Osteopenia (cont.)

Often osteopenia does not require treatment with prescription medications. In this situation, the bone density test may be repeated to monitor the bone mineral density (BMD), usually after two years, to detect progressive bone loss and determine if treatment is necessary. Two years may seem like a long time between tests, but BMD changes very slowly, and this length of time is usually necessary to detect significant bone loss.

A follow-up test for BMD is frequently repeated after treatment with prescription medication for osteopenia is begun. Again, because changes in BMD occur slowly, the repeat testing is usually done several years after treatment is begun. However, follow-up testing while on treatment is controversial because

• decrease in the risk for fracture while on treatment for osteopenia and osteoporosis is not always mirrored by an increase in BMD on DXA or other testing



• and if repeat testing shows continued bone loss, this does not mean the medication is not working because it is also likely the bone loss would have been much worse if left untreated.

The best way to prevent osteopenia is by living a healthfully. In regard to osteopenia, this includes ensuring adequate calcium intake either through diet or supplements, ensuring adequate vitamin D intake, not drinking too much alcohol (no more than two drinks daily), not smoking, and getting plenty of exercise. For most people, prescription medications are not necessary to prevent osteopenia. However, some people taking certain medications (such as prednisone or other steroids) for more than a few months may need to take prescription medication to prevent bone loss.

• Osteopenia is decreased bone density but not to the extent of osteoporosis. This decreased bone density leads to bone fragility and an increased chance of breaking a bone (fracture).
• About 34 million people in the U.S. have osteopenia, and 50% of Caucasian women will fracture a bone in their lifetime.
• Women over the age of 65 and any postmenopausal woman with risk factors for bone loss should be tested for osteopenia or osteoporosis. The DXA scan is a widely available and accurate method for diagnosing osteopenia or osteoporosis.
• Not everyone with osteopenia requires treatment with prescription medications; your doctor can determine if you should be treated based on your bone density and other risk factors.
• An adequate intake of calcium and vitamin D, avoiding excessive alcohol, not smoking, and getting plenty of exercise can help prevent osteopenia.

REFERENCES:

Khosla, S. and L.J. Melton. "Clinical Practice: Osteopenia." N Engl J Med 356 (2007): 2293-2300.

National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2010.

Last Editorial Review: 2/7/2011 8:50:12 PM

Source: MedicineNet.com
http://www.medicinenet.com/osteopenia/article.htm