Osteopenia: Resolve to Beat It.

Patient Expert

Osteopenia is getting a reputation these days as a "non-diagnosis:" it's not osteoporosis, but might be a faint first warning that your bones may not be as healthy as they should be - though then again, maybe they're just fine" (See what I mean by non-diagnosis?) Whatever significance it has, osteopenia tells you your bone density isn't what it used to be. So what, if anything, should you do about that?

They say getting old isn't for sissies. And boy, are "they" ever right

When you were a kid, do you remember worrying about your health? HA. Your biggest concern was whether you and your best friend would be in the same class next year, or how to wheedle money out of your mom for an ice cream cone.

Ditto young adulthood. Fit, strong, and filled with energy, no challenge was too big; you could climb every mountain (and often did).

But as you got into your 30s, you might have noticed the tiniest hint of slowing down. Maybe you blamed it on the kids - they were a handful, who wouldn't be tired? But as 30s turned to 40s, then 50s, you could look back a couple of decades and say, "Wow, I sure don't recover from a sixpack like I used to," or "How did I ever run a 10K? I'd get tired walking it now."

Getting older isn't an option; it's inevitable, and most of us accept it with a modicum of grace. Sure, we don't like it; who would? But given the alternative, we soldier on, gradually feeling ourselves diminish: physically, mentally, and emotionally.

One thing we won't feel as we age is our bones losing their mass. Right around age 30 marks the peak of our bone strength; from there, the balance of formation and resorption - osteoblasts building bones up, osteoclasts tearing them down - shifts in favor of the osteoclasts, and it's up to us to do what we can to slow the inexorable process of becoming "fragile" - moving towards an increase in fracture risk, and possibly osteoporosis.

Osteoporosis is diagnosed when your T-score, measuring bone mineral density (BMD), is -2.5 or lower, as measured via DEXA scan. Your doctor will immediately prescribe bisphosphonates to help raise that T-score, or at least keep it from continuing to fall. S/he will also make sure you're getting enough calcium and vitamin D, probably by suggesting supplements to go along with a healthy diet.

Osteopenia means your bones are somewhere between their ultimate healthiness (T-score of 1.0 and above), and the -2.5 score of osteoporosis. You're not as strong as a 30-year-old; but you also don't have osteoporosis.

Is that bad? Well, it might be, if your scores are falling rapidly. But if you're in your 50s, and just a shade below 1.0 - heck, isn't that just normal aging?

Yes - but that doesn't mean there's nothing you can do about it. Growing old is a given; and doing everything you can to maintain good health should be, as well.

If your initial DEXA scan reveals T-scores in that gray osteopenia range, there are things you can do to bring your scores back up - or at least hold them steady. For a good proactive approach to dealing with bone loss, read Osteopenia: Do You REALLY Need the Drugs? You'll find a list of 10 different tactics - from spending a few minutes in the sun each day, to cutting back on diet soda - that can really make a difference in how your bones age.

Making your New Year's resolutions? Add this: I'll make the lifestyle "tweaks" necessary to maintain bone health.

Notice I said tweaks; change is scary, and so often we resolve to "change" our lives" and then give up.

But adding a chewable Viactiv to your daily multivitamin, or cutting your nightly happy hour drink from two glasses of wine to one? You can do that.

Sticking to reasonable, attainable resolutions is 100% better than making major resolutions that are history within weeks.

Happy New Year! For big results this year - start small.