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Difference Between Osteopenia and Osteoporosis

Mrunal Belvalkar
Though both are conditions related to the bones of the human body, osteopenia is quite different from osteoporosis. Learn the exact difference between the two diseases in this story.
To understand the two medical conditions osteopenia and osteoporosis, let us look a little more closely at the words themselves. Much like other medical terms, the words that describe the various conditions of the bone all begin with the prefix 'osteo-'. 'Osteo-' originated from the Greek word 'osteon', meaning 'bone'.
Whenever the term '-penia' is a part of any medical term, it means deficiency or low level of something; for example, leukopenia means a condition wherein the white blood cell count of an individual is lower than normal. Finally, the term '-porosis' refers to the presence of pores.
Now that you have understood the meaning of the words, let us look at the terms as a medical condition. Osteopenia refers to a condition in which the mineral density of the bones is lower than normal. The average bone mineral density of a healthy adult human being is 1500kg/m3; hence bone density lower than this is osteopenia.
Osteoporosis, on the other hand, refers to a condition wherein the bones are internally weak, brittle and more prone to fractures due to reduced bone mineral density, a deteriorating bone structure and altered profile of bone proteins in terms of type and amount of proteins.

Osteopenia vs. Osteoporosis

Osteopenia and osteoporosis are the two most common diseases of the skeletal system. Osteoporosis affects more than 50% of Americans, with more than 80% of them being women. Though a less severe condition, osteopenia has been recognized by the WHO as one of the precursors to osteoporosis. A medical condition affecting more than half of the population of a country is something very serious indeed!

Osteopenia - Low Bone Mineral Density

Quick facts:
  1. Low bone mineral density (-1.0 to -2.5, as determined by T-score of bone density test).
  2. Not a very severe condition.
  3. No characteristic symptoms.
  4. Affected by lifestyle, eating habits, exercise, nutrition, etc.
BMD stands for bone mineral density. Osteopenia is a condition marked by a lower than normal bone mineral density. In layman's terms, BMD refers to the amount of bone matter per cubic centimeter of bone. The average bone density of a healthy adult human being is 1500kg/m3.
Bone density is also measured as T-score. The T-score of a healthy adult human being is -1.0 or higher. Osteopenia is marked by a condition wherein the T-score of an individual is in the range of -1.0 to -2.5.
We tend to overlook the wear and tear of bones, or we find it hard to grasp the fact that something as hard and strong as bones is also subject to wear and tear. However, everybody begins to lose a bit of their bone density as they hit the thrilling 30s. But 30s can be 'threatening' along with being 'thrilling' if you are not aware!
I do not mean to scare you, but isn't it better to be safe than sorry? Normal wear and tear causes the gradual weakening of bones. If however, your bones have been weak to begin with (due to bad eating habits, a hectic lifestyle, less exercise or too much exercise), you could become a victim of osteopenia by the time you reach your 40s.
With respect to treatment, there is some good news - even simple exercises can take care of the condition for you. If all it takes to care for weak bones is the right amount of the right kind of exercise, I think it is a very trivial lifestyle change to incorporate, isn't it?

Osteoporosis - 'Porous' Bones

Quick facts

1. Low bone mineral density (less than -2.5, as determined by T-score of bone density test).
2. Severe condition marked by fracture of bones that do not usually occur in healthy people (hip, rib