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Osteopenia: Let's Talk About Bone Health

If we want to live our lives with vitality through to the very end, we really must appreciate the importance of protecting our bone health. After the age of fifty, especially in women, our bones become more vulnerable and once they start to weaken, osteopenia can result. There aren't any signs or symptoms when our bones lose their mineral density, that is until we start to collapse a bit. The thing is though, we can do pretty simple lifestyle changes earlier in life to help preserve our bone density and prevent #osteoporosis so we can maintain our vitality.


Osteopenia isn't as severe as osteoporosis, a disease that weakens the bones so much that they can break more easily. You've seen older women whose back is so weak it literally collapses upon itself, causing them to hump over. Not everyone with osteopenia develops osteoporosis either, but it can happen. If you know you are losing bone mineral density and have been diagnosed with osteopenia, this is your big wake up call to start prioritizing your bone health. It's time to strengthen and protect those bones, and hopefully your primary care provider is talking to you about this, and how you can monitor your bone density.



Bones are made up of living tissues, and until the age of thirty, we build more bone than we lose. After about 35 though, bones begin to break down faster than we build them naturally. Even in a healthy person, bone density decreases throughout life. Some scenarios speed this up even more, such as hyperthyroidism, anorexia and bulimia, steroids, cancer treatments, menopause, poor nutrition, low #vitaminD, gastrointestinal surgery, even some medications for heartburn, high blood pressure, seizures, and even some birth control. Inflammatory diseases such as Lupus, Crohn's, and Rheumatoid arthritis are also contributing factors. Smoking, alcohol and caffeine are other causes, but potentially the most impactful is lack of movement and weight bearing exercises.


Your primary care practitioner has this in mind when offering your annual wellness exam. We do a body composition measurement on all our wellness clients, from early adulthood through the senior years so we have some awareness of bone density. There are higher grade tools for measuring bone density though, with the gold standard being the dual-energy X-ray absorpitometry (DEXA). This is a quick and painless imaging, using low radiation X-rays, to determine your bone density and whether you may already have either osteopenia or osteoporosis. Bones are evaluated in what we call a T-score, with +1 to -1 reassuring, and -1 to -2.5 indicating osteopenia, and then anything beyond -2.5 indicative of osteoporosis. Doing this over time helps us establish a trend as well.


Osteopenic Treatment


Conventional medicine will tell you there is no cure here, but that's because we don't always believe people will invest in themselves and make the necessary changes in the lifestyle. Bone density can be preserved as much as possible with calcium, a healthy diet, and by supplementing vitamin D and calcium but getting weight on your bones is vital to building their strength. Resistance bands, kettle ball exercises, walking, dancing, jumping, biking, and yoga are great options. We use to recommend exercises in the pool for the senior population because it was so good for their joints, but we've learned that this reduced weight bearing on the bones and worsened their scenario.


If you are supplementing calcium, aim for about 1,200 mg daily and about 4,000 mg of vitamin D3. You'll want to take this with K2 and of course, fish oils are always important. Go outside and walk in the sun, at least 7K to 10K steps daily. Eat fresh, clean foods. Limit alcohol.


Every two to three years, the #DEXA scan is recommended for women over the age of 65 years or younger if there are risk factors and they are postmenopausal, but there are a number of ways to monitor this if you aren't at high risk. As I mentioned, our practice does offer the bone density test which can give some hint to bone health. If you breastfed, this will assist you greatly into your later years - the more accumulated years, the better. Men aren't without risk either; one in three white and Asian men older than 50 years have low bone density.


Falls & Fractures


The bigger risk really is falling, which is the leading cause of fractures in those with low bone density. We always use to believe though that falls caused those hip fractures in the elderly, and certainly with some that is true, but with a good number, the hip breaks first and then the individual falls. When the backs start to collapse as well, this reduces the space for organ function and is super restrictive on our movement, even efforts to breathe.


If you are at risk, or your grandmother, assure there is ample lighting in their living space, and put railings on stairs, the shower, and around the stool. Remove any tripping hazards such as smaller furniture, rugs that turn up at the corners, or items which are out of place. Treat slippery surfaces immediately, such as spills, ice, and snow. Use nonskid rugs on the floor.



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