Low bone density

Low bone density (sometimes called osteopenia) refers to bone density that is lower than the normal peak density but not low enough to be classified as osteoporosis. Bone density is a measurement of how dense and strong the bones are. If your bone density is low compared to normal peak density, you are said to have low bone density. Having low bone density means there is a greater risk that, as time passes, you may develop bone density that is very low compared to normal, known as osteoporosis.

Low bone density has no symptoms. You notice no pain or change as the bone becomes thinner, although the risk of breaking a bone increases as the bone becomes less dense.

Low bone density is diagnosed with a bone density test, usually done to see whether you have osteoporosis. The most accurate test of bone density is dual-energy X-ray absorptiometry (DXA), although there are other methods. DXA is a form of X-ray that can detect as little as 2% of bone loss per year. A standard X-ray is not useful in diagnosing low bone density, because it is not sensitive enough to detect small amounts of bone loss or minor changes in bone density.

The United States Preventive Services Task Force (USPSTF) recommends that all women age 65 and older routinely have a bone density test to screen for osteoporosis. If you are at increased risk for fractures caused by osteoporosis, routine screening should begin sooner. USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone density screening.

The FRAX tool can help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone density test on your hip, you can type in your score. If you have not had that test, you can leave the score blank.

Information for men

Experts suggest that older men talk to their doctors about osteoporosis and, if they are at risk, have bone density tests done. Many men don't think they are at risk for low bone density or osteoporosis, since these are commonly considered to be conditions of older women. Because men have a higher peak bone density than women at middle age, low bone density and osteoporosis tend to happen at an older age in men. But aside from the hormonal change in women as they go through menopause, the things that put people at risk for low bone density are true for men as well as for women. Men are also at risk if they have low levels of the hormone testosterone. Talk with your doctor if any risk factors apply to you.

Low bone density is treated by taking steps to keep it from progressing to osteoporosis and, for a few people, by taking medicine. Lifestyle changes can help reduce the bone loss that leads to low bone density and osteoporosis.

What you eat is very important to bone development. Calcium is the most critical mineral for bone mass. Your best sources of calcium are milk and other dairy products, green vegetables, and calcium-enriched products.

Your doctor may also want you to take a calcium supplement, often combined with vitamin D. Vitamin D helps your body absorb calcium and other minerals. It is found in eggs, salmon, sardines, swordfish, and some fish oils. It is added to milk and can be taken in calcium and vitamin supplements. In addition to what you take in from food, your body makes vitamin D in response to sunlight.

Exercise is important for having strong bones, because bone forms in response to stress. Weight-bearing exercises such as walking, hiking, and dancing are all good choices. Adding exercise with light weights or elastic bands can help the bones in the upper body. Talk to your doctor or a physical therapist about starting an exercise program.

In addition to diet and exercise, quitting smoking and avoiding excessive use of alcohol will also reduce your risk of bone loss.

There are medicines for treating low bone density. But these are more commonly used if you have progressed past low bone density to the more serious condition of osteoporosis. Medicines that may be used for low bone density include bisphosphonates, raloxifene, and hormone replacement.

There are things you can do to help prevent osteoporosis. Certain lifestyle changes will help slow the loss of bone density.

• Eat food that has plenty of calcium and vitamin D. Yogurt, cheese, milk, and dark green vegetables are high in calcium. Eggs, fatty fish, cereal, and fortified milk are high in vitamin D.
• Ask your doctor if you need to take a calcium plus vitamin D supplement. You may be able to get enough calcium and vitamin D through your diet.
• Get regular exercise.
  • Do 30 minutes of weight-bearing exercise on most days of the week. Walking, jogging, stair climbing, and dancing are good choices.
  • Do resistance exercises with weights or elastic bands 2 or 3 days a week.
• Limit alcohol to 2 drinks a day for men and 1 drink a day for women. Too much alcohol can cause health problems.
• Do not smoke. Smoking can make bones thin faster. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Prescription medicines are available for treating low bone density. But these are more often used to treat osteoporosis.