Osteopenia and Osteoporosis

Osteopenia is a condition that precedes osteoporosis. In osteopenia, bone density is lower than normal but not low enough to be classified as osteoporosis. Osteopenia has no symptoms and is detected solely through bone density measurement (densitometry).

What is Osteopenia?

As people age, bones become thinner. Everyone loses bone mass after the age of 30. Simply put, existing bone mass is absorbed by the body more quickly than new bone is formed.

Bones lose minerals, mass, and structure, becoming thin and porous. In some individuals, osteopenia is not due to the loss of bone mass but rather a result of having a naturally lower bone density. Besides aging, certain conditions, treatments, and processes can cause osteopenia:

• Certain metabolic disorders that prevent the body from utilizing necessary dietary minerals and vitamins
• Nutritional deficiencies (insufficient intake of vitamins and minerals)
• Use of steroids
• Chemotherapy
• Radiation exposure

Why Does Osteopenia Occur?

Women are more prone to developing osteopenia and osteoporosis. This is explained by the fact that women lose bone mass more rapidly due to hormonal changes that occur during menopause.

Not everyone diagnosed with osteopenia will necessarily develop osteoporosis. However, the risk exists, which is why timely intervention is essential. Osteopenia is a condition, not a disease. At this stage, certain steps can be taken to prevent the onset of osteoporosis:

• Regular physical activity
• Maintaining a healthy body weight
• Adequate intake of calcium and vitamin D
• Quitting smoking

What is Osteoporosis?

In contrast to osteopenia, osteoporosis is a serious disease. It can be considered a stealthy illness, as it develops without pronounced symptoms and significantly diminishes quality of life.

In osteoporosis, the loss of bone mass is greater, bones are very porous, and fractures are easy to occur. The risk of bone fractures is high even with minimal physical effort or contact. Hip fractures (hip osteoporosis) and forearm fractures are the most common.

Symptoms often go unnoticed, and the condition is usually detected after a fracture occurs.

Symptoms of Osteopenia

In a small number of people, certain symptoms may appear, which are often mistaken for arthritis, leading to a lack of medical consultation:

• Dull back pain (mostly pronounced while standing, alleviated when lying down)
• Stooped posture
• Decreased height over time

 

Osteopenia and Osteoporosis – Risk Factors

Many factors can influence the development of osteoporosis, starting from gender, age, race, lifestyle, health conditions, and treatments.

Non-modifiable Risk Factors:

• Gender: Women are more prone to osteoporosis than men.
• Age: The older a person is, the greater the chance of developing osteoporosis.
• Race: The highest risk is found among individuals of Caucasian descent and those of Asian origin.
• Family History: If there have been cases of osteoporosis in the family (parents, siblings), the risk is higher.
• Body Size: Individuals with smaller bodies generally have less bone mass, thus a higher risk.

In addition to these factors, there are modifiable risk factors:

Hormonal Factors: Osteoporosis is more common in individuals with excess or deficiency of certain hormones.

• Reduced levels of sex hormones tend to weaken bones.
• Decreased estrogen levels in women during menopause is one of the most significant factors for developing osteoporosis.
• Reduced testosterone levels in men also pose a risk. Treatments that lower these hormone levels (such as those for prostate cancer that reduce testosterone, or treatments for breast cancer that lower estrogen) represent a risk factor.
• Overactive thyroid function is a risk factor for developing osteoporosis.
• Osteoporosis is also associated with excessive activity of the adrenal and parathyroid glands.

Dietary Factors: Low calcium intake contributes to decreased bone density, along with various nutritional disorders, malnutrition, and restricted food intake.

• Use of steroids and other medications: Long-term use of corticosteroids disrupts bone renewal processes.
• Health conditions: The risk of osteoporosis is higher in individuals suffering from celiac disease, inflammatory bowel disease, gastroesophageal reflux, rheumatoid arthritis, lupus, and others.
• Poor lifestyle habits: Sedentary lifestyles, excessive sitting, and inadequate physical activity are significant risks for developing osteoporosis. Additionally, excessive alcohol consumption and tobacco use contribute to bone weakening.

To detect porous changes in bones in a timely manner, densitometry (bone density measurement) and certain laboratory tests are necessary, which can indicate potential changes, such as:

• 25-OH vitamin D3
• 1,25-dihydroxy vitamin D
• Ionized calcium
• PTH (parathyroid hormone)
• Osteocalcin
• DPD (deoxypyridinoline)
• ALP (alkaline phosphatase)
• Beta-CrossLaps
• Estradiol in women and testosterone in men

However, the best course of action is timely prevention. Change lifestyle habits, which means increasing physical activity, ensuring optimal nutrient intake, getting daily exposure to sunlight to produce adequate vitamin D, and avoiding excessive alcohol and carbonated beverage consumption, as well as quitting smoking.
For more information, please consult your physician.