Osteopenia
Osteopenia is when the density (or strength) of your bone is lower than normal. This is measured by a scan called a DEXA scan (a scan measuring bone mineral density). It 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 the menopause due to decreasing levels of a hormone called oestrogen 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 diary products, leafy green veg, soybeans or foods fortified with calcium such as certain cereals. Vitamin D is also important for bone strength as it helps with the absorption of calcium. Your body makes vitamin D from direct sunlight exposure or if this is not possible (such as in the winter months in the UK) you can take vitamin D supplementation. Other ways to help improve bone strength include taking 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. It is usually picked up by your doctor on a DEXA scan or if you are at risk you may be put on treatment to avoid you 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 put you at higher risk of osteopenia, such as kidney disease, an eating disorder, or coeliac disease. Even though it is more common in women, men can also develop osteopenia.
How to help with oseopenia
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 it is likely that you will only know you have osteopenia after having a DEXA scan or after 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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