Published on Feb 06, 2020 and last reviewed on Feb 20, 2023 - 4 min read
Abstract
Osteopenia is a condition with weaker bones. It is commonly considered as the precursor of osteoporosis. Here in this article, we distinguished how osteopenia differ from other bone disorder, and clarified the causes, risk factors, symptoms, investigations and treatment of Osteopenia.
Osteopenia is when the bone density is low but not that severe as seen in osteoporosis.
Decreased bone density leads to an increased risk of fracture.
It commonly affects women above 65 years of age and postmenopausal women.
To diagnose osteopenia, the DEXA (Dual-energy X-ray absorptiometry) scan is an accurate method.
Osteopenia can be prevented by including food rich in calcium and vitamin D, avoiding smoking, and exercising regularly.
Osteopenia is not a disease, but it is when the bone density is lower than normal. The bone density starts to reduce after about 35 years of age. The amount of bone minerals present in your bone is measured with the help of bone mineral density (BMD). Osteopenia patients have lower BMD than normal. Although it is not considered a disease, it increases the chances of the individual developing osteoporosis, which can result in fractures, loss of height, stooped posture, and severe pain.
There are various precautionary measures that you can take to prevent osteopenia and osteoporosis. Regular exercise and healthy food choices help in keeping the bones strong. Osteopenia is frequently confused with other bone disorders, such as:
Osteomalacia - Vitamin D and phosphate deficiency leads to improper mineralization of newly formed bones.
Osteomyelitis - It is a type of bone infection.
Osteoarthritis - It causes inflammation of the joints due to the destruction of cartilage present in the joint.
Osteoporosis - It is when osteopenia becomes worse and the body loses too much bone minerals making them weak and brittle.
There are various factors that result in loss of bone density. The following are some of the risk factors:
Aging - As you age, old bones break down faster than the formation of new bones. As a result, bone density is lost. Most people older than 50 years have osteopenia.
Menopause - Menopausal women lose bone more quickly as their estrogen levels are low. Women who had menopause before 45 years of age are more susceptible.
A family history that is, any of your family members have low BMD.
Getting oophorectomy (ovaries removal) before menopause.
Not exercising regularly.
Consuming a diet that lacks calcium and vitamin D.
Smoking.
Other conditions, such as anorexia and bulimia, Cushing syndrome, hyperthyroidism, rheumatoid arthritis, lupus, and Crohn’s disease can increase the risk of osteopenia.
Excessive alcohol consumption.
Taking medicines like Phenytoin or Prednisone.
This condition does not cause pain until it results in a broken bone (bone fracture). As osteopenia does not result in pain, it often goes undiagnosed.
In rare cases, if osteopenia results in a hip fracture or fracture of a bone in the spine (vertebral fracture), it becomes very painful.
According to the National Osteoporosis Foundation, it is best to get your BMD regularly if you fall under the following categories:
Older women (age 65 or more).
Postmenopausal women (younger than 65 years).
Women who attained menopause before 45 years of age.
Postmenopausal women, who have broken their bone while performing normal day to day activity.
Although this condition commonly affects women, men above 50 years should also get their BMD tested.
DEXA test - The most common way to measure BMD is by dual-energy X-ray absorptiometry, otherwise called DEXA or DXA test. This test uses X-rays and is painless, and usually measures the bone density in the spine, hip, shin, wrist, or heel. The density value is then compared to the density of a 30-year-old individual of the same race and sex. Your doctor will use the DEXA result to diagnose you.
The following treatment options can strengthen your bones, slow the progression of osteopenia, and prevent osteoporosis:
Lifestyle Modification:
Exercise makes your muscles and bones get stronger. You can walk, climb stairs, dance, and lift weights regularly.
Consume a diet rich in calcium and vitamin D, such as dairy products, green vegetables, sardines, salmon, and tofu.
Spend a few minutes outdoors under the sun, as it helps your body make vitamin D.
Avoid smoking.
Do not consume alcohol in excess, as it alters the balance of calcium in your body.
Consume less salt.
Avoid overindulging on caffeinated drinks.
Your doctor will prescribe medications if you have already broken a bone, to reduce the chances of more fractures and osteoporosis. The following medicines can be prescribed:
Bisphosphonates (Alendronic acid, Ibandronic acid, Risedronic acid) - It slows down the process of bone breakdown. It prevents further bone loss and is commonly used to prevent osteoporosis in menopausal women.
