Osteopenia

What is osteopenia?

Osteopenia is a loss of bone density. Having reduced bone density means your bones don’t have as much mineral content as they should. This can make them weaker and increase your risk of bone fractures (broken bones).

If you have osteopenia, your bone density is lower than average. It can progress to osteoporosis.

Most people need their bone density checked every few years after they turn 50 or enter postmenopause, but you might need yours monitored more often. Visit a healthcare provider for regular checkups. They’ll tell you when you’ll need your bone density tested.

What’s the difference between osteopenia vs. osteoporosis?

Osteopenia is an early sign of osteoporosis. Their names sound so similar because they’re closely related.

Osteopenia is the medical definition for having reduced bone density. Osteopenia is the warning sign that means you have an increased osteoporosis and fracture risk.

If it’s not treated, osteopenia can become osteoporosis. Osteoporosis silently weakens your bones. People with osteoporosis are much more likely to break a bone, especially from falls. If you have osteoporosis, even a minor slip that might not normally cause injuries can lead to fractures.

How common is osteopenia?

Experts estimate that more than 40 million Americans have osteopenia. They think around one-third of adults older than 50 have some degree of bone density loss.

What are osteopenia symptoms?

Osteopenia doesn’t usually cause any symptoms you can feel or notice. That’s why healthcare providers sometimes call osteopenia and osteoporosis silent diseases.

What causes osteopenia?

Osteopenia usually happens naturally as you age. Your bones are living tissue like any other part of your body. It might not seem like it, but they’re constantly growing, changing and reshaping themselves throughout your life.

Most people lose some bone density as they get older. Your bones are densest around age 25 and start breaking down faster than your body can rebuild them after that. This natural decline doesn’t cause issues in most people. However, if you lose too much bone density, you can develop osteopenia, which may mean you’re more likely to have osteoporosis later in your life.

What are the risk factors?

Anyone can develop osteopenia, but some groups of people are more likely to have it, including:

• Adults older than 50.
• People assigned female at birth (AFAB). People AFAB are four times more likely to have osteopenia than people assigned male at birth (AMAB).
• People who are in postmenopause.
• People who smoke or use tobacco products.
• People who regularly drink alcohol (more than two drinks per day).

Some health conditions can lower your bone density or worsen osteopenia, including:

• Hyperthyroidism.
• Diabetes.
• Chronic kidney disease (CKD).
• Malnutrition.
• A calcium or vitamin D deficiency.
• Hormonal imbalances (like Cushing syndrome).
• Anorexia and other eating disorders.
• Autoimmune diseases that affect your bones (like rheumatoid arthritis or collagen defects).

Medications that can increase your osteopenia risk include:

• Diuretics.
• Corticosteroids.
• Medications used to treat seizures.
• Hormone therapy for cancer (including to treat breast cancer or prostate cancer).
• Anticoagulants.
• Proton pump inhibitors (PPIs, like those that treat acid reflux, which can affect your calcium absorption).

What are osteopenia complications?

Increasing your bone fracture and osteoporosis risk are osteopenia’s main complications. Osteopenia on its own won’t cause symptoms. But having reduced bone density makes you much more likely to break a bone, even after small injuries or falls.

How is osteopenia diagnosed?

A healthcare provider will diagnose osteopenia with a bone density test. A bone density test is an imaging test that measures the strength of your bones. It uses X-rays to measure how much calcium and other minerals are in your bones.

Checking for changes in your bone density is the best way to catch osteopenia before it becomes osteoporosis. Your provider might suggest you get regular bone density tests if you have a family history of osteoporosis. People AFAB usually need bone density screenings regularly after they turn 50. People assigned male at birth (AMAB) typically need them after age 70.

If you have osteopenia, you’ll probably need a bone density test every few years to see how your bones have changed.

What is the best treatment for osteopenia?

Your provider will suggest osteopenia treatments that slow down your bone loss and strengthen your existing bone tissue. The most important part of treating osteopenia is preventing bone fractures and osteoporosis.

The most common osteopenia treatments include:

• Physical activity and exercise: Staying active can strengthen your bones (and all the tissue connected to them, like your muscles, tendons and ligaments). Your provider might suggest weight-bearing exercises to strengthen your muscles and train your balance. Physical activities that make your body work against gravity like walking, yoga, Pilates and tai chi can improve your strength and balance without putting too much stress on your bones. You might need to work with a physical therapist to find exercises and movements that are right for you.
• Vitamin and mineral supplements: You might need over-the-counter (OTC) or prescription calcium or vitamin D supplements. Your provider will tell you which type you need, how often you should take them and which dosage you’ll need. Most people don’t need prescription medication to treat osteopenia. Your provider may suggest prescription medication to treat osteoporosis if you develop it later.
• Following an eating plan that’s healthy for you: Eating enough, and getting the right kinds of vitamins and minerals, can strengthen your bones (and improve your overall health). Your provider or a registered dietitian can help you create an eating plan that fits your unique needs.

Can you prevent osteopenia?

You usually can’t prevent osteopenia. Everyone naturally loses some bone density as they age, and you can’t stop that from happening. Some of the best ways to strengthen your bones and slow bone loss are the same as the treatments for osteopenia. Talk to your provider about ways to improve your bone health if you’re worried about osteopenia or osteoporosis.

What can I expect if I have osteopenia?

You should expect to monitor your bone density for the rest of your life if you have osteopenia. Most people with osteopenia need their bone density checked every few years. Your provider will tell you how often you’ll need bone density tests.

Can I reverse my osteopenia?

Osteopenia is a natural progression of bone loss. But you can slow it down to prevent osteoporosis. The sooner you know you have osteopenia, the better. Once you start treatment, you may slow down your bone loss so much that you never develop osteoporosis. Some people can reverse osteopenia and regain a typical amount of bone density.

How do I take care of myself?

Some of the best ways to take care of your bones are great ways to support your overall health:

• Stay physically active as often as you can.
• Get plenty of vitamin D and calcium in your diet.
• Limit how much alcohol you drink.
• Avoid smoking and other tobacco products.

When should I see my healthcare provider?

Visit a healthcare provider if you notice any changes in your body that make you worried about your bone health. Tell your provider about any other symptoms you’re experiencing, especially if you have bone pain or trouble moving.

Ask your provider how often you should have your bone density checked, especially if someone in your biological family has osteopenia or osteoporosis.

What questions should I ask my healthcare provider?

You may want to ask your healthcare provider:

• How often should I have my bone density checked?
• Do I have any risk factors?
• Which treatments will I need?
• What are some good physical activities to improve my bone health?

A note from Cleveland Clinic

Having osteopenia means you have reduced bone density. Some health conditions and medications can cause it or increase your risk, but it usually happens naturally as you age. Most people’s bone density is at its highest around age 25 and slowly decreases over time after that.

Your healthcare provider will tell you how often you’ll need bone density tests, and which treatments can slow down your bone loss. The most important part of treating osteopenia is helping you prevent osteoporosis.