Your BMD estimates the chances of breaking a bone from a normal activity. However, having osteopenia does increase your chances of developing osteoporosis. This bone disease causes fractures, stooped posture, and can lead to severe pain and loss of height. You can take action to prevent osteopenia. The right exercise and food choices may help keep your bones strong.
If you have osteopenia, ask your doctor about how you can improve and prevent worsening so you can avoid osteoporosis. Aging is the most common risk factor for osteopenia.
After your bone mass peaks, your body breaks down old bone faster than it builds new bone. That means you lose some bone density. Women lose bone more quickly after menopause, due to lower estrogen levels.
If you lose too much, your bone mass may drop low enough to be considered osteopenia. About half of Americans older than age 50 get osteopenia. The more of these risk factors you have, the higher your risk is:.
Your doctor may recommend that you have your BMD tested for other reasons. For instance, about one in three white and Asian men older than age 50 have low bone density. It uses X-rays that have lower radiation than a typical X-ray. The test is painless. DEXA usually measures bone density levels in your spine, hip, wrist, finger, shin, or heel. The FRAX tool uses your bone density and other risk factors to estimate your risk of breaking your hip, spine, forearm, or shoulder within the next 10 years.
In addition, studies finding an increased risk of breast cancer, heart disease, and strokes in women taking HRT has resulted in these medications being used much less frequently. Certainly, there are still people who use HRT for menopausal symptoms, and it can work well for these symptoms. One significant cause of bone loss in menopausal women is the reduction in the amount of estrogen produced by the body.
It makes sense then that hormone replacement therapy HRT would help reduce bone loss. As with any medication, you must weigh the risks and benefits of any medication you use. For young women who have had surgical menopause and are suffering from life-limiting hot flashes, HRT may be a good option. Yet, even in this setting, the goal of treatment with HRT should not be a reduction in osteoporosis risk.
Used most often by people with cancer, denosumab is a monoclonal antibody which prevents the formation of osteoclasts, cells which cause the breakdown of bone. Denosumab is also used for people with any type of cancer which has spread to their bones to reduce the risk of fractures. Given by injection, denosumab has a side effect profile similar to bisphosphonates and may increase the risk of osteonecrosis of the jaw. Calcitonin is a man-made version of a hormone in our bodies that regulates bone metabolism and helps change the rate at which the body reabsorbs bone.
It is available both as a nasal spray and by injection and can reduce the risk of spine fractures. Miacalcin nasal spray, in particular, may be an option for postmenopausal women who can't tolerate the side effects of other medications. Forteo teriparatide is a man-made version of the body's natural parathyroid hormone and is usually used only for people with severe osteoporosis who are at a high risk of fractures. It is the only medication which can actually stimulate the body to grow new bone.
Use is currently restricted to only 2 years. There is debate over the use of medications to treat osteopenia, and some argue that osteopenia is a natural part of aging. Yet we know that some people will be at a greater risk of suffering fractures, and all that a fracture might mean if it is left untreated. If you have osteopenia, you and your healthcare provider can estimate your year risk of developing a hip or spine fracture using charts and tables available from the World Health Organization or the Osteoporosis Foundation.
Whether or not you choose to use medications for osteopenia, there are things you can do to reduce your risk of fractures. From making sure your stairs are free of clutter to staying off of ladders, there are a number of simple ways you can reduce your chance of a fall. Getting adequate calcium and vitamin D is important as well.
Many people get ample calcium in their diet, but vitamin D is harder to come by, especially in Northern climates. Talk to your healthcare provider about checking your vitamin D level most people are deficient. If your level is low or in the lower part of the normal range, ask about whether or not you should take a vitamin D3 supplement. Regular exercise and abstaining from smoking are also crucially important in the prevention of osteoporosis.
Unlike osteoporosis, there aren't clear guidelines on treating osteopenia, and each person must be evaluated carefully to decide whether medications may be of benefit. One major consideration is whether a person is expected to progress to having osteoporosis or is at an increased risk of suffering fractures as a result of other medical conditions. There are several medications which can be effective in reducing bone loss, but these all come with the risk of side effects as well.
Currently, the only drugs approved for osteopenia osteoporosis prevention are Actonel and Evista. Other medications, however, may be considered based on an individuals particular circumstances. If you have been diagnosed with osteopenia have a careful discussion with your healthcare provider. Talk about what may be expected in the years to come.
Talk about your risk of fractures, and what fractures might mean with regard to your mobility and independence. Then talk about the potential side effects of any treatment and weigh these against any benefit you might predict.
It's important to be your own advocate in your care, especially in a situation such as this in which treatment options must be carefully individualized. Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. See more conditions.
Osteoporosis treatment: Medications can help. Products and services. Osteoporosis treatment: Medications can help Osteoporosis treatment may involve medication along with lifestyle change. By Mayo Clinic Staff.
Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. Something went wrong on our side, please try again. Show references Osteoporosis: In-depth. Accessed June 9, Goldman L, et al. In: Goldman-Cecil Medicine. Elsevier; Eastell R, et al.
Pharmacological management of osteoporosis in postmenopausal women: An Endocrine Society clinical practice guideline. Journal of Endocrinology and Metabolism. Ferri FF. In: Ferri's Clinical Advisor Rosen HN, et al. Overview of the management of osteoporosis in postmenopausal women.
Rosen HN. Risks of bisphosphonate therapy in patients with osteoporosis. Bone HG, et al. Lancet Diabetes and Endocrinology. Kearns AE expert opinion. Mayo Clinic. June 15, See also Aging and unsteady gait Ankylosing spondylitis: Am I at risk of osteoporosis?
In fact, osteopenia does not need to be treated with any drugs at all. At first, this may not make sense. But the research has shown that the drugs most commonly used to treat osteoporosis—bisphosphonates, such as alendronate brand name Fosamax , and the drug raloxifene brand name Evista —do not significantly reduce fracture risk in women with osteopenia.
Because women with osteopenia have had so little bone loss and have such a low risk for fracture there is very little for the drug to do. So why are many women with osteopenia being prescribed medication?
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