Hormone replacement therapy (HRT) - HRT was previously used to prevent bone loss, but nowadays, doctors use it rarely as it results in severe side effects. Some of the side effects include blood clots in the legs and lungs and stroke.
Teriparatide - It is a type of hormone that is produced by your parathyroid glands. It helps the body in forming new bone, and it is injected daily under your skin.
Raloxifene - This drug is prescribed for postmenopausal women and patients taking glucocorticoids, as it prevents and treats osteoporosis. It also reduces the risk of you getting breast cancer.
Make sure you consult your treating doctor before taking any of these pills, as they all have some possible health risks and side effects. So learn about the possible side effects and then start taking them.
To help build stronger bones and prevent fractures, there are a lot of natural therapies available. The following are some options:
Calcium - The daily calcium requirement for adults is between 1,000 and 1,200 milligrams.
Vitamin D supplements - The daily vitamin D requirement for adults is 600 to 800 international units (IU). And spend a few minutes outdoors under the sun every day.
Other supplements - If you feel that your diet lacks calcium and you do not spend enough time outdoors, then you can include nutritional supplements, such as Boron, Copper, Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA), Dehydroepiandrosterone (DHEA), Folic acid, Vitamin B6 and B12, Manganese, Zinc, Silicon, and Strontium.
For more information on osteopenia, consult an orthopedician and traumatologist online.
Osteopenia can be fatal if the treatment is not provided sooner. Osteopenia itself is not that serious and can be treated. But without any treatment, it can lead to osteoporosis which can be fatal. Therefore the life expectancy in women of 75 years is 15 years and the same in men below the age of 60.
Some of the food products that can impact bone density include -
- Hydrogenated oil.
- Alcohol consumption.
- Soft drinks.
- Food rich in vitamin A.
- Consuming excessive amounts of salt.
Osteopenia is a progressive disease that affects bone density. Bones are living tissues that get degraded or resorbed with age. Therefore with other aggravating factors, such as the lifestyle of the patient, the amount of resorption increases, which can lead to osteopenia. This is usually seen in people after 50 years of age.
Osteopenia usually affects the bones of the person. However, it can also lead to other side effects, such as digestive problems and bone and joint pain. These symptoms can further make a person feel tired.
The primary objective of maintaining bone health is to make some changes in the lifestyle, which includes things like
- Monitoring the diet. Including food rich in vitamin D and calcium in the diet.
- Maintaining a healthy weight.
- Do not smoke or drink alcohol.
- Physical activities such as walking, running, and other weight-bearing activities can help strengthen bones.
Bone loss can be prevented with regular exercise such as walking. Walking helps in keeping the bones strong and reduces the risk of bone fractures in the future.
Bone loss can be prevented with regular exercise such as walking. Walking helps in keeping the bones strong and reduces the risk of bone fractures in the future.
Sunlight is a richer source of vitamin D. Vitamin D is considered essential for bone strength. Without vitamin D body cannot absorb calcium which helps in strengthening the bones of the body.
Some of the things that can be done to increase bone density are -
- Doing weight lifting and strength training.
- Eating more vegetables.
- Eating food rich in calcium, such as milk, cheese, yogurt, and some leafy greens, such as kale and beans.
- Maintaining a healthy weight.
- Eating food rich in vitamins D and K.
- Taking more protein in the diet.
- Eating foods rich in omega-3 fatty acids such as salmon, mackerel, nuts, and seeds.
- Avoid excessive drinking.
Women are more susceptible to diminished bone density in their bodies than males. Therefore, during a bone density test, a T-score of -2.5 or lower (-3.3 or -3.8) should go for treatment to avoid any fractures.
Fortified cereals are considered good in patients with bone problems. These cereals contain essential minerals and vitamins that help the brain function, strengthen bones, and increase immunity. In addition, cereals like raisin, bran, and bran flakes provide enough calcium in one serving to help with bone strengthening.
Vitamin D deficiency is the main reason behind impaired calcium absorption in the body. Without vitamin D, calcium does not get absorbed, leading to hypocalcemia (low calcium level), malabsorption, and malnutrition.
Last reviewed at:
20 Feb 2023 - 4 min read
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