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Osteopenia vs Osteoporosis – What Does It Mean?

Osteopenia vs Osteoporosis – What Does It Mean?Osteoporosis is a weakening of the bone to the point that it is at risk of fracturing. This is due to a loss of bone mineral density – the compact material that gives bone its strength. Bone mineral density (BMD) can vary from person to person for a number of different reasons. When bone density is lower than normal but not as yet to the point that it can be termed osteoporosis, then it is referred to as osteopenia. In this regard, osteopenia can be seen as a risk factor for developing osteoporosis in the future.

How does osteopenia develop?

As with various organs and systems in the body, age has an effect on the bones as well. These physiological changes are considered somewhat normal with aging. However, if it reaches a severe point and becomes diseased, then it is said to be pathological. From the thirties onwards, the bones start losing small amounts of bone mineral. This is a natural thinning of the bones. Some people have a naturally lower than normal bone mineral density which could be considered as osteopenia despite there not being any age-related or underlying disease.

Loss of bone mineral density is a result of bone being resorbed faster than it is deposited. However, the bones are not severely weakened where it is at a high risk of fracturing with even minor injury like in osteoporosis. Nevertheless the loss of bone mineral in osteopenia and associated thinning and weakening means it can fracture more easily than an adult with normal bone density. The age at which the bone mineral density loss can be classified as osteopenia varies from person to person.

Causes of Osteopenia

There are several factors that play a role in osteopenia. Although bone loss is normal with age, it may not reach the point of osteopenia in every person. Some factors that can contribute to osteopenia includes :

  • Genetics – a family history of osteopenia is a strong risk factor.
  • Hormonal changes as is seen in menopause.
  • Prolonged immobility.
  • Sedentary lifestyle.
  • Excessive alcohol consumption.
  • Cigarette smoking.
  • A person with a thin frame and naturally low body weight.

These risk factors for osteopenia are largely the same as with osteoporosis. Osteopenia has thus far been discussed as a normal process of aging or being influenced by lifestyle factors but it can also be related to certain underlying diseases. These conditions can speed up the natural loss of bone mineral density with age or trigger it in early adulthood. Osteopenia may therefore be a consequence of :

  • Impaired nutrition either with eating disorders or malabsorption syndromes such as celiac sprue.
  • Medication including chemotherapy (cancer treatment), long term corticosteroid use and anti-epileptic drugs.
  • Chronic inflammatory diseases like rheumatoid arthritis.

Treatment of Osteopenia

In the majority of cases, osteopenia can be treated, managed and even reversed to some degree with lifestyle measures. This includes the same measures that are outlined in the osteoporosis diet and living with osteoporosis. The use of medication like bisphosphonates and other osteoporosis drugs to build stronger bones is almost never used for osteopenia. However, regular bone scans are necessary to ensure that the condition has not progressed to osteoporosis and to monitor the improvement of bone mineral density with diet and exercise.


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