What Your Doctor Won’t Tell You About Osteopenia

Margaret Martin, Physical Therapist, advises:

When it comes to the crunch…

If you have a bone density scan (DEXA) and your score is in the range of osteopenia, it’s common that the doctor will report that it’s not osteoporosis and “let’s keep an eye on it”.

In other words, it’s not crunch time yet.

But it is, for two main reasons:

• most bone fractures occur in people with osteopenia, not osteoporosis, partly because not only do more people have osteopenia, but also people with osteopenia are more likely to find out about it by getting a scan after breaking something, whereas someone with an osteoporosis diagnosis probably already knows to be careful. Additionally, bone quality matters as well as bone density, while the scans only show bone density. So, a non-osteoporosis diagnosis can be misleading when it comes to fracture risk.
• while bone mineral density loss is technically possible to reverse at any time, really the window of opportunity for the best results is before it gets to the point of osteoporosis. Thus, the osteopenia diagnosis should be a prompt to take action—not necessarily with medication, but ideally through lifestyle changes to prevent progression to osteoporosis.

However, most doctors are content with “doesn’t need treatment from me now, my job is just treating people who do need treatment from me, therefore this is fine”.

For reference: osteopenia is defined by a T-score between -1.0 and -2.5 on a DEXA scan, which measures bone density and compares it to that of a healthy 30-year-old woman (or man, if you are a man). The numbers are standard deviations, i.e. a score of -1.0 is one standard deviation below the norm.

With regard to risk for fractures:

• non-modifiable risk factors include genetics (usually identified by a family history of fractures), previous fragility fractures, early menopause, and amenorrhea.
• modifiable risk factors include improving diet (protein, calcium, vitamin D, vitamin K, fruits and vegetables in general), not smoking, not drinking alcohol, controlling blood sugar, and doing regular bone-strengthening exercises (weight-bearing and/or resistance being generally considered best)

For more on all of this, enjoy:

Click Here If The Embedded Video Doesn’t Load Automatically!

Want to learn more?

You might also like:

Weight Vests Against Osteoporosis: Do They Really Build Bone?

Take care!