Osteopenia - a Warning Sign of Osteoporosis

Osteoporosis is a silent disease - at first. Over a period of many years, beginning as early as age 30, our bones start losing minerals and mass faster than they can be replaced. All bones, but especially those of the spine, hips, and ribs, become thinner and less dense, making them more fragile and prone to breakage. But in many cases it's not until a bone actually breaks - usually during normal, everyday use - that the disease asserts itself.

The best way to diagnose osteoporosis is with a bone density test. The most accurate of these is the DEXA (dual energy x-ray absorptiometry) scan, which is sensitive enough to detect very small amounts of bone loss. This is fortunate, because these small deviations from normal are actually signs of osteopenia - the precursor to osteoporosis.

A "normal" bone density measurement is that of a healthy 35-year-old. If the measurement is between 1 and 2.5 "standard deviations" below this normal, the person has osteopenia. If the measurement is more than 2.5 standard deviations below, the person has full-blown osteoporosis.

Osteopenia, therefore, is an early stage of osteoporosis. But it's actually a more hopeful diagnosis, because it means treatment can be started much earlier, before the disease has progressed to the point of being a health hazard.

One thing that many people don't know is that osteoporosis can be reversed. Especially if the bone loss is detected at the osteopenia stage, it's possible that to not only stop bone loss but also rebuild the bone.

Some of the risk factors for bone loss are unavoidable; for example, family history and small stature can't be changed. But many others can be minimized or eliminated altogether. Diet can be changed to include foods that are higher in bone-building minerals and vitamins and lower in bone-leaching caffeine and alcohol. Cigarette smoking can be decreased or stopped altogether. And activity levels can be increased to include weight-bearing exercise.

However, it's not a good idea to assume that because you don't fit the "usual risk profile," you won't develop osteopenia or osteoporosis. For example, bone loss is more common in women, but men do develop it; it just takes longer, because men's bone density starts out higher than women's.

If you think you're at risk for bone loss, ask your doctor to order a bone density test. If you do have osteopenia, take heart - you've been given a warning, but there's still time to act, and many things you can do. Ask your doctor, nutritionist, or other health practitioner for suggestions, and then act on those suggestions. It's not a fast process, but there's a very good chance you'll see your bone density measurements take a turn for the better.