Osteopenia is a term used to describe bone density that is somewhat lower than normal — but not low enough to be diagnosed as osteoporosis. Osteoporosis is a condition in which thinning bones become so fragile that they are prone to fracture easily. A person who has osteopenia is at risk for osteoporosis and may benefit from treatments to strengthen bone.
How Osteopenia Happens
Generally by age 30, your bones are as strong and dense as they will ever be. After that, the bones begin to get thinner with age.
Women are more likely than men to develop osteopenia, because their bones are thinner to begin with. Hormonal changes at the time of menopause also speed up bone loss.
Depending on bone density measures and other factors — such as previous fractures, poor health, and poor mobility — women with osteopenia may have the same risk for a broken bone as women with osteoporosis. Women at risk of bone fractures need treatments to help slow bone loss or help new bone form.
The following healthy habits and treatments for osteopenia may strengthen bones and reduce fracture risk.
A Healthy Lifestyle
The best remedies for osteopenia are lifestyle habits everyone should adopt. If you have strong bones, a healthy lifestyle can help keep them that way. If you already have osteopenia, these same habits can help reduce the risk of osteoporosis.
Exercise. Like muscle, bone becomes stronger when you exercise. The best exercise for bones is weight-bearing exercise that forces your body to work against gravity. This type of exercise includes walking, stair climbing, dancing, and working out with weights.
Diet. For strong bones, you need a diet rich in calcium and vitamin D. High-calcium foods include:
Dairy products such as cheese, ice cream, low-fat milk, and yogurt
Green vegetables such as broccoli and collard greens
Sardines and salmon, with bones
Your body makes its own vitamin D when your skin is exposed to sunlight. If you spend much time outdoors in the sunshine you probably have most of the vitamin D you need. A few foods naturally contain vitamin D. Others, such as grains and milk products, are fortified with vitamin D. Good dietary sources of vitamin D include:
Fish such as salmon, tuna, and mackerel
Fish liver oils
Fortified breakfast cereals, juices, milk products, yogurt, and margarine
A small percentage of the population may have accelerated bone loss or osteoporosis from Celiac disease, or a gluten sensitivity to wheat products.
Smoking and drinking. If you smoke, it’s important to quit. Studies have shown a direct relationship between cigarette smoking and decreased bone density. Quitting smoking may help limit bone loss due to smoking.
If you drink alcohol, do so in moderation (no more than one drink per day for women and two drinks per day for men). Too much alcohol can interfere with the balance of calcium in your body and affect the production of hormones and vitamins that play a role in healthy bones. It can also increase your risk of falling, which could cause you to break a bone.
Cutting back on salt and caffeine. Both caffeine and salt may contribute to calcium and bone loss. To improve bone health, switch to non-caffeinated beverages, avoid soft drinks, check labels of packaged foods for sodium content, and remove the salt shaker from your table.
Drugs for Osteopenia
Depending on your situation, particularly if you have already broken a bone, your doctor may prescribe medication to reduce the risk of developing osteoporosis and further fractures. Medications that may be used for osteopenia or prevention of osteoporosis in these cases include:
Bisphosphonates. Bisphosphonates are medications that slow the natural process that breaks down bone, which results in maintenance or a small increase of bone density. Bisphosphonates are the main drugs used to prevent and treat osteoporosis in postmenopausal women. This class of drugs includes Fosamax, Boniva, Actonel, and Reclast. Most bisphosphonates are taken by mouth, usually once a week or once a month. Reclast is given by injection, usually once a year.
Calcitonin. Calcitonin, a hormone that helps prevent the breakdown of bone, is available generically and under the brand names Fortical and Miacalcin. It is given by injection or nasal spray. Calcitonin is also found in salmon.
Hormone replacement therapy. Once a popular therapy for preventing bone loss, hormone replacement therapy is rarely used for that purpose anymore, because it has been found to increase the risk for deep venous thrombosis (blood clots in the leg), pulmonary embolus (blood clots in the lung), and other health problems. Sometimes, if hormone replacement has been helpful for easing a woman’s menopausal symptoms, her doctor may recommend continuing it for bone loss, too. If you are considering hormone replacement therapy to prevent osteoporosis, speak with your doctor about the potential risks.
Parathyroid hormone. Forteo, a portion of hormone made by your parathyroid glands, is the first agent to stimulate the formation of new bone. It is approved for women and men and is given daily by a shot beneath the skin.
Evista. Similar to the breast cancer drug tamoxifen, this drug is used to prevent and treat osteoporosis. It may also be protective against heart disease and breast cancer; however, more studies are needed to confirm its protective effect. It is taken by mouth once a day.
Natural Treatments for Osteopenia
Although your doctor may recommend medications if you have already broken a bone, there are a number of nutritional supplements and herbs women with osteopenia may try to promote stronger bones. The main ones are calcium and vitamin D supplements. If you aren’t getting enough calcium in your diet and don’t spend much time in the sun, speak to your doctor about these supplements. Calcium is an important mineral needed to make bone. Vitamin D helps your body use calcium. Most adults should get between 1,000 and 1,200 milligrams of calcium and 400 and 1,000 international units (IU) of vitamin D daily.
Evidence is limited, but other nutritional supplements that may potentially help strengthen bones include:
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — the two omega-3 fatty acids found in fish
Folic acid, vitamin B6, and vitamin B12
Herbs that might be helpful include:
Talk to your doctor about herbal and nutritional supplements before taking them.