How to Prevent and Manage Osteopenia

Table of ContentsView AllTable of ContentsOsteopenia Self-CarePreventing FallsOsteopenia Medications

Table of ContentsView All

View All

Table of Contents

Osteopenia Self-Care

Preventing Falls

Osteopenia Medications

Anosteopeniadiagnosis means that you’ve lost bone mineral density but your bones haven’t weakened enough for you to haveosteoporosis. Still, it is a risk factor for bone fractures and, without treatment, will progress to the osteoporosis stage.

People with osteopenia should work bone health into their diet and lifestyle routines. You can take simple measures to help stimulate your bones to stay healthy and slow bone loss when you understand theosteopenia diagnosisandmedications.

This article explains the diagnosis and risk factors for bone health, as well as how to prevent and manage osteopenia.

1:10The Best Exercises to Prevent Osteoporosis

1:10

The Best Exercises to Prevent Osteoporosis

People with strong, thick bones at younger ages have a lower risk of developing osteopenia and osteoporosis.Healthy lifestyle habits can help manage and prevent osteopenia. Here are some easy things you can do to give yourself the best chance possible of avoiding osteopenia and osteoporosis in the future.

Diet

Your bones need calcium and other nutrients to maintain their strength. For most adults, 1,000 milligrams (mg) daily is recommended.The best sources of these are natural ones, including:

You can also takecalcium supplements, though you should talk to your healthcare provider first. Many of the calcium supplements need to be taken with other supplements to be effective (and some types of calcium are better than others).

The 10 Best Supplements for Bone Health, According to a Dietitian

Exercise.Pascal Le Segretain / Staff / Getty Images

Exercise

Weight-bearing exercises and resistance exercises stimulate your bones to become stronger. There’s evidence that activity in your early years has protective effects later. A 2022 study of 238 males and females identified benefits in bone health on the basis of exercise done decades earlier.

Lifting weights, walking, dancing, and anything that loads weight onto your bones will help, but keep in mind that body weight itself may not offer benefits.Excess weight often leads to problems with bone and joint health, as well as other medical issues.

Does Walking With a Weighted Vest Offer Health Benefits?

Avoid Smoking and Alcohol

Smoking is considered an independent risk factor for osteopenia and osteoporosis because it disrupts how bone tissue is produced.Talk to your healthcare provider about alcohol intake, which may affect bone health.

Vitamin D

Your body needs healthy levels ofvitamin Dto properly absorb calcium. Most adults need 600 IU (15 micrograms) per day, although that increases to 800 IU in people age 70 and older.

Vitamin D vs. D3: What’s the Difference?

Reduce Salt and Caffeine

Risk factors for osteoporosis include excess salt intake, high levels of coffee drinking, and even “fizzy” drinks.Avoid cola drinks, diet and regular; cola drinks have phosphoric acid in them, which may speed the loss of calcium in your bones.

In the U.S., the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.

How Much Caffeine Is Too Much?

Other Vitamins

Some medications are associated with a risk of osteopenia and osteoporosis, including steroids. A 2024 study suggestsvitamin Emay offer protective benefits for bone when people take steroids.

Vitamin Calso may offer general bone health benefits. However, the evidence for vitamins A, B12, K were mixed, and more research is needed to understand how they affect different populations.

Some drugs, including anti-coagulants, cancer treatments, and thyroid medication, can increase the risk of bone loss. Talk about these risks with your healthcare provider.

The biggest danger in osteopenia is the increased risk offracturing a hipor your back if you fall. If you have been diagnosed with osteopenia, take special care to prevent falls. You can:

Having your eyes checked to ensure your vision is corrected with eyeglasses or contact lenses can improve your safety and limit falls. Talk to your healthcare provider about medications, including sleep aids, that may increase your risk when taking them.

Your healthcare provider may recommend treatment with medication for osteopenia. Several different drugs are available.

Bisphosphonates

Bisphosphonates can be used to slow bone loss.They can be given as injections or in oral doses.Fosamax(alendronate) a commonly used oral drug, may reduce the risk of both hip and spine fractures. Ibandronate injections may be effective at reducing spinal fractures.

Selective Estrogen Receptor Modulators (SERMS)

Evista (raloxifene) and Soltamox (tamoxifen) are hormone therapies available to limit bone loss in females after menopause.They reduce the risk of spinal fractures but research continues on how well it works to prevent hip fractures.

Denosumab

Prolia (denosumab) can be given to certain people with an increased risk of bone loss due to cancer.They include postmenopausal females treated for breast cancer and males treated for prostate cancer. It’s also used when any type of cancer spreads to the bones.

