Osteopenia

Guidance for NHS Patients Diagnosed with Osteopenia

Understanding Osteopenia

Osteopenia is a condition where your bone mineral density (BMD) is lower than normal, but not low enough to be classified as osteoporosis. It is often a precursor to osteoporosis, where the bones become fragile and more prone to fractures. The condition is common as people age, particularly in postmenopausal women and older men, but it can affect anyone.

Osteopenia doesn’t usually cause symptoms, so people may not be aware they have it until they are tested or experience a fracture. However, it’s important to manage the condition and take steps to protect bone health to reduce the risk of progression to osteoporosis.

How Osteopenia is Diagnosed

The most common way to diagnose osteopenia is through a DEXA (Dual-energy X-ray Absorptiometry) bone scan. The DEXA scan measures the density of bones, typically in the hip and spine, and compares the results to a healthy young adult (known as the T-score). The score helps to classify bone health as follows:

• T-score above -1.0: Normal bone density
• T-score between -1.0 and -2.5: Osteopenia (low bone density)
• T-score below -2.5: Osteoporosis (very low bone density)

A DEXA scan provides an accurate assessment of bone density and helps doctors determine the appropriate steps to prevent further bone loss.

Self-Help Advice for Reducing the Risk of Progression to Osteoporosis

While osteopenia cannot always be reversed, lifestyle changes can help maintain bone health and reduce the risk of it progressing to osteoporosis.

1. Ensure a Healthy, High-Calcium Diet

   • Calcium is essential for maintaining strong bones. It is important to ensure that you are getting enough through your diet. Adults generally need 700 mg of calcium per day. If you are over 50 or postmenopausal, you may need 1,200 mg per day.
   • Good dietary sources of calcium:
     • Dairy products (milk, cheese, yogurt)
     • Leafy green vegetables (e.g., broccoli, kale, spinach)
     • Fortified foods (e.g., some plant milks, breakfast cereals)
     • Fish with edible bones (e.g., sardines, salmon)
     • Tofu and fortified soy products

2. Vitamin D for Calcium Absorption

   • Vitamin D is important for calcium absorption and bone health. You can get vitamin D from:
     • Sunlight exposure (15-30 minutes per day depending on skin type)
     • Fatty fish (salmon, mackerel)
     • Fortified foods (e.g., milk, cereals, plant-based milks)
     • Supplements may be recommended, especially in winter months or for those at risk of deficiency.

3. Weight-Bearing Exercise

   • Physical activity, particularly weight-bearing exercises, can help strengthen bones and reduce the risk of fractures. Weight-bearing exercises involve activities that make you work against gravity, helping to stimulate bone formation.
     • Examples:
       • Walking or hiking
       • Dancing
       • Weightlifting or resistance training
       • Jogging or running
       • Tennis or other racquet sports
   • Aim for at least 30 minutes of moderate activity on most days of the week.

4. Avoid Smoking

   • Smoking is harmful to bone health. It reduces the body’s ability to absorb calcium and increases the risk of bone loss and fractures. If you smoke, seek support to quit. Your doctor or local NHS services can provide advice and resources.

5. Moderate Alcohol Intake

   • Drinking excessive alcohol can interfere with bone health by affecting calcium absorption and bone-building processes. It’s best to drink alcohol in moderation:
     • For women, no more than 2-3 units per day to a maximum of 14 units a week
     • For men, no more than 3-4 units per day to a maximum of 14 units a week
   • A unit of alcohol is typically a small glass of wine, half a pint of beer, or a single shot of spirits.

6. Maintain a Healthy Weight

   • Being underweight or overweight can negatively affect bone health. Achieving a healthy weight can reduce strain on your bones and reduce the risk of fractures.

7. Regular Check-ups

   • Stay in touch with your healthcare provider to monitor your bone health. They may suggest further bone density tests and guide treatment options, which may include medications if necessary.

8. Supplements

   • If you’re unable to get enough calcium or vitamin D through your diet, your doctor may recommend supplements. Always consult a healthcare professional before starting any new supplement.

Additional Resources

For more information on managing osteopenia and maintaining bone health, the following NHS websites can be useful:

• NHS Osteoporosis and Bone Health: NHS Website - Osteoporosis
• NHS Healthy Eating and Nutrition: NHS Website - Healthy Eating
• NHS Physical Activity Guidelines: NHS Website - Exercise
• NHS Help to Quit Smoking: NHS Website - Smoking

By following these guidelines, you can help protect your bone health and reduce the likelihood of osteopenia progressing to osteoporosis. Be proactive about your health and work with your healthcare provider to develop a plan that’s right for you.