Osteopenia and Osteoporosis

I recently found out that I'm Osteopenic in my neck and right hip.  I had never heard of it before, until I received my bone density scan results in the mail.  Since those with RA are more prone to getting Osteopenia and Osteoporosis, I figured it was time to do a blog on both. 

If you don't already know, patients who have RA, are at risk for these because inflammation untreated and being on prednisone for a long time, can cause some bone loss.  I've been on and off prednisone for almost 23 years, and my rheumatologists have had a hard time controlling my JRA since I was 3.  Because of that, I've had inflammation many times and each time I was put on prednisone since it's the only thing that works.  For those who don't know, prednisone is corticosteroid tablet that is used as a short-term medicine only, because of it's long term side effects, like bone loss.  Let's take a look at what Osteopenia and Osteoporiosis actually are, and how they affect us.

Osteopenia is diagnosed when the bone mineral density (BMD) is lower than normal, but not low enough to be Osteporosis.  Bone mineral density is a measurement of the level of minerals in the bones, which indicates how dense and strong they are.   If your BMD is low, compared with others, than you are considered osteopenic and are are a greater risk, as time goes on, of developing osteoporosis.   As you get older, your bones naturally become thinner because existing bones cells are absorbed into the body faster than new bone is being made.  When this occurs, the bone loses mass, structure, and minerals, making them weaker and more prone to breaking or fracturing.   Bone loss beings at age 30, when your bones have reached their peak BMD.  The stronger your bones are by the time you're 30, the less likely you are to develop osteopenia or osteoporosis. 

Osteopenia is more common in women, than men because, women have lower BMD and bone loss speeds up when hormonal changes take place, like menopause.  In both men and women different factors can contribute to osteopenia, such as: Eating disorders, or metabolism troubles that don't allow the body to absorb or take in vitamins and minerals. Chemotherapy, or medicines like steroids used to treat certain conditions like Rheumatoid Arthritis.  Exposure to radiation.  Other conditions such as family history, being Caucasian or Asian, limited exercise, smoking, drinks lots of soda and alcohol. 

Osteopenia is treated by taking action to help prevent it from turning into osteoporosis.  Treatment includes change in diet, like adding more calcium enriched foods. Foods that are rich in calcium include cheese, ice cream, leafy green vegetables (spinach is my favorite), low-fat milk, Salmon, Sardines (with bone), Tofu and yogurt.   Your doctor may also recommend you go on a Vitamin D supplement, since vitamin D helps your body absorb calcium into the bones.  It's important to get at least 1,200 milligrams per day of calcium and 800 - 1,000 international units of vitamin D3. Weight bearing exercises, and sometimes medicine, like Boniva, is used especially if the risk of getting osteoporosis is high.

Osteoporosis, is severe thinning of the bone tissue and bone mineral density over time.  It's estimated that 1 in 5 American women over the age of 50 are diagnosed with Osteoporosis.  "Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production and bone tissues may suffer." (Med Health)   This happens over time, and since Osteoporosis has no symptoms, it's usually not detected until one falls and fractures a bone.  This is why early testing is very important, as well as early treatment, even diet changes, can help huge in the long run.

Osteoporosis is treated in similar ways as Osteopenia, and the main goal of both is to slow down or even stop the progression of bone loss.  Change in diet is also used to treat Osteoporosis, as you can see above.  Bisphosphonates are the most common used medications given.   These medications are taken in pill form and they include alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel). Most are taken by mouth, usually once a week or once a month.  Bisphosphonates can also being given intravenously, but that is rarely the case.   There are many other medications used as well like nasal sprays and hormone replacement therapy, but are less common.

Exercise is another very much recommended mode of treatment, it helps prevent fractures.  Weight-bearing exercises such as jogging, playing tennis or dancing; Resistance exercises like free weights and stretch bands; Balance exercises like yoga or tai-chi; riding a stationary bike or using rowing machines. These help strengthen the bones and muscles to prevent fractures.  It's important to know that if you are at risk, don't do any exercise that you are at risk of falling, you could end up hurting yourself worse.

It's important to follow your doctors orders if you are diagnosed with either of these bone loss disorders.  If left untreated, you could end up with a compression fracture of the spine, disability caused by severely weakened bones, hip and wrist fractures, and the loss of the ability to walk due to a hip fracture.   Call your doctor if you have any of these symptoms.


There are steps to take to prevent either Osteoporosis or Osteopenia from occurring, even if you are at risk.   Eating a diet that is rich in Vitamin D and calcium is one sure way to prevent it.  If you're not sure you're getting enough, talk to your doctor about taking Vitamin D and Calcium supplements.  Other ways to prevent bone loss is avoiding drinking access alcohol, don't smoke and get regular exercise.  Following these simple steps can help you lead a healthy life.