Your bone health, and a discussion of two critical bone disorders.
What's the difference between Osteopenia and Osteoporosis?
Osteopenia always comes before osteoporosis.
Osteoporosis
Osteoporosis is when bones weaken to the point that they can break easily. It is called a “silent disease” because people who develop it may not notice any changes until a bone breaks — usually a bone in the hip, spine, or wrist.
Osteopenia
Osteopenia is the softening of the bone. Bones become weaker, but not thin enough to break. Osteopenia sounds a lot like osteoporosis, but the two conditions are different.
Osteopenia isn't reversible. But you can prevent it from turning into osteoporosis, a more serious form of bone density loss, and avoid the risk of a potentially life-altering fracture.
Causes
If you do not eat enough food with calcium and vitamin D
Your body does not absorb enough calcium and vitamin D from your food, such as after gastric bypass surgery or due to other medical conditions
Other causes of bone loss include:
A decrease in estrogen in women at the time of menopause
Being confined to a bed due to a prolonged illness (mostly affects bones in children)
Having certain medical conditions that cause increased inflammation in the body such as Crohn's disease or rheumatoid arthritis
Taking certain medicines, such as certain seizure medicines, hormone treatments for prostate or breast cancer, and steroid medicines taken for more than 3 months
Other risk factors include:
A family history of osteoporosis
Drinking a large amount of alcohol
Low body weight
Smoking
Having an eating disorder, such as anorexia nervosa
Certain ethnic groups have a higher rate of low bone mass
Symptoms
Osteopenia and Osteoporosis can be tricky to recognize because they generally don’t have any symptoms. Most people don't realize they have low bone density until they experience a fracture.
Exams and Tests
A DEXA scan is a low-radiation x-ray that measures the density of the minerals in your bones. Most often, it measures density in the spine and hip bones. This test is used to:
Diagnose bone loss and osteoporosis.
Predict your risk for future bone fractures.
See how well osteoporosis medicine is working. (For this purpose, the DEXA scan is most often repeated every 2 years.)
The US Preventive Services Task Force recommends this screening test at least once for women age 65 and older, and for some women younger than age 65 who have an increased risk for osteoporosis.
In some cases, your calcium and vitamin D levels will be checked.
Treatment
Treatment for osteoporosis and osteopenia may involve:
Changing your diet
Starting an exercise routine
Reducing tobacco and alcohol use
Taking calcium and vitamin D supplements - 1,200 mg of calcium and 400 IU of vitamin D daily. This can be over-the-counter medication and does not require a prescription.
Preventing falls
Using medicines
Pay attention to what you eat. Adding more calcium and Vitamin D to your diet is one of the best things you can do for your bones. High-calcium foods include most dairy products like cheese, milk, and yogurt; and dark, leafy greens like spinach. Foods high in Vitamin D include eggs; oily fish like salmon and sardines; and beef liver.
Refine your exercise plan. All exercise is good. But when it comes to your bones, it's important to challenge them with weight-bearing activities. If you enjoy low-impact movements like tai chi or swimming, make some room for running, walking, and even some strength training.
-->Walk outdoors for 15 minutes to get your daily vitamin D requirement.
How to Avoid Falling at Home
Make sure your vision is good. Have your eyes checked once a year.
Do not take medicines that make you drowsy.
Wear shoes that fit well and have low heels. This includes slippers.
Do not walk outdoors alone on icy days.
Use a nightlight or keep a flashlight close to you at night.
Remove rugs and other loose items from your floor. If you have a rug covering a slippery floor, make sure the rug does not have any loose or fringed edges.
If your bathroom is not close to your bedroom (or wherever you spend most of your time during the day), get a commode. A commode is a type of portable toilet that you can put anywhere in your home. Place it nearby so you do not have to walk to the bathroom.
Put grab bars and handrails next to your toilet and inside your shower. Never use towel racks to pull yourself up. They are not strong enough to hold your weight.
Put anti-slip stickers on the floor of your tub or shower.
Buy a shower chair and a hand-held shower head so you can sit while taking a shower.
When getting up after you're lying down, sit for a few minutes before you stand up.
Place items in your kitchen and bathroom cabinets at shoulder height so you do not have to reach too high or bend too low.
Medicines may be used to strengthen bones when:
Osteoporosis has been diagnosed by a bone density study, whether or not you have a fracture, and your fracture risk is high.
You have had a bone fracture, and a bone density test shows that you have thin bones, but not osteoporosis.
Bisphosphonates -- the main medicines used to prevent and treat osteoporosis in postmenopausal women. They can be given by mouth or by intravenous (IV) injection.
Hormone Therapy.
Denosumab -- lessens bone loss and increases bone density. Given by injection under the skin.
Teriparatide-- man-made forms of a hormone your body makes that increases bone density.
Romosozumab -- a newer medicine for more severe bone thinning.
Estrogen receptor modulators.
Calcitonin -- a man-made form of a hormone your body makes that increases bone density. Used mainly to treat the acute pain from a spine compression fracture.
The length of time a woman should take these medicines depends on her level of risk. Recommendations include:
Low fracture risk -- 5 years of oral medicine or 3 years of IV therapy
High fracture risk -- 10 years of oral medicine or 6 years of IV therapy