The difference between Osteopenia and Osteoporosis

The difference between osteopenia and osteoporosis

What is the difference between Osteopenia and Osteoporosis?

Factors like age, diet, family history, and the extent of physical activities can influence the women’s risk of developing Osteopenia or Osteoporosis, both of which are bone disorders. Women need to be aware of the difference between Osteopenia and Osteoporosis so that they can take steps to prevent or treat the progression.

Let’s talk about the differences between Osteopenia and Osteoporosis based on their pathogenesis (that’s the way the disease itself progresses), risk factors, and treatment.

How does it start?

First things first.  Osteo means ‘bone’ and porosis means ‘porous’ or full pores.  So Osteoporosis means porous bones.

More specifically, the difference between Osteopenia and Osteoporosis is the level of bone density. Osteopenia marks the early stage or precursor of osteoporosis when the loss of bone density has occurred only to some extent. Detection of Osteopenia at an early stage and treating it may slow down the bone loss thereby preventing Osteoporosis.  Osteopenia is considered to be a midway point when the bones begin to lose their density though they haven’t become porous enough to be characterized as Osteoporosis. [3]

Osteoporosis refers to the weakness of the bones caused due to the reduced bone mineral density. [1]

Interpreting Bone Density Scores

Interpretation of Bone Mineral Density (BMD) is the key to the diagnosis of Osteopenia and Osteoporosis. The lower the BMD, the more is your risk of developing a fracture. Both Osteopenia and Osteoporosis are caused due to the reduced bone mineral density.

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The bone density tests can help to determine the extent of bone loss and thus, help in the correct diagnosis of the conditions. BMD tests can be done by scanning the bones in the spine, hip, shin, wrists, or the heels. It is a painless procedure that can enable a highly accurate assessment of the density of minerals in the bones. [4]

In healthy adult women, the peak bone density is usually at about age 30 and the BMD of women at this age is considered the standard or basis for determining the bone health in a patient. The test result is called the T-score range

 A T-score between +1 and -1 is considered normal or healthy.  If your T-score is from -1.0 to -2.5, it could be diagnosed as osteopenia. A T-score of less than -2.5 warrants the diagnosis of osteoporosis. Women diagnosed with osteopenia have a higher risk of osteoporosis. Early diagnosis of osteopenia through regular BMD tests can allow most patients to take clear steps to manage the risk are essential to prevent osteoporosis.

What are the causes of low bone density?

Low bone mineral density can occur primarily due to aging in both men and women. The risk is higher in women due to hormonal fluctuations occurring in their body during and after menopause. [5]

Lack of exercise and improper dietary habits can also trigger the loss of bone density. Women who do not consume an adequate amount of calcium and vitamin D are more likely to develop Osteopenia and Osteoporosis.

Genetics can also play a role in the development of these diseases. Women who have a family history of Osteoporosis or Osteopenia are more likely to develop it. Other genetically linked health conditions such as cystic fibrosis are also known to contribute to the development of Osteopenia and Osteoporosis.

Women who suffer from thyroid problems can develop low bone density due to the imbalance of hormones that play a role in the absorption of calcium and vitamin D.

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Your risk of Osteopenia and Osteoporosis is increased if:

  • You have had menopause before the age of 45
  • Your ovaries are removed before menopause
  • You’ve had a habit of smoking or using tobacco in other forms
  • You have a habit of abusing alcohol or caffeinated beverages
  • You take medications that interfere with calcium absorption or the process of bone formation such as phenytoin or prednisone

Can there be complications of Osteopenia and Osteoporosis?

Yes.  If you have advanced Osteoporosis, even a missed step, light fall, or minor injury can cause the bones to break.  In severe cases, a simple sneeze can also result in fractures of ribs as the weakened bones are unable to sustain the pressure of even a sneeze or cough.

Fractures caused due to osteoporosis usually occur in the hip bone, femur, and the spine. Some spinal fractures are called vertebral compression fractures.

The risk of fractures is lower in women with osteopenia than in women with osteoporosis. However, it is important to detect and treat osteopenia so that the progression towards osteoporosis can be prevented.

How can I improve?

The best ways to prevent Osteopenia and Osteoporosis are through nutrition, exercise, and good habits.

  • Increase your intake of calcium and vitamin D-rich foods. Get a little sunshine!  A small amount of sun exposure is also recommended to improve vitamin D supply to the body. [6] [7]
  • Avoid smoking to prevent bone loss.  Also consider limiting your intake of alcohol and caffeinated beverages. [8]
  • Exercise regularly to build stronger bones and muscles. Brisk walking, running, dancing, and stair climbing are some of the best physical activities that can strengthen the muscles and bones and prevent bone loss.
  • If you are over 50,  you should get a bone mineral density (BMD) test at least once every year to detect these conditions before undesirable consequences occur. A regular DEXA scan is also recommended to assess bone health.
  • Consider vitamin D and calcium supplements.  And your doctor may recommend hormone replacement therapies to prevent the bone loss linked to hormonal imbalances.

It’s pretty easy-

The difference between Osteopenia and Osteoporosis is the extent of bone loss. So we should all make sure our bones are healthy and strong by eating a nutritious diet and getting adequate levels of calcium and vitamin D. This can help minimize the bone loss linked to Osteopenia and Osteoporosis and minimize the risk of fractures. No one wants broken bones!

References:

  1. https://www.health.harvard.edu/womens-health/osteopenia-when-you-have-weak-bones-but-not-osteoporosis
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985792/
  3. https://www.ncbi.nlm.nih.gov/books/NBK499878/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369457/
  5. https://pubmed.ncbi.nlm.nih.gov/15501643/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745207/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367643/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304634/1

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