Osteopenia: Early Signs of Bone Loss


About 18 million Americans have osteopenia. Osteopenia refers to early signs of bone loss that can turn into osteoporosis. With osteopenia, bone mineral density is lower than normal. However, it is not yet low enough to be considered osteoporosis.

Not everyone who has osteopenia develops osteoporosis with its painful, debilitating fractures. But osteopenia can turn into osteoporosis if it is not diagnosed early and promptly treated. Osteoporosis can result in easily fractured bones and other very serious bone problems. It can also cause disfigurement and lead to loss of mobility and independence.

How can my doctor determine if I have osteopenia?

Bone health is measured in two ways. The first is bone density. Bone density defines the thickness of your bone. The second is bone mass. Bone mass means how much bone you have.

What does my doctor measure to determine my bone density and risk for osteopenia?

To find bone density, your doctor measures the levels of minerals in your bones. These minerals include:

  • calcium
  • phosphate
  • other minerals

The denser the content of your bone mineral is, the stronger your bones are.

With aging, your body absorbs back calcium and other minerals from your bones. This reabsorption can make your bones weaker and lead to osteopenia and osteoporosis. The bones become more vulnerable to fractures and other damage.

At what age does bone mass start to decline?

Bone mass, or the amount of bone you have, usually peaks around age 30. Then bone mass begins to decline. Your body starts to reabsorb bone faster than new bone can be made.

How do I know if I'm at risk for osteopenia or osteoporosis?

Most people with osteopenia don't know it. In fact, the first sign may be a broken bone. A broken bone may mean that the condition has already become osteoporosis.

What are some risk factors for osteopenia and osteoporosis?

Risk factors for developing osteopenia are the same as those for developing osteoporosis. They include:

  • being female
  • being thin and/or having a small frame
  • getting too little calcium in the diet
  • smoking
  • leading an inactive lifestyle
  • a history of anorexia nervosa
  • a family history of osteoporosis
  • heavy alcohol consumption
  • early menopause

For in-depth information, see WebMD's Self-Test: Check Your Risk.

How can my doctor test for osteopenia and osteoporosis?

The most accurate way to diagnose osteopenia and osteoporosis is through bone mineral density testing. This is usually done with a dual-energy X-ray absorptiometry (DEXA) scan.

DEXA scan results are reported as T-scores:

  • Normal bone: T-score above -1
  • Osteopenia: T-score between -1 and -2.5
  • Osteoporosis: T-score below -2.5

Other tests can be done to help diagnose osteoporosis and osteopenia. Quantitative ultrasound is one such test. It measures the speed of sound in the bone to assess bone density and strength. DEXA scans are usually still needed to confirm results from ultrasound and other tests.

Who should get a bone density test?

Experts advise that you receive regular bone density scans in these cases:

  • You are a woman 65 or older.
  • You are a woman 60 or older with certain risk factors. Low body weight is considered the most important risk factor.

There are no clear guidelines for when to begin screening for women between 60 and 65 who have no other risk factors. Nor are there specific guidelines for women under 60 who have additional risk factors. That's why it's important to work with your doctor to determine a screening plan to meet your needs.

How is the female athlete triad related to osteopenia and early bone loss?

The female athlete triad is a combination of three medical conditions that are becoming increasingly common in women athletes. These conditions are eating disorders, amenorrhea or lack of menstrual periods, and osteopenia or low bone mass. These issues are of growing concern mainly because of the media's increased pressure on teens to maintain a "perfect" body weight and be thin.

Female athletes who compete in gymnastics, dancing, swimming, skating, and running are at high risk for the female athlete triad as they strive to appear lean and fit.

We know that more female athletes lack a menstrual period than women in the general population. Not having a period is associated with decreased estrogen levels. Decreased estrogen levels may be the cause of low bone mass or osteopenia.

Low-calorie diets are usually the first predictor of eating disorders. Excessive exercise or exercise obsession can be another sign of an eating disorder. Each of these three problems must be medically evaluated and treated to ensure a good outcome for the woman.


How can I prevent osteopenia and osteoporosis?

Osteopenia is every woman's concern -- no matter what your age or health status. That's because osteopenia is the first step to full-blown osteoporosis or severe bone loss.

Moreover, fractures don't wait until you have osteoporosis. The risk of fractures increases when your bone density decreases. Once you have just one fracture , you are at a greater risk for more fractures. The good news is that osteopenia can be prevented or reversed before fractures occur. Here are some prevention tips:

  • Eat a balanced diet. Include plenty of calcium and vitamin D. You'll find these nutrients in foods like milk, yogurt, cheese, and broccoli.
  • Exercise regularly. Choose weight-bearing exercise like walking, running, or tennis. Also do strength training using weights or resistance bands.
  • Avoid smoking.
  • If you drink, do so in moderation.
  • If you have gone through menopause, talk to your physician about the newer osteoporosis medications.

Fri, 26 Nov 2010 @13:42

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