August 29, 2016
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Osteopenia (cont.)

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What follow-up is needed after treatment of osteopenia has been initiated?

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 changes in bone density.

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.

What types of specialists treat osteopenia?

Osteopenia can be diagnosed and treated by many different medical specialists, including primary-care providers (such as internists and family practitioners), rheumatologists, endocrinologists, and gynecologists. Other specialists may treat osteopenia, as well, especially if they are prescribing a medication that predisposes to osteopenia, such as the cortisone medication prednisone.

Is it possible to prevent osteopenia?

The best way to prevent osteopenia is by living healthfully. In regard to osteopenia, prevention 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. Weight-bearing exercise, such as walking, lifting light weights, or doing push-ups, is the most effective exercise for preventing and treating bone loss. This is because this type of exercise signals to the bones to become stronger.

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.

Medically Reviewed by a Doctor on 3/4/2016


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