. I am positive for 10 years with high cd4's (900's) undetectableVL (with meds). I eat a very high protein diet complemented with an array of vegatables and fruits and good grains. I do about 4-5 hours of cardio a week (running with intervals) and also resistance (free weights) and body sculpting (pilates, crunches) three times a week. I thought I was the picture of health with the exception of a lower belly "pooch" and my extra fat (it's pinchable) hangs out there. My lipids are great and so's the blood sugar. All my numbers are great.

The problem is the phase angle...For what I do I think it's really bad. It's 5.4...does this mean that inspite of my intense efforts on all fronts my cells are dying anyway??? Is there anything I can do that I'm not already doing that can get my phase angle higher...I'm very upset....Thank you

Response from Ms. Fields-Gardner

First off, you cannot depend on a phase angle to tell you what is going on... only that something is an issue to be explored. For those of you tuning in late on the phase angle discussion, we are talking about a bioelectrical impedance analysis (BIA) test that is typically done to determine body composition and becoming a more common test in HIV care.

Depending on which machine you use, you will be able to ferret out a phase angle number which is calculated from two other numbers: resistance and reactance. The number is a ratio and reflects changes that happen in resistance or reactance numbers. Ratio-based evaluations are a bit problematic because they can go up for "good" or "bad" reasons, just as they can go down for "bad" or "good" reasons.

We generally expect a man with good health and physical condition to have a phase angle better than 6.0 and a woman's phase angle is expected to be higher than 5.0. A level of 5.4 isn't "really bad"... it is just a bit lower than the goal.

But, when it is lower it doesn't necessarily point to a particular problem (as you mention cell death). Here are reasons why phase angle can drop:

decrease in body cell mass (muscle and organ tissues) increase in extracellular mass (reflecting fluid changes) increase in fat

So, while you should be concerned about body cell mass (BCM) loss, you will have to look to that evaluation to see if you fall into a normal range or if there is a deficit. With your description of your regimen and the assumption that your weight is okay, it is unlikely that this particular item will be your problem.

If the culprit is an increase in extracellular mass (ECM or ECT), then you might look to a couple of items: minor infection or injury. Overexercise or even taking the test too soon after an exercise session will result in this reading because of an increase in peripheral (arms and legs) fluids seen during exercise. Low grade infections, while not apparently a viral load issue in your case, can come and go with very little in the way of noticable symptoms even though the BIA is very sensitive to fluid changes and will pick it up.

If it is fat increasing, the good or bad of it really depends on where that is happening and if you could use it. You really do need some fat on the body in order to maintain hormonal normality, but if fat is deposited elsewhere it could be a bad thing. You don't mention any significant change in body shape for fat, so I am not sure that is the obvious suspect.

What you really need is someone to interpret your test appropriately using your estimates of BCM, ECM, and fat and comparing them to expected values. Expected values are based on your height (an accurate one) and your weight along with sex (male, female, or transgender). While age doesn't enter into the equations, it is a consideration for clinical evaluation.

In addition, if it has been a little while since that test, get another one done so that you can compare results.

Best wishes!!


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