Q: My doctor just told me I have thin bones. She calls the problem "osteopenia." Does this mean I'll definitely develop osteoporosis?
A: Osteopenia means "too little bone." Osteoporosis, on the other hand, is an advanced form of osteopenia in which the bone loss is more severe.
You'd hear the term osteopenia most often as part of a bone density report. This would be noted when the amount of bone measured is mildly reduced, but not severe enough to qualify as osteoporosis.
Virtually everyone with osteoporosis at one time had osteopenia. That's because he process of bone loss is typically quite gradual. It progresses from normal bone to osteopenia to osteoporosis over many years.
Not all people with osteopenia go on to develop osteoporosis. In fact, most often bone loss may stop or slow down so much that it never becomes severe.
Once you have osteopenia, there is no precise way to estimate whether you will go on to develop osteoporosis. Many factors are involved in the rate of bone loss over time. These include:
1. Family history of osteopenia or osteoporosis
2. Ethnic background
3. Age and gender
5. Calcium and vitamin D intake
6. Estrogen use after menopause, or other drugs that prevent or slow bone loss
7. Medical problems and drugs you take for other conditions
8. Weight-bearing exercise
9. Alcohol intake
10. Smoking history
How much each of these factors contributes may change over time. For instance, bone loss is very gradual in most women during early adulthood. But around menopause, bone loss becomes more rapid. And while you can't change some factors -- like your genes, gender or age -- you can change many of the other risk factors.
If you have osteopenia (mild bone loss), review your risk factors with your doctor. And be sure to get enough weight-bearing exercise, vitamin D and dietary calcium. If bone loss continues over time, you may need additional tests and treatments.
(Robert H. Shmerling, M.D. is a practicing physician in rheumatology at Beth Israel Deaconess Medical Center, Boston, Mass., and an Associate Professor in Medicine at Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)
Not everyone with thinning bones will develop osteoporosis
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