Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 31, 2016

Osteopenia is a condition where the body's bone density is lower than normal but is not low enough to be considered osteoporosis. Bone density refers to a determination of how dense and strong the body's bones are. Osteopenia may lead to osteoporosis. 


Definition and Facts

Osteopenia is a measure of low bone mass. Having osteopenia does not necessarily mean that a person is progressively losing bone. A person may have osteopenia because he or she never developed a high peak bone mass in their youth. It could also be because the person was born with bones that are less dense than average.

It is said that 21.8 million American women have the condition and 11.8 million men as well. The diagnosis of osteopenia may be difficult to attain. If there are indications that a person is progressively losing bone, then they will need to consider their diet and nutrition. If a person is not losing bone and has a healthy diet, then there may be no action that is necessary to take to maintain health. 

Symptoms & Complaints

Osteopenia does not involve pain unless a bone is fractured. Some fractures that come as a result of osteopenia or osteoporosis can be very painful. This is the case with hip fractures or vertebral fractures.

Fractures in people with osteopenia do not always result in pain, and these kinds of fractures can go unnoticed. For this reason, a person may have osteopenia or even osteoporosis many years before either of these conditions are diagnosed.


There are many causes of osteopenia. Common causes and risk factors are:

Diagnosis & Tests

Osteopenia is diagnosed with a bone mineral density test. The most accurate form of this is a dual-energy X-ray absorptiometry scan. The DEXA scan can detect as little as 2 percent of bone loss per year. A standard X-ray is not useful for diagnosing osteopenia.

Screening for osteoporosis is recommended for women who are 65 or older. Women who are 60 to 64 should be screened if they have at least one risk factor in addition to menopause. The risk factors include:

It should be noted that osteopenia is a condition that affects men as well as women. It is just that the condition typically affects men at an older age than women. Men are also at risk if they have low levels of testosterone

Treatment & Therapy

Osteopenia is treated by making an effort to prevent further bone loss and to prevent the development of osteoporosis. Sometimes, medication is needed. However, mucgh can be done with lifestyle changes that can help lessen bone loss. Diet is crucial for bone development. Calcium is the most critical nutrient for bone mass. The best sources of calcium are milk and other dairy products, green vegetables, and calcium-enriched products A person's doctor may recommend that they take a calcium supplement.

Many times, such supplements will be combined with vitamin D. Vitamin D aids the body in absorbing calcium and other minerals. Foods that contain it are eggs, salmon, swordfish, and some fish oils. It is added to milk and can be taken in the form of calcium and vitamin supplements. Also, the body manufactures vitamin D in response to sunlight so spending enough time in the sun is important.

Exercise is also crucial to maintaining strong bones. Bone develops in response to physical stress. Weight-bearing exercises like walking, hiking, and dancing are all good at preventing osteopenia. Adding exercises with weights or elastic bands can support the bones in the upper body. A doctor can be useful in figuring out an adequate exercise plan. A physical therapist may also assist patients in devising exercise plans.

It is important to not smoke and to avoid consuming alcohol in excess. Caffeine and sodas are also known to be a problem. There are medications that can treat bone thinning, but they are more typically used for osteoporosis. The medication that is prescribed for osteopenia includes bisphosphonates, raloxifene, and hormone replacement therapy

Prevention & Prophylaxis

The following steps are recommended for preventing osteopenia:

  • The person needs to get enough calcium. They should choose high quality organic dairy products such as yogurt and milk. They should also consume sardines and dark leafy greens. They should consider taking a calcium supplement if they are not getting three servings a day of calcium-rich food. 
  • The person should make sure to get enough vitamin D. It is a good idea to supplement with 2,000 IU daily for adults. 
  • The person should watch their sodium intake and adopt a low sodium diet. They should avoid processed food and fast foods.
  • The person should increase their intake of vegetables and fruit. Potassium, magnesium, and vitamin C have been connected with higher total bone mass. 
  • The person should limit caffeine intake.
  • The person should avoid alcohol or drink only in moderation. 
  • The person should try to do at least 30 minutes of exercise most days of the week. 
  • The person should eat magnesium-rich foods every day. These include spinach, tofu, almonds, broccoli, and lentils. Pumpkin seeds and sunflower seeds are also rich in magnesium. 
  • The person should consume vitamin K foods every day. Foods that are rich in this are green leafy vegetables. However, most vegetables are good sources of it as well. 

Taking all of these steps is a good way of avoiding osteopenia and osteoporosis.