A person with osteopenia has a lower than normal bone mineral density (BMD). The BMD measure is a measure of how much mineral is present in your bones and how strong they are. Although osteopenia does not mean you have osteoporosis, which can cause fractures and deformities, it does increase your risk of developing osteoporosis in the future. The causes, symptoms, diagnosis, treatment, and prevention of osteopenia are therefore important to learn.
Age is one of the main causes of osteoporosis. As you age, your body breaks down old bones more quickly than it builds new ones, so you lose some bone density over time. This process starts around age 35 and accelerates after age 50, especially in women going through menopause.
Some other factors that can cause or worsen osteopenia are:
Medical conditions that affect bone metabolism, such as hyperthyroidism, hyperparathyroidism, Cushing’s syndrome, inflammatory diseases, and eating disorders.
Medications that interfere with bone formation or increase bone loss, such as corticosteroids, anticonvulsants, antacids, and some cancer treatments.
Hormonal changes that reduce estrogen or testosterone levels, such as menopause, removal of ovaries, or low testosterone in men.
Poor nutrition that lacks calcium and vitamin D, which are essential for bone health.
Unhealthy lifestyle choices that include smoking, drinking too much alcohol or caffeine, and being physically inactive.
There are often no symptoms of osteopenia until it progresses to osteoporosis. You may not experience any pain or changes in your appearance. However, some people with osteopenia may experience bone pain or weakness.
A bone mineral density test uses X-rays to measure the density of your bones in different parts of your body, such as your spine, hip, wrist, or heel. The test is painless and takes only a few minutes.
Bone mineral density is measured by a T-score. This score compares your bone density with that of a healthy 30-year-old person of the same gender and race. The lower your T-score, the lower your bone density.
According to the World Health Organization (WHO), the T-score ranges for different levels of bone density are:
Normal: T-score above -1.0
Osteopenia: T-score between -1.0 and -2.5
Osteoporosis: T-score below -2.5
It is possible that your doctor will also use another tool called FRAX to estimate your 10-year risk of having a fracture due to low bone density. FRAX takes into account your age, gender, weight, height, family history, medical history, and lifestyle factors.
The main goal of treating osteopenia is to prevent it from progressing to osteoporosis and reduce the risk of fractures. Treatment options include:
There are several medications that can slow down bone loss or stimulate bone formation. These include bisphosphonates, selective estrogen receptor modulators (SERMs), hormone therapy (HT), calcitonin, denosumab, teriparatide, and romosozumab.
Calcium and vitamin D supplements that provide adequate amounts of calcium and vitamin D for your bones. The recommended daily intake of calcium for adults is 1,000 to 1,200 mg per day. The recommended daily intake of vitamin D for adults is 600 to 800 IU per day.
A healthy lifestyle includes quitting smoking, limiting alcohol and caffeine intake, eating a balanced diet rich in fruits and vegetables, and exercising regularly.
The best way to prevent osteopenia is to start taking care of your bones early in life. You can do this by:
Getting enough calcium and vitamin D from food or supplements throughout your life.
Doing physical activities that put stress on your bones and muscles at least three times a week for 30 minutes each time.
Avoiding smoking and excessive alcohol and caffeine consumption.
Having regular check-ups with your doctor and getting screened for osteopenia if you are at risk.
Rather than being a disease, osteopenia is a warning sign that your bones are deteriorating. The causes, symptoms, diagnosis, treatment, and prevention of osteopenia can help you protect your bones and prevent osteoporosis. You can never too late to take care of your bones and improve your quality of life.
