From the Guidelines
Osteopenia is a condition characterized by low bone mass, where your bone density is lower than average, but not low enough to be classified as osteoporosis, putting you at an increased risk for fractures. This condition is defined by a T-score between −2.5 and −1.0, according to the World Health Organization (WHO) criteria 1. It's essential to understand that osteopenia is often a precursor to osteoporosis and can be managed with lifestyle changes and, in some cases, medication. To put it simply, osteopenia is like an early warning sign that your bones are losing their strength, which can happen naturally as we age, especially after age 50.
Key Points to Understand About Osteopenia
- Osteopenia is diagnosed using a dual-energy X-ray absorptiometry (DXA) scan, which measures bone mineral density (BMD) 1.
- The condition is characterized by a T-score between −2.5 and −1.0, indicating lower than average bone density but not low enough to be classified as osteoporosis.
- Osteopenia increases the risk of fractures, although the risk is not as high as with osteoporosis.
- Lifestyle changes, such as increasing calcium and vitamin D intake, engaging in regular weight-bearing exercise, avoiding smoking, and limiting alcohol consumption, can help manage osteopenia.
Managing Osteopenia
To manage osteopenia, it's recommended to:
- Increase calcium intake to 1000-1200mg daily through foods like dairy products, leafy greens, and fortified foods, or supplements if needed.
- Ensure adequate vitamin D levels, aiming for 800-1000 IU daily, to help the body absorb calcium.
- Engage in regular weight-bearing exercise, such as walking, jogging, or resistance training, to stimulate bone growth.
- Avoid smoking and limit alcohol consumption, as these can worsen bone loss.
- Consider bone-strengthening medications if recommended by a doctor, although this is not always necessary for osteopenia.
It's crucial to understand that osteopenia itself doesn't cause symptoms, and regular bone density testing is essential, especially for women after menopause and men over 70, to monitor bone health and prevent further bone loss 1.
From the Research
Definition of Osteopenia
- Osteopenia is a term used to define bone density that is not normal but also not as low as osteoporosis 2
- According to the World Health Organization, osteopenia is defined by bone densitometry as a T score -1 to -2.5 2
Causes of Osteopenia
- There are many causes for osteopenia, including calcium and vitamin D deficiency and inactivity 2
- Genetics plays an important role in a person's bone mineral density, and often Caucasian women with a thin body habitus who are premenopausal are found to have osteopenia 2
Treatment of Osteopenia
- Correction of calcium and vitamin D deficiency and walking 3 to 5 miles a week can often improve bone density in the hip and spine 2
- A variety of pharmaceutical agents have been recommended for the treatment of osteopenia and osteoporosis, including hormone replacement therapy, selective estrogen receptor modulator therapy, and anti-resorptive therapy 2
- Bisphosphonates, such as alendronate, have been shown to reduce fractures in women with osteoporosis and may also be effective in women with osteopenia 3