Osteopenia is a condition where bone density is below average, but not low enough to be osteoporosis. It can be an indication of decreasing bone mass and can occur even with a healthy lifestyle. Women are at higher risk, and bone scans can help assess the condition. Lifestyle changes such as exercise and diet can help slow bone loss, and medication may be necessary in some cases. Certain conditions and medications can also cause osteopenia.
Osteopenia refers to a condition in which a person’s bone density, or bone mineral density (BMD), is measured as below average. This is not osteoporosis and some people naturally have lower BMD than others. It can be an indication that BMD is decreasing and that osteoporosis will be the result.
Generally, by the time a person is in their 30s, they have the highest possible measurement of bone mineral density. If at that age, the BMD is already below 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 eat a good diet, exercise regularly, and don’t smoke, osteopenia can occur. Both this and osteoporosis are partly determined by genetics; bone mass density appears to be higher in some populations. Thin women, whether Caucasian or Asian, are at increased risk for both conditions.
There are usually no symptoms caused by osteopenia, as lower BMD does not mean your bones are fragile enough to break. What is important is that women have a bone scan to assess BMD. A scan can measure whether you have osteopenia, but it can’t tell you how quickly bone mass is lost. If you have a lower BMD, you may need to have annual scans to assess your chances of developing osteoporosis.
An assessment of BMD through bone scan is a rapid series of X-rays called dual energy X-ray absorptiometry (DEXA). Some people have bone scans done with computed tomography (CT) scans instead. DEXA is thought to be more accurate and the radiation level is no more risky than a basic chest X-ray. The DEXA process is so accurate that it can measure up to 2% below the normal BMD reading.
If you are diagnosed with osteopenia, you will be provided with information on how to change your diet to include more calcium, stop smoking, and add more exercise opportunities to your lifestyle. If a second scan a year later shows your BMD is declining, you may also be receiving medication. There are several new ones on the market that help slow down and may also help support bone density, such as Boniva®.
A person with osteopenia doesn’t necessarily develop osteoporosis, but it’s true that most women start losing bone mass after age 30. Abstaining from smoking, avoiding caffeine, and 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 lower BMD. If you take steroids for conditions like lupus, that too could result in a below-normal BMD reading. Medications for the treatment of seizures and bipolar disorders such as Tegretol®, Dilantin® and Neurontin® can reduce bone mass. Usually, there is no way around taking these medications when you need them. So it’s important to embrace lifestyle changes so you don’t reduce your BMD further.
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