Friday, October 11, 2013

What Is Osteopenia?

Karen's Whole Body DXA Bone Scan 9/28/13
I recently participated in a research study where I received 5 different images of my fat, muscles and/or bones via a DXA scan.

As a participant, I signed forms that emphasized that this scan was for research purposes and not for diagnostic purposes. The print out of my scans also notes: "Image not for diagnostic use."

Nevertheless, I decided to take my DXA results as an opportunity to learn more about bone health.

If you are concerned about bone health, please consult with a board-certified medical expert.

The DXA operator was a Ph.D. in exercise physiology who has done research on bone and muscle loss. Dr. Young also reviewed my results. I had lower-than-average results for percent of body fat. That's good news.  However, I also had lower-than-average results for muscle mass and bone mass. That's not good news.

I feel confident in designing a program for increasing muscle mass. I lifted weights 2 to 3 times a week for a couple of years in my late 40s, but I have slacked off. It's time to add that back to my workout schedule.

However, I am less confident about how to address the bone loss. I need to learn more about how to maintain healthy bones.

Technically speaking, my overall bone mass scores T scores were -0.7, This places me very near the zone of osteopenia. Osteopenia describes the state where bone mass density (BMD) falls between the T scores of -1 and -2.5,  which is one standard deviation below the norm. This range differs from osteoporosis, which occurs when scores are between -2.6 and -5. Those lower scores are two standard deviations below the mean.

My biggest concern is about some of the individual scores for various bones in my body. While my head and legs showed high bone density, I had low scores of -2.4 and -2.3 in my hips and -1.2 in my L3 spinal cord.

Osteopenia is less severe and actually not even a disease. In fact, it's relatively new, having been defined and named only in 1992. It's more of a "caution sign" flashing well before the red light. It indicates risk of osteoporosis. It's important to note that osteropenia doesn't automatically mean a further decay. Some people never advance to the more severe state of bone weakness--osteoporosis.

There is actually a lot of controversy about how to properly measure bone mass density and controversy on whether or not to treat osteopenia with prescription medication. In an article by Kate Murphy of the New York Times, she refers to the controversy that such medications cause more harm in side effects than they result in good in outcomes:
Dr. Alonso-Coello was the lead author of an analysis of osteoporosis drugs published last year in The British Medical Journal, concluding that they were largely ineffective and unnecessary in women with osteopenia.
I don't have the training to weigh in on this debate. However, I believe that people need to do work with medical professionals, seek second opinions and read a wide range of evidence-based studies before taking any medication--especially medication ingested over weeks, months and years. Often the risks of certain side effects of medications are higher than the probability of prevention. and lower than the rate of cure. Make an informed decision.

As I read about bone health in the wake of my DXA results, I more fully understand that bone health is something people should strive for throughout their entire lifespan. Some risk factors are beyond my control: I'm white, female, moving through menopause, and small-framed.

Some modifiable risk factors are now well in my past. I avoided dairy as a child.  Also, I was very bookish and avoided athletics when I was younger and had Mother Nature on my side for building stronger bones. Bone mass density peaks around 28-30 years of age. The thicker bones you have before then, the more protection you have against age-related decay. In my 20s I ran for a few years; however, I developed heal spurs, so I switched to low-impact exercises. I didn't realize that I was limiting my bone density by adopting so much low-impact exercise.

Nevertheless, it's never too late to make lifestyle changes that can improve our bone health.

Here is my provisional plan for increased bone health:.
  • Diet. Increase my intake of calcium, vitamin D, magnesium, potassium and vitamin K. 
  • High-impact Exercise.  Increase walking and running in place of low-impact such as swimming, cycling or low-impact machines such as the arc trainer and the elliptical. 
  • Strength Training. Some experts encourage lifting weights as a better way to increase bone strength since high-impact exercise has its limits. 
  • Supplements.  I prefer getting my vitamins and minerals from whole foods, but I might start taking a daily supplement if I can't eat enough food to address my bones' needs.  I need to schedule an appointment with my doctor to explore this option further. 
Aging brings a number of concerns to my attention, which can make it difficult to address every aspect of my health while also maintaining my other responsibilities as wife, mother, adjunct instructor, gal pal, volunteer, committee member, and blogger. Nevertheless, I need to make "steward of thinning bones" a more prominent role so that I can do all I can to improve--or at least maintain--my current bone mass density. 



  1. Read yesterday that a study found vitamin D useless in preventing or aiding cases of osteoporosis

    1. I just wrote a post about Vitamin D. (I'm writing one post a month about bone health.) 10-15 minutes of sunshine a day (for light-skinned people) is the best way to get Vitamin D. See the link above in the "Related" section at the bottom of the post.

  2. I saw that on CNN while I was at the gym. It is important to stay current about research.

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  4. Karen:
    I have been a lifelong walker, walking everywhere I could.
    Now at age 58 I find I have great bone density but also a bad knee.
    Can't win for losing....

  5. It is so hard to keep up with these changes! When I saw my doctor for a routine checkup in January, she told me to take extra D.

  6. I'd like my bone density scans to be compared with women in my own age group. Am I showing normal changes in my bone density? Comparing our bone density to that of 20 year olds makes me cranky.

  7. I had the same though Barbara had. I am sure everything in my body was stronger, denser and firmer at 30 than it is at 63. What seems important is to determine if at your age the density is in a normal and sustainable range. Becoming a tri-athlete to strengthen mt bones would NOT be on my list of things likely to get done.

    1. Barbara and Jo: Yes, we have to accept the inevitability of the aging process. However, walking 30 minutes a day and doing strength training (weight lifting) 3 times a week correlates with many health factors and it helps with bone density. I could do better about lifting weights. I need to make a chart or something to get me motivated.

  8. Make an action plan exactly like you mentioned in your comment. Check it weekly with a friend who has her own action plan for accountability purposes.