What is osteopenia?
Osteopenia means your bone mineral density is significantly below the average for a young normal woman (BHOF, 2024). Up until about the age of 25, your bones are building at a rate faster than they can break down. You reach peak bone mass by that time. Some inherited factors can cause you to have a low peak mass that is already in the osteopenic range. For about 10-15 years, your bone density usually remains stable but in your late 30s and 40s, bone loss starts to occur (AAOS, 2021). For women in their late 40s, as they approach menopause, the rate of bone loss accelerates substantially putting more women at risk for osteopenia and/or osteoporosis.
Lower bone density makes bones brittle and more likely to break.
Who is most at risk for osteopenia?
There are certain risk factors that could put you at a higher risk for developing osteopenia. Menopause and aging are unavoidable factors that everyone faces at some point. Other risk factors include:
- Family history of osteoporosis
- Lack of physical activity
- Poor nutrition
- Bad lifestyle choices (smoking, excessive alcohol use)
- Certain chronic health conditions such as rheumatoid arthritis, diabetes celiac disease or other disorders that affect your ability to absorb nutrients
- Some medications (including steroids, certain antidepressants and certain medications for heartburn)
How osteopenia is assessed
In order to receive proper treatment, your healthcare provider needs to know what your current health status is. They will assess your overall health and lifestyle and check for other medical conditions. They will ask whether you have had any broken bones or height loss and will measure your height and assess your posture. If indicated, they will recommend measuring your bone mineral density (BMD) and looking for evidence of hidden vertebral fractures.
Bone density is measured using a DXA (dual x-ray absorptiometry) scan with the results coming in the form of a T-score. A T-score of 0 means your bone density is average for a young, healthy adult. A T-score of -1 to -2.5 is considered low bone mineral density and leads to a diagnosis of osteopenia. Osteopenia can turn into osteoporosis if your T-score drops below -2.5. The lower your T-score, the higher your risk of fracture.
Your T-score will address whether or not you have low bone density and will help your physician determine treatment.
Can you reverse osteopenia?
You can reverse the diagnosis of osteopenia by reducing the rate of bone loss. If you treat osteopenia correctly, you can improve your T-score, improve the strength of your bones and prevent osteopenia from progressing to osteoporosis.
For some, medications can aid in slowing the degradation of bone and add some bone density. Addressing lifestyle factors that negatively affect bone health, such as smoking, poor nutrition and lack of physical activity can also help. In addition to adding physical activity to your routine, there are specific types of exercises that stimulate bone growth and improve bone strength. A comprehensive exercise program such as Wellen's, which is designed specifically to build bone and reduce your fracture risk is a great way to be sure you're incorporating hand-picked bone-building exercises. Lastly, ensuring that your body is getting adequate nutrition to build bone can improve outcomes.
Medication for osteopenia
There are certain medications your doctor might prescribe if you are diagnosed with osteopenia. Estrogen treatment, raloxifene and bisphosphonates can be used to preserve bone mass (BHOF, 2024). One downside to these medications is reliance on them. Coming off of these medications may cause your condition to progress and bone density can revert back to the osteopenia range. Learn more about medications and treatment for osteopenia here.
Lifestyle changes for osteopenia
Diet and exercise can help promote healthy bones.
Exercises for osteopenia
There are a few different types of exercise that promote bone health. Balance training, resistance training and weight-bearing exercise will build stronger bones. However, not all exercises are safe for everyone: always make sure to get medical advice or clearance before beginning a new exercise routine.
Nutrition for osteopenia
Eating foods that are good sources of vitamin D (enriched milks and certain fatty fishes), calcium (i.e. dairy products, enriched plant-based milks, some green leafy vegetables) can promote the bone-building process.
Adding supplements to your diet such as a vitamin D or calcium supplement is another way to ensure that you are getting these important micronutrients. However, it is best to speak with your doctor about whether or not supplements are appropriate for you.
Can you reverse osteoporosis?
As with osteopenia, osteoporosis can also be treated and reversed with some medications. The rate of bone loss can also be improved with an active and healthy lifestyle. Osteoporosis treatment is a multimodal approach using a combination of medications, exercise, frequent check-ins with healthcare providers and leading a healthy lifestyle. At Wellen, we are on a mission to provide you with all the resources you need to do just that.
If you've recently been diagnosed with osteopenia, check out our osteopenia checklist and get started on your journey to better bone health.