About 18 million Americans have osteopenia, a health problem that can turn into osteoporosis. Bone mineral density is lower than normal. However, it is not yet low enough to be considered osteoporosis.
Assessing Bone Health
Bone health is measured in two ways: by density and by mass. Bone mass means how much bone you have. Bone density means how thick the bone is.
Bone Density and Osteopenia
To find bone density, your doctor measures the levels of minerals in your bones. These minerals include:
- Other minerals
The more dense your bone mineral content, the stronger your bones are.
Bone Mass and Osteopenia
Bone mass is the amount of bone you have. Usually, bone mass peaks around age 30. Then bone mass begins to decline. Bone is reabsorbed by your body faster than new bone can be made.
Are You At Risk for Osteopenia and Osteoporosis?
Often, people with osteopenia are not aware they have this problem. In fact, the first sign of osteopenia may be a broken bone. A broken bone may mean that the condition has already become osteoporosis.
The risk factors for developing osteopenia are the same as those for developing osteoporosis. They include:
- Being female
- Being thin and/or having a small frame
- Getting too little calcium in the diet
- Leading an inactive lifestyle
- A history of anorexia nervosa
- A family history of osteoporosis
- Heavy alcohol consumption
- Early menopause
The most accurate way to diagnose osteopenia and osteoporosis is through bone mineral density testing. This is usually done with a dual-energy X-ray absorptiometry (DEXA) scan.
DEXA scan results are reported as T-scores:
- Normal bone: T-score above -1
- Osteopenia: T-score between -1 and -2.5
- Osteoporosis: T-score below -2.5
Other tests can be done to help diagnose osteoporosis and osteopenia. Quantitative ultrasound is one such test. It measures the speed of sound in the bone to assess bone density and strength. DEXA scans are usually still needed to confirm results from ultrasound and other tests.
Who Needs Bone Density Screening for Osteopenia?
When should you begin getting bone density screenings? Experts currently recommend that you receive regular bone density scans in these cases:
- Women 65 and older
- Women 60 or older with certain risk factors; low body weight is considered the most important
There are no clear guidelines for when to begin screening for women between 60 and 65 who have no other risk factors. Nor are there specific guidelines for women under 60 who have additional risk factors. Work with your doctor to determine a screening plan to meet your needs.
Maintaining Your Bone Health Despite Osteopenia
Osteopenia does not have to turn into osteoporosis. You can help prevent this by practicing good bone health:
- Eat a balanced diet. Include plenty of calcium and vitamin D. You'll find these nutrients in foods like milk, yogurt, cheese, and broccoli.
- Exercise regularly. Choose weight-bearing exercise like walking, running, or tennis. Also do strength training using weights or resistance bands.
- Avoid smoking.
- If you drink, do so in moderation.
For women who have gone through menopause, hormone replacement therapy (HRT) may be an option. It may help prevent bone loss that occurs when the body stops producing estrogen. This may reduce your risk of osteopenia. HRT may also help prevent osteopenia from progressing to osteoporosis. However, HRT is not without risks. Talk with your doctor if you wish to consider using HRT to help prevent osteopenia and osteoporosis.