What If I Am Told That I Have Osteopenia But Not Osteoporosis?

If you have osteopenia, then your T-score is 1 to 2.5 standard deviations below the bone density of the aver-age healthy young adult. Given a score in that range, your bone mass is somewhere between 10% and 30% below normal for a young adult, and your risk of fracture, based on your T-score alone, is as much as 2 to 5 times that of a healthy young adult with normal bone density. Therefore, it’s still important to prevent falls.

Although your T-score may indicate that you have osteopenia, it is best to assume that your bone loss will continue if you do not embrace the goals and behaviors intended to improve your bone health. Sometimes clinicians don’t use the term osteopenia. Instead, they prefer to tell patients that they have low bone mass.

Some clinicians may suggest prescription medications specifically intended to prevent further bone loss or to increase bone density. However, management options for osteopenia have been controversial, and some clinicians think prescription medications for osteopenia are not appropriate. See Question 55 for more about medications for osteoporosis and who should be treated. In either case and whether you have lost bone mass or not, your clinician should always emphasize the importance of calcium, vitamin D, and appropriate exercise.

Finding out that you have osteopenia represents an opportunity. While no one wants to have low bone mass, you have an opportunity to avoid developing osteoporosis. Even if your clinician doesn’t prescribe medications for you, you can still make behavioral changes that can make the difference between having osteopenia and going on to develop osteoporosis.

So, now that you have been told you have osteopenia, what can you do to change your lifestyle to make it more bone-friendly? There are several things that you can do now, no matter what your age:

Calculate your intake of calcium and vitamin D, making sure that you are getting the necessary amount every day.

Get moving. Exercise can help slow the rate of bone loss by increasing the rate of bone formation. Consistent, moderate exercise is associated with a big decrease in hip fractures. Remember that bone strength increases in your body at the location where you exercise. For example, walking benefits the lower spine, hips, and leg bones but not the arms or upper back.

Stop smoking.

If, on average, you drink more than one or two alcoholic drinks per day (one serving of alcohol is 5 ounces of wine, 12 ounces of beer, or one cocktail containing 1.5 ounces of hard liquor), cut back or avoid alcohol entirely.

Drink water, milk, or calcium-enriched beverages instead of coffee and soda. If you drink coffee, add milk to add some calcium. Large amounts of caffeine can interfere with calcium absorption.

However, if you are getting an adequate amount of calcium, moderate caffeine intake (1–2 cups/day) is unlikely to cause a problem. Large amounts of phosphorus can also interfere with calcium, but you would have to consume more than 3 to 4 grams of phosphorus per day for phosphorus to be a problem.

Next article discusses dietary changes to lessen or avert the effects of osteoporosis and osteopenia.