Forteo (teriparatide), a synthetic parathyroid hormone, and calcitonin also may be used to treat bone loss.

Summary

Osteopenia is a loss of bone density that isn’t quite as severe as osteoporosis. People diagnosed with osteopenia may benefit from lifestyle changes and medications that can limit bone loss and halt the disease progression.

Diet and nutrition are key to bone health, so ensuring enough calcium and vitamin D is important. Some studies suggest vitamin E and vitamin C also may offer benefits. Weight-bearing exercise can help to strengthen bones. Lifestyle choices also include avoiding smoking, alcohol, and caffeine.

Medications can help to treat osteopenia and prevent further bone loss. Talk to your healthcare provider about the benefits and risks of medication.

16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wang Y, Han X, Shi J, Liao Z, Zhang Y, Li Y,et al.Distinct Metabolites in Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 23;15(23):4895. doi: 10.3390/nu15234895.Wang J, Zheng Y, Wang Y, Zhang C, Jiang Y, Suo C,et al.BMI trajectory of rapid and excessive weight gain during adulthood is associated with bone loss: a cross-sectional study from NHANES 2005-2018.J Transl Med. 2023 Aug 12;21(1):536. doi: 10.1186/s12967-023-04397-9.Moon RJ, Citeroni NL, Aihie RR, Harvey NC.Early Life Programming of Skeletal Health.Curr Osteoporos Rep. 2023 Aug;21(4):433-446. doi: 10.1007/s11914-023-00800-y.National Institutes of Health.Calcium.U.S. Department of Agriculture.FoodData Central, yogurt, plain, low fat.U.S. Department of Agriculture.Fish, salmon, pink, canned.Zhang J, Parsons C, Fuggle N, Ward KA, Cooper C, Dennison E.Is Regular Weight-Bearing Physical Activity Throughout the Lifecourse Associated with Better Bone Health in Late Adulthood?Calcif Tissue Int. 2022 Sep;111(3):279-287. doi: 10.1007/s00223-022-00995-9.Jing Z, Li Y, Zhang H, Chen T, Yu J, Xu X,et al.Tobacco toxins induce osteoporosis through ferroptosis.Redox Biol.2023 Nov;67:102922. doi: 10.1016/j.redox.2023.102922.Lee CY, Chuang YS, Lee CH, Wu MT.Linking metabolic syndrome with low bone mass through insights from BMI and health behaviors.Sci Rep. 2023 Sep 1;13(1):14393. doi: 10.1038/s41598-023-41513-7.MedlinePlus.Vitamin D.Qin Y, Yang X, Ning Z.Causal roles of educational duration in bone mineral density and risk factors for osteoporosis: a Mendelian randomization study.BMC Musculoskelet Disord. 2024 May 2;25(1):345. doi: 10.1186/s12891-024-07428-8.Skalny AV, Aschner M, Tsatsakis A, Rocha JBT, Santamaria A, Spandidos DA,et al.Role of vitamins beyond vitamin D3 in bone health and osteoporosis (Review).Int J Mol Med. 2024 Jan;53(1):9. doi: 10.3892/ijmm.2023.5333.UpToDate.Drugs that affect bone metabolism.Harvard Health Publishing.Osteopenia: When you have weak bones, but not osteoporosis.Kim K, Kim Y, Kim KC.The efficacy of selective estrogen receptor modulators monotherapies in postmenopausal women with osteopenia.J Bone Metab. 2022 Aug;29(3):175-183. doi:10.11005/jbm.2022.29.3.185Wang WY, Chen LH, Ma WJ, You RX.Drug efficacy and safety of denosumab, teriparatide, zoledronic acid, and ibandronic acid for the treatment of postmenopausal osteoporosis: a network meta-analysis of randomized controlled trials.Eur Rev Med Pharmacol Sci. 2023 Sep;27(17):8253-8268. doi: 10.26355/eurrev_202309_33586.

16 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wang Y, Han X, Shi J, Liao Z, Zhang Y, Li Y,et al.Distinct Metabolites in Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 23;15(23):4895. doi: 10.3390/nu15234895.Wang J, Zheng Y, Wang Y, Zhang C, Jiang Y, Suo C,et al.BMI trajectory of rapid and excessive weight gain during adulthood is associated with bone loss: a cross-sectional study from NHANES 2005-2018.J Transl Med. 2023 Aug 12;21(1):536. doi: 10.1186/s12967-023-04397-9.Moon RJ, Citeroni NL, Aihie RR, Harvey NC.Early Life Programming of Skeletal Health.Curr Osteoporos Rep. 2023 Aug;21(4):433-446. doi: 10.1007/s11914-023-00800-y.National Institutes of Health.Calcium.U.S. Department of Agriculture.FoodData Central, yogurt, plain, low fat.U.S. Department of Agriculture.Fish, salmon, pink, canned.Zhang J, Parsons C, Fuggle N, Ward KA, Cooper C, Dennison E.Is Regular Weight-Bearing Physical Activity Throughout the Lifecourse Associated with Better Bone Health in Late Adulthood?Calcif Tissue Int. 2022 Sep;111(3):279-287. doi: 10.1007/s00223-022-00995-9.Jing Z, Li Y, Zhang H, Chen T, Yu J, Xu X,et al.Tobacco toxins induce osteoporosis through ferroptosis.Redox Biol.2023 Nov;67:102922. doi: 10.1016/j.redox.2023.102922.Lee CY, Chuang YS, Lee CH, Wu MT.Linking metabolic syndrome with low bone mass through insights from BMI and health behaviors.Sci Rep. 2023 Sep 1;13(1):14393. doi: 10.1038/s41598-023-41513-7.MedlinePlus.Vitamin D.Qin Y, Yang X, Ning Z.Causal roles of educational duration in bone mineral density and risk factors for osteoporosis: a Mendelian randomization study.BMC Musculoskelet Disord. 2024 May 2;25(1):345. doi: 10.1186/s12891-024-07428-8.Skalny AV, Aschner M, Tsatsakis A, Rocha JBT, Santamaria A, Spandidos DA,et al.Role of vitamins beyond vitamin D3 in bone health and osteoporosis (Review).Int J Mol Med. 2024 Jan;53(1):9. doi: 10.3892/ijmm.2023.5333.UpToDate.Drugs that affect bone metabolism.Harvard Health Publishing.Osteopenia: When you have weak bones, but not osteoporosis.Kim K, Kim Y, Kim KC.The efficacy of selective estrogen receptor modulators monotherapies in postmenopausal women with osteopenia.J Bone Metab. 2022 Aug;29(3):175-183. doi:10.11005/jbm.2022.29.3.185Wang WY, Chen LH, Ma WJ, You RX.Drug efficacy and safety of denosumab, teriparatide, zoledronic acid, and ibandronic acid for the treatment of postmenopausal osteoporosis: a network meta-analysis of randomized controlled trials.Eur Rev Med Pharmacol Sci. 2023 Sep;27(17):8253-8268. doi: 10.26355/eurrev_202309_33586.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Wang Y, Han X, Shi J, Liao Z, Zhang Y, Li Y,et al.Distinct Metabolites in Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 23;15(23):4895. doi: 10.3390/nu15234895.Wang J, Zheng Y, Wang Y, Zhang C, Jiang Y, Suo C,et al.BMI trajectory of rapid and excessive weight gain during adulthood is associated with bone loss: a cross-sectional study from NHANES 2005-2018.J Transl Med. 2023 Aug 12;21(1):536. doi: 10.1186/s12967-023-04397-9.Moon RJ, Citeroni NL, Aihie RR, Harvey NC.Early Life Programming of Skeletal Health.Curr Osteoporos Rep. 2023 Aug;21(4):433-446. doi: 10.1007/s11914-023-00800-y.National Institutes of Health.Calcium.U.S. Department of Agriculture.FoodData Central, yogurt, plain, low fat.U.S. Department of Agriculture.Fish, salmon, pink, canned.Zhang J, Parsons C, Fuggle N, Ward KA, Cooper C, Dennison E.Is Regular Weight-Bearing Physical Activity Throughout the Lifecourse Associated with Better Bone Health in Late Adulthood?Calcif Tissue Int. 2022 Sep;111(3):279-287. doi: 10.1007/s00223-022-00995-9.Jing Z, Li Y, Zhang H, Chen T, Yu J, Xu X,et al.Tobacco toxins induce osteoporosis through ferroptosis.Redox Biol.2023 Nov;67:102922. doi: 10.1016/j.redox.2023.102922.Lee CY, Chuang YS, Lee CH, Wu MT.Linking metabolic syndrome with low bone mass through insights from BMI and health behaviors.Sci Rep. 2023 Sep 1;13(1):14393. doi: 10.1038/s41598-023-41513-7.MedlinePlus.Vitamin D.Qin Y, Yang X, Ning Z.Causal roles of educational duration in bone mineral density and risk factors for osteoporosis: a Mendelian randomization study.BMC Musculoskelet Disord. 2024 May 2;25(1):345. doi: 10.1186/s12891-024-07428-8.Skalny AV, Aschner M, Tsatsakis A, Rocha JBT, Santamaria A, Spandidos DA,et al.Role of vitamins beyond vitamin D3 in bone health and osteoporosis (Review).Int J Mol Med. 2024 Jan;53(1):9. doi: 10.3892/ijmm.2023.5333.UpToDate.Drugs that affect bone metabolism.Harvard Health Publishing.Osteopenia: When you have weak bones, but not osteoporosis.Kim K, Kim Y, Kim KC.The efficacy of selective estrogen receptor modulators monotherapies in postmenopausal women with osteopenia.J Bone Metab. 2022 Aug;29(3):175-183. doi:10.11005/jbm.2022.29.3.185Wang WY, Chen LH, Ma WJ, You RX.Drug efficacy and safety of denosumab, teriparatide, zoledronic acid, and ibandronic acid for the treatment of postmenopausal osteoporosis: a network meta-analysis of randomized controlled trials.Eur Rev Med Pharmacol Sci. 2023 Sep;27(17):8253-8268. doi: 10.26355/eurrev_202309_33586.

Wang Y, Han X, Shi J, Liao Z, Zhang Y, Li Y,et al.Distinct Metabolites in Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis.Nutrients. 2023 Nov 23;15(23):4895. doi: 10.3390/nu15234895.

Wang J, Zheng Y, Wang Y, Zhang C, Jiang Y, Suo C,et al.BMI trajectory of rapid and excessive weight gain during adulthood is associated with bone loss: a cross-sectional study from NHANES 2005-2018.J Transl Med. 2023 Aug 12;21(1):536. doi: 10.1186/s12967-023-04397-9.

Moon RJ, Citeroni NL, Aihie RR, Harvey NC.Early Life Programming of Skeletal Health.Curr Osteoporos Rep. 2023 Aug;21(4):433-446. doi: 10.1007/s11914-023-00800-y.

National Institutes of Health.Calcium.

U.S. Department of Agriculture.FoodData Central, yogurt, plain, low fat.

U.S. Department of Agriculture.Fish, salmon, pink, canned.

Zhang J, Parsons C, Fuggle N, Ward KA, Cooper C, Dennison E.Is Regular Weight-Bearing Physical Activity Throughout the Lifecourse Associated with Better Bone Health in Late Adulthood?Calcif Tissue Int. 2022 Sep;111(3):279-287. doi: 10.1007/s00223-022-00995-9.

Jing Z, Li Y, Zhang H, Chen T, Yu J, Xu X,et al.Tobacco toxins induce osteoporosis through ferroptosis.Redox Biol.2023 Nov;67:102922. doi: 10.1016/j.redox.2023.102922.

Lee CY, Chuang YS, Lee CH, Wu MT.Linking metabolic syndrome with low bone mass through insights from BMI and health behaviors.Sci Rep. 2023 Sep 1;13(1):14393. doi: 10.1038/s41598-023-41513-7.

MedlinePlus.Vitamin D.

Qin Y, Yang X, Ning Z.Causal roles of educational duration in bone mineral density and risk factors for osteoporosis: a Mendelian randomization study.BMC Musculoskelet Disord. 2024 May 2;25(1):345. doi: 10.1186/s12891-024-07428-8.

Skalny AV, Aschner M, Tsatsakis A, Rocha JBT, Santamaria A, Spandidos DA,et al.Role of vitamins beyond vitamin D3 in bone health and osteoporosis (Review).Int J Mol Med. 2024 Jan;53(1):9. doi: 10.3892/ijmm.2023.5333.

UpToDate.Drugs that affect bone metabolism.

Harvard Health Publishing.Osteopenia: When you have weak bones, but not osteoporosis.

Kim K, Kim Y, Kim KC.The efficacy of selective estrogen receptor modulators monotherapies in postmenopausal women with osteopenia.J Bone Metab. 2022 Aug;29(3):175-183. doi:10.11005/jbm.2022.29.3.185

Wang WY, Chen LH, Ma WJ, You RX.Drug efficacy and safety of denosumab, teriparatide, zoledronic acid, and ibandronic acid for the treatment of postmenopausal osteoporosis: a network meta-analysis of randomized controlled trials.Eur Rev Med Pharmacol Sci. 2023 Sep;27(17):8253-8268. doi: 10.26355/eurrev_202309_33586.

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