Osteopenia or thin bones is a condition in which the body has less bone density and mass than normal, but not enough to be diagnosed with osteoporosis. In general, people who experience this condition do not show any pain. This condition is more common in women than men, and is usually found in people aged 50 and over, but it can occur at other ages, depending on the strength of each person’s bones during adolescence. However, this condition can also lead to osteoporosis, so patients should take good care of their bone health.
Symptoms of Osteopenia
Patients with Osteopenia have lower than normal bone density. Their bones are weaker than the general population, but they are not as prone to fracture as those with osteoporosis . Patients often do not show any abnormal symptoms or pain.
Causes of Osteopenia
The bone system has osteoclasts that function to create new bone from calcium and protein according to the body’s growth process and to replace worn out bone. There are also osteolytic cells that function to break down old bone tissue. Osteopenia often occurs when the body breaks down more bone than it makes, which may be caused by insufficient calcium in the body.
There are several risk factors that may be the cause of Osteopenia, such as:
- Age: As we age, replacement of worn out bone may be slower, resulting in reduced bone mass density, especially in those over 50 years of age.
- Gender: Women are more at risk of developing this condition than men because they have lower bone mass, live longer, and tend not to consume as much calcium as men.
- Hormones: Decreasing levels of the female hormone estrogen, such as in menopause, can be a cause of osteopenia. Women who reach menopause before the age of 45 or who have had their ovaries removed before menopause may also be at risk of developing osteopenia. Men with low testosterone levels are also at risk of developing osteopenia.
- Genetics: People who have a family history of this condition are at risk of inheriting the condition.
- Eating behaviors , eating foods that do not contain enough calciumor vitamin D to meet the body’s needs for bone formation and growth, can lead to osteoporosis, including drinking soft drinks, tea, coffee or alcoholic beverages, and smoking or other tobacco products.
- Exercise behavior: People who do not exercise often, especially those who lack exercise that focuses on stretching, may be at risk for this condition.
- Diseases and illnesses such as eating disorders such as anorexiaand bulimia, celiac disease, hyperthyroidism, hyperparathyroidism, and Cushing syndrome.
- The use of certain medications , such as steroids such as prednisolone and hydrocortisone, and certain anticonvulsants such as carbamazepine, gabapentin, and phenytoin, among others. In addition, chemotherapy or radiation therapy may also cause this condition.
Diagnosis of Osteopenia
Because osteopenia often has no symptoms, doctors may recommend that people at risk for the condition get a bone density test. People at risk for osteopenia include women age 65 and older, women age 50 and older who have early menopause and other risk factors, postmenopausal women who have fractured a bone while performing everyday activities, such as pushing themselves up from chairs and seats or vacuuming, men age 50 and older who have other risk factors, and women age 50 and older who have fractured a bone.
Generally, bone density examination can be done by taking a DEXA Scan , which is a method used to assess bone density in various areas such as the spine, hip, fingers, wrist, shin or heel. It is a method that takes a short time to scan, has a low amount of radiation entering the body during the scan, and is painless for the patient. The bone mineral density (BMD) value of a normal person is more than -1.0, while those with osteopenia will have a BMD value between -1.0 and -2.5, while patients with osteoporosis will have a BMD value less than -2.5.
Treatment of Osteopenia
Treatment of Osteopenia involves strengthening the bones and slowing down the process of this condition to prevent and reduce the risk of osteoporosis. The methods are as follows:
Health care and bone maintenance
Doctors may recommend eating foods high in calcium and vitamin D, avoiding smoking, drinking alcohol, carbonated drinks, or caffeinated drinks, and avoiding foods high in sodium. In addition, patients should exercise regularly in an appropriate manner. Patients in early adulthood or premenopausal women may exercise by walking, running, or jumping for 30 minutes a day to strengthen their bones. However, older adults may choose to exercise in a gentler manner to reduce the risk of falls, such as walking, swimming, or cycling. As for those who exercise by lifting weights, they should consult a doctor about safety before starting this activity.
Calcium and vitamin D supplementation
Your doctor may recommend taking calcium and vitamin D supplements , which help increase calcium absorption to maintain proper bone mass. You may also want to get some gentle sunlight exposure to increase your body’s vitamin D levels, perhaps for just 10-15 minutes twice a week.
Use of medication
In general, doctors do not recommend medication to treat this condition because the patient has a low chance of breaking a bone. However, if the patient’s bone density is at risk of osteoporosis, the doctor may recommend certain medications that inhibit bone breakdown or increase bone density, such as alendronate, risedronate, ibandronate, and zoledronate. These medications can cause side effects, such as gastrointestinal problems, bone and joint pain, or fatigue.
Hormone boosting
Doctors may inject or prescribe medications to increase levels of certain hormones, such as estrogen, which helps build bone. This is often used to treat osteopenia in women who are menopausal or have had their ovaries removed, and whose bodies are no longer able to produce normal levels of estrogen. However, this treatment may increase the risk of blood clots in the legs and lungs, as well as other health problems.
Complications of Osteopenia
Osteopenia can lead to osteoporosis, which can cause bones to deteriorate, become brittle, deformed, or break easily. It can also cause a reduction in height, a hunched back, or a forward-bending posture, and severe pain. In addition, patients may experience bone fractures , which occur when a bone is subjected to excessive impact, causing pain and impairment of function. It can also cause bleeding or injury around the affected bone. In cases where a fracture occurs in a major area, such as the spine or hip, the patient may become disabled and even die.
Prevention of Osteopenia
People can prevent and reduce their risk of developing Osteopenia by following these guidelines:
- Choose to eat nutritious foods,especially foods high in calcium such as yogurt, cheese, milk, various beans, green vegetables such as kale, water mimosa, moringa leaves, betel leaves, neem, holy basil, ivy gourd, spinach, broccoli, and foods high in vitamin D such as liver, egg yolks, meat, pumpkin, mushrooms, mackerel, and sardines, as well as foods that contain both calcium and vitamin D such as cereals, bread, salmon, and orange juice.
- Exercise regularly without overdoing it. For those who exercise by lifting weights, consult a doctor before starting to do it, and always check your health and physical readiness.
- Avoid smoking, alcohol, soft drinks and caffeinated beverages.
- Get adequate exposure to gentle sunlight to help increase the amount of vitamin Din the body. For those with other health problems, consult your doctor about the safety of sun exposure.
- Be careful when using medications, especially steroid medications that need to be used for a long time.
- People over 65 years of age should have a bone density test.
