What is Osteopenia?

Osteopenia is a condition characterized by bone mineral density lower than normal but not low enough to be classified as osteoporosis. It signifies reduced bone density, potentially increasing the risk of fractures. Common causes include aging, hormonal changes, inadequate calcium or vitamin D intake, and certain medications. Osteopenia often lacks noticeable symptoms, making early detection crucial through bone density tests like DXA scans. Lifestyle modifications such as regular exercise, a balanced diet rich in calcium and vitamin D, and avoiding smoking and excessive alcohol intake can help manage osteopenia. In some cases, medication may be prescribed to prevent further bone loss.

What’s the difference between Osteopenia vs. Osteoporosis?

Osteopenia and Osteoporosis are both conditions that affect bone density, but they differ in severity.

Osteopenia is a condition where bone mineral density is lower than normal but not low enough to be classified as osteoporosis. It indicates a weakening of the bones but is not as severe as osteoporosis. Individuals with osteopenia are at a higher risk of developing osteoporosis if preventive measures are not taken.

Osteoporosis, on the other hand, is a more severe condition characterized by significantly reduced bone density and increased bone fragility. It puts individuals at a much higher risk of fractures, even with minor trauma or falls.

Osteopenia is a milder form of bone loss, while osteoporosis is a more advanced and severe condition associated with a greater risk of fractures and complications.

How common is Osteopenia?

Osteopenia is fairly common, especially among older adults. It's estimated that about half of adults aged 50 and older in the INDIA have osteopenia based on bone density testing.

However, prevalence rates can vary depending on factors such as age, sex, race, and lifestyle habits. Women, especially postmenopausal women, are more likely to develop osteopenia and osteoporosis due to hormonal changes that affect bone density.

Symptoms and Causes?

What are osteopenia symptoms?

Osteopenia typically doesn't cause noticeable symptoms in its early stages. In fact, many people may not realize they have osteopenia until they experience a bone fracture or undergo a bone density test, such as a DXA scan, for other reasons. However, as bone density decreases, some individuals may experience:

Recurrent bone fractures, especially with minimal trauma or falls.
Back pain, caused by compression fractures in the spine.
Loss of height over time, due to vertebral compression fractures.
Stooped posture or curvature of the spine (kyphosis), resulting from vertebral fractures.

It's important to note that these symptoms are more commonly associated with osteoporosis, the more severe form of bone loss. If you're experiencing any of these symptoms, especially if you're at risk due to factors like age, sex, or medical history, it's essential to consult with a healthcare professional for proper evaluation and management. Early detection and intervention can help prevent further bone loss and reduce the risk of fractures.

What causes osteopenia?

Osteopenia usually happens naturally as you age. Your bones are living tissue like any other part of your body. It might not seem like it, but they’re constantly growing, changing and reshaping themselves throughout your life.

Most people lose some bone density as they get older. Your bones are densest around age 25 and start breaking down faster than your body can rebuild them after that. This natural decline doesn’t cause issues in most people. However, if you lose too much bone density, you can develop osteopenia, which may mean you’re more likely to have osteoporosis later in your life.

What are the risk factors?

Anyone can develop osteopenia, but some groups of people are more likely to have it, including:

Adults older than 50.
People assigned female at birth (AFAB). People AFAB are four times more likely to have osteopenia than people assigned male at birth (AMAB).
People who are in postmenopause.
People who smoke or use tobacco products.
People who regularly drink alcohol (more than two drinks per day).

Some health conditions can lower your bone density or worsen osteopenia, including:

Hyperthyroidism.
Diabetes.
Chronic kidney disease (CKD).
Malnutrition.
A calcium or vitamin D deficiency.
Hormonal imbalances (like Cushing syndrome).
Anorexia and other eating disorders.
Autoimmune diseases that affect your bones (like rheumatoid arthritis or collagen defects).

Medications that can increase your osteopenia risk include:

Diuretics.
Corticosteroids.
Medications used to treat seizures.
Hormone therapy for cancer (including to treat breast cancer or prostate cancer).
Anticoagulants.
Proton pump inhibitors (PPIs, like those that treat acid reflux, which can affect your calcium absorption)

Osteopenia diet ;

To get enough calcium and vitamin D, eat dairy products such as cheese, milk, and yogurt. Some types of orange juice, breads, and cereals are fortified with calcium and vitamin D. Other foods with calcium include:

Dried beans
Broccoli
Wild freshwater salmon
Spinach

The goal for people with osteoporosis is 1,200 milligrams of calcium a day and 800 international units (IU) of vitamin D. However, it isn’t clear whether this is the same for osteopenia..

Osteopenia exercises ;

Walking, jumping, or running at least 30 minutes on most days will strengthen your bones if you have osteopenia, are a young adult, or are a premenopausal female. These are all examples of weight-bearing exercises, which means you do them with your feet touching the ground. While swimming and biking may help your heart and build muscles, they don’t build bones. Even small increases in BMD can significantly reduce your risk for fractures later in life. However, as you get older, it becomes harder for you to build bone. With age, your exercise should emphasize muscle strengthening and balance as well. Walking is still great, but now swimming and biking count, too. These exercises can help reduce your chances of falling. Talk with your doctor about the best and safest exercises for you.

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 a 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 ?

A DEXA (Dual-energy X-Ray Absorptiometry) test is a type of bone density scan that measures the mineral content and density of your bones, typically focusing on the hip and spine. It is the most commonly used method for diagnosing osteoporosis and assessing the risk of fractures. During the test, you lie on a table while a scanner passes over your body, emitting low-dose X-rays. These X-rays are absorbed differently by bones and soft tissues, allowing the technician to measure bone density.

DEXA scans are quick, non-invasive, and painless, and they expose you to only a small amount of radiation. The results of the test are usually reported as a T-score, which compares your bone density to that of a healthy young adult of the same gender. A T-score of -1 and above is considered normal, between -1 and -2.5 indicates osteopenia, and -2.5 and below indicates osteoporosis.

The DEXA scan results help healthcare providers evaluate your risk of fractures and determine whether lifestyle changes, medications, or other interventions are needed to improve bone health and reduce fracture risk. It's an essential tool for early detection and management of osteoporosis and related conditions.