Osteopenia

Overview
If you have osteopenia, you have lower bone density than normal. Your bone density peaks when you’re about 35 years old.

Bone mineral density (BMD) is the measurement of how much bone mineral is in your bones. Your BMD estimates the chances of breaking a bone from a normal activity. People who have osteopenia have a lower BMD than normal, but it’s not a disease.

However, having osteopenia does increase your chances of developing osteoporosis. This bone disease causes fractures, stooped posture, and can lead to severe pain.

You can take action to prevent osteopenia. The right exercise and food choices may help keep your bones strong. If you have osteopenia, ask your doctor about how to keep it from worsening so you can prevent osteoporosis.

Osteopenia symptoms
Osteopenia doesn’t usually cause symptoms. Losing bone density doesn’t cause pain.

Osteopenia causes and risk factors
Aging is the most common risk factor for osteopenia. After your bone mass peaks, your body breaks down old bone faster than it builds new bone. That means you lose some bone density. Women lose bone more quickly after menopause. If you lose too much, your bone mass may drop low enough to be considered osteopenia.

About half of Americans older than age 50 get osteopenia. The more of these risk factors you have, the higher your risk is:

being female, with small-boned women of Asian and Caucasian descent having the highest risk
family history of low BMD
being older than age 50
menopause before age 45
removal of ovaries before menopause
not getting enough exercise
a poor diet, especially one lacking calcium and vitamin D
smoking or using other forms of tobacco
drinking too much alcohol or caffeine
taking prednisone or phenytoin
Certain other conditions can also increase your risk of developing osteopenia:

anorexia
bulimia
Cushing syndrome
hyperparathyroidism
hyperthyroidism


Diagnosing osteopenia
Who should be tested for osteopenia?
The National Osteoporosis Foundation recommends that you have your BMD tested if you’re:

a woman age 65 or older
younger than 65, postmenopausal, and have one or more risk factors
postmenopausal and you’ve broken a bone from normal activity, like pushing a chair to stand up or vacuuming
Your doctor may recommend that you have your BMD tested for other reasons. For instance, about one in three white and Asian men older than age 50 have low bone density.

DEXA test
Dual-energy X-ray absorptiometry, called DEXA or DXA, is the most common way to measure BMD. It’s also known as a bone mineral density test. It uses X-rays that have lower radiation than a typical X-ray. The test is painless. DEXA usually measures bone density levels in your spine, hip, wrist, finger, shin, or heel. DEXA compares the density of your bone to the density of a 30-year-old’s of the same sex and race. The result of a DEXA is a T-score, which your doctor can use to diagnose you.

Osteopenia treatment
The goal of treatment is to keep osteopenia from progressing into osteoporosis.

The first part of treatment involves diet and exercise choices. The risk of breaking a bone when you have osteopenia is fairly small, so doctors don’t usually prescribe medicine unless your BMD is very close to the osteoporosis level. They may talk to you about taking a calcium or vitamin D supplement, although generally, it’s better to get enough of each from your diet.