Osteopenia
Osteopenia is when your bone's density (or strength) is lower than normal. A test measures this and is called a DEXA scan (a scan measuring bone mineral density). Osteopenia is similar to osteoporosis, although a milder form. In osteoporosis, the density of the bone becomes even lower and puts the bone at risk of breaking. If you have osteopenia and your bone density continues to decrease, it can lead to osteoporosis. As we age, our bones naturally become less dense. However, this particularly accelerates in women after menopause due to decreasing levels of estrogen, which helps to protect bone strength.
Calcium is a mineral that helps make and keep our bones strong. It is particularly important as it can help slow the loss of bone density and can help prevent osteopenia. You get calcium from your diet from foods such as dairy products, leafy green vegetables, and soybeans or foods fortified with calcium, such as certain cereals. Vitamin D is also important for bone strength as it helps your body absorb calcium. Your body makes vitamin D from direct sunlight exposure, or if this is not possible (such as in the winter months in the US), you can take vitamin D supplementation. Other ways to help improve bone strength include regular exercise (weight-bearing exercise can help strengthen bones) and avoiding smoking or excessive alcohol intake.
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How do I know I have osteopenia or are at risk of it?
Osteopenia does not cause any symptoms, so you may not notice you have it. Your doctor usually picks it up on a DEXA scan, or if you are at risk, you may be put on treatment to avoid developing osteopenia or osteoporosis.
You are more at risk of osteopenia if you are a woman, you’ve gone through menopause early, you are taking or have had a long course of steroids, if you have a very low body weight (BMI less than 18.5), or you have a family history of osteoporosis. Certain chronic medical conditions may also increase your risk of osteopenia, such as kidney disease, an eating disorder, or celiac disease. Even though it is more common in women, men can also develop osteopenia.
What can I do to prevent osteopenia?
You can implement lifestyle changes to reduce your risk of osteopenia such as exercising regularly and stopping smoking if you currently smoke. Nearly everyone should take vitamin D supplementation, particularly over the winter months. Your local pharmacist can help advise you on this if you are unsure.
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When should I see my doctor?
As osteopenia does not cause any symptoms, you will likely only know you have osteopenia after having a DEXA scan or seeing your doctor. If you have been told you have osteopenia and don’t yet have a treatment plan, you should book a routine doctor's appointment to discuss this further.
What will my doctor do?
Your doctor will ask you about your medical history, what medications you are taking and if you have any current symptoms. If you are female and comfortable, they will also ask you about your periods and if they have stopped, when your last one was. They will calculate your risk of developing osteopenia or osteoporosis and discuss any interventions that may lower your risk such as lifestyle changes or medication. You may be referred for a DEXA scan, this is a quick and painless scan that is able to look at your bone density.
There are medications that help slow down or stop your bones from losing strength or density. These can include medications such as bisphosphonates or calcium and vitamin D tablets. HRT (hormone replacement therapy) which is used to help treat menopause symptoms also helps prevent bone loss but does come with its own risks which your doctor will discuss with you are thinking of starting this.
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