What is Osteopenia?

Osteopenia refers to a condition where a person’s bone density, or bone mineral density (BMD) is measured as below average. This is not osteoporosis, and some people naturally have a lower BMD than others. It can be an indication that BMD is decreasing, and that osteoporosis will be the result.

Generally, when a person is 30, they have the highest possible measurement of bone mineral density. If at that age, BMD is already lower than average, the person is said to have osteopenia. As people age, and particularly as women reach menopause, they tend to lose some bone mass. Even if you have a good diet, exercise regularly and don’t smoke, osteopenia may occur. Both it, and osteoporosis are partly determined by genetics; bone mass density appears to be higher in certain populations. Women who are thin, Caucasian or Asian, are most at risk for both conditions.

There are usually no symptoms caused by osteopenia, since lower BMD doesn’t mean your bones are fragile enough to break. What is important is that women have a bone scan to evaluate BMD. One scan can measure whether you have osteopenia, but it cannot tell you the rate at which bone mass is being lost. If you have a lower BMD, you may need to have scans done yearly in order to evaluate the chances of developing osteoporosis.

An evaluation of BMD through bone scan is a quick series of x-rays called dual-energy x-ray absorptiometry (DEXA). Some people have bone scans done with computerized axial tomography (CAT) scans instead. DEXA is thought more accurate, and the level of radiation not any more risky than a basic chest x-ray. The DEXA process is so precise it can measure as little as a 2% below normal reading of BMD.

If you are diagnosed with osteopenia, you will be given information on changing your diet to include more calcium, ceasing smoking, and adding more exercise opportunities to your lifestyle. If a second scan a year later shows that your BMD is decreasing, you may also be given medication. There are several new ones on the market that help to slow and may even help to sustain bone density, like Boniva®.

A person with osteopenia does not necessarily develop osteoporosis, but it is true that most women begin to lose bone mass after the age of 30. Abstaining from smoking, avoiding caffeine, getting regular exercise, including not only aerobic work but also strength training, can help slow bone loss.

Sometimes osteopenia is the result of certain conditions. Chemotherapy, used for people with many different forms of cancer, can cause a lower BMD. If you take steroids for conditions like lupus, this may too, result in a below normal BMD reading. Medications for the treatment of seizures and bipolar disorders like Tegretol®, Dilantin®, and Neurontin® can all reduce bone mass. Usually, there’s no way to avoid taking these medications when you need them. Thus it’s important to embrace lifestyle changes so as not reduce your BMD further.

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