Osteopenia - Causes, Symptoms, Diagnosis, and Treatments

Quick Facts:

1. Osteopenia is when the bone density is low but not that severe as seen in osteoporosis.

2. Decreased bone density leads to an increased risk of fracture.

3. It commonly affects women above 65 years of age and postmenopausal women.

4. To diagnose osteopenia, the DEXA (Dual-energy X-ray absorptiometry) scan is an accurate method.

5. Osteopenia can be prevented by including food rich in calcium and vitamin D, avoiding smoking, and exercising regularly.

What Is Osteopenia?

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.

What Are the Causes and Risk Factors for Osteopenia?

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.

What Are the Symptoms of Osteopenia?

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.

How Is Osteopenia Diagnosed?

According to the National Osteoporosis Foundation, it is best to get your BMD regularly if you fall under the following categories:

1. Older women (age 65 or more).

2. Postmenopausal women (younger than 65 years).

3. Women who attained menopause before 45 years of age.

4. 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.

How Is Osteopenia Treated?

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.

Medications:

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:

1. 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.

2. 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.

3. 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.

4. 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.

Natural Therapy:

To help build stronger bones and prevent fractures, there are a lot of natural therapies available. The following are some options:

1. Calcium - The daily calcium requirement for adults is between 1,000 and 1,200 milligrams.

2. 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.

3. 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.