Osteopenia: symptoms, causes and how to treat it

Definition of osteopenia

What is osteopenia?

Osteopenia is the stage before entering osteoporosis, which is bone loss. In other words, osteopenia is also a condition that indicates low bone mass. That means, a person's bones are no longer as strong as they should be so they tend to break easily.

People who have this condition have a bone density level that is slightly lower than normal, but is not yet considered osteoporosis.

In an analogy, people with healthy bones have an A grade, people with osteoporosis have a D or F value, while people with osteopenia have a B or C value.

Even so, a person with this musculoskeletal disorder does not always cause osteoporosis. This depends on other risk factors the person has. In addition, people with osteopenia can take steps to prevent osteoporosis.

How common is this disease?

Osteopenia is a common condition. However, a third of cases are more common in people aged over 50 years and over. Based on gender, this condition affects women more often than men.

Signs & symptoms of osteopenia

Osteopenia is a condition that generally causes no symptoms. Therefore, this condition is very difficult to detect early. Even so, some people with osteopenia experience symptoms such as decreased height.

Height will indeed decrease by about 2.5 cm when the peak height in adulthood has passed. However, if your height is reduced by more than the stated number, this could be an indication of a problem with the quality of your bones.

In addition to decreased height, fractures (fractures) can also indicate bone abnormalities, such as osteopenia.

When to see a doctor?

If you notice that you have lost more than 1 inch (2.5 cm) of height for no apparent reason, a medical check-up to a doctor is necessary. Especially if you are over 50 years old, and have had an accident or fracture.

Causes of osteopenia

As you age, your bones will undergo changes. New bone will grow, then the old bone will be damaged and replaced by new bone.

When you are young, new bone will grow faster than the breakdown of bone damaged by the body. This is what causes high bone mass and reaches its total at the age of 35 years.

After passing that age, the body will break down old bone faster than creating new bone. This condition makes bone mass decrease, thus making the bones weak and easy to break. This natural decrease in bone mass is the cause of osteopenia.

Osteopenia risk factors

Risk factors that can increase your risk of osteopenia are:

• Are over 65 years of age.
• Experiencing premature menopause (experiencing menopause at a young age, that is, under the age of 40).
• Have a family history of osteopenia.
• Underwent surgery to remove the ovaries so that estrogen levels decrease.
• Have health problems, such as hyperthyroidism (overactivity of the thyroid gland).
• Have a habit of drinking excessive alcohol.
• Smoke.
• Long-term use of corticosteroid or anti-convulsant drugs.
• Have an eating disorder, such as anorexia or bulimia.

Specific risk factors in women

Women are known to be more likely to have osteopenia than men. This is caused by various things, namely:

• Women have lower overall bone mass and absorb less calcium than men.
• The rate at which bone loss is also faster after a woman experiences menopause so that estrogen levels decrease. Estrogen itself is needed to keep bones healthy.

Diagnosis & treatment of osteopenia

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

The best way to diagnose osteopenia is to undergo a bone density test called dual-energy x-ray absorptiometry (DXA). This diagnostic test uses low-energy X-rays to see the calcium content of the bones.

Then, the results will be compared with a T score (bones of a healthy young adult) and a Z score (bones of other people of the same age and sex). Most commonly, this test is done to examine the lumbar spine, hips, and wrists.

Note that a T score that ranges from -1 to -2.5 is considered osteopenia. The lower your T score, the more bone loss you will have.

What are the treatment options for osteopenia?

Osteopenia can be treated with regular exercise, fulfillment of nutrients that can keep bones healthy, and medications. However, the use of drugs really needs careful consideration given the risk of side effects that arise if used in the long term.

According to the Harvard Medical School website, if your T score is less than -2, you need to do regular weight training and get adequate vitamin D and calcium from food and sunlight.

If the T score is closer to -2.5, your doctor may prescribe certain medications to keep your bones strong.

Some of the medications your doctor may prescribe to treat osteopenia are:

Bisphosphonates

This drug is prescribed to prevent osteopenia from becoming osteoporosis. Some examples of these drugs are alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel), and zoledronic acid (Reclast, Zometa, Aclasta).

Weekly or monthly doses can be just as effective as daily doses and are often better tolerated. Ibandronate can be given intravenously every three months; zoledronic acid once a year to treat osteoporosis and once every two years.

The side effects of this drug are acid reflux, throat irritation, fever, and pain in the legs and arms. To avoid irritation of the esophagus, the medicine should be taken after fasting overnight, except for drinking water and avoiding lying down.

Raloxifene (Evista)

This osteopenia medication can mimic the hormone estrogen so that it can help keep bones healthy. The side effects of this medication are hot flashes, leg cramps, and blood clots. Those of you who have a high risk of stroke and have hypertension are usually not prescribed by a doctor.

Conjugated estrogens / bazedoxifene (Duavee)

This drug is prescribed to women with osteopenia who still have an intact uterus. Drug use is usually given in conjunction with drugs such as raloxifene (Evista) to increase bone density and prevent fractures.

Short-term use is quite safe, but long-term use is still being observed by experts.

The use of this drug must be very careful because it can cause side effects that can endanger health. Therefore, during the consultation, talk to your doctor about the health of your body.

Home remedies for osteopenia

Treatment for people with osteopenia is closely related to changes in a healthier lifestyle. This is also the same treatment that you have to undergo at home.

You can apply weight training to strengthen bones, build muscle, improve balance, and prevent fractures. Apart from lifting weights, you can also try brisk walking, walking leisurely, jogging, or climbing stairs.

For the fulfillment of vitamin D and calcium, you can eat bone-strengthening foods, including non-fat dairy products, such as yogurt, cheese, and milk. Combine with nuts, salmon, chicken, broccoli and citrus fruits.

If you want to take certain supplements to strengthen bones, it's best to talk to the doctor who treats your condition first.

Prevention of osteopenia

Besides being treatable, osteopenia can also be prevented. The ways to prevent osteopenia that you can do are:

• Stop smoking and stay away from secondhand smoke.
• Use certain medications under a doctor's supervision, especially corticosteroids and anti-seizure drugs.
• Do exercise regularly, at least 30 minutes a day.
• Increase your consumption of foods rich in vitamin D and calcium, such as fish, lean dairy products, nuts, seeds, and fruits and vegetables. For those of you who have an eating disorder, follow the dietary rules recommended by your doctor or nutritionist.
• Get a bone density test if you are menopausal, age 65 and older. However, consult your doctor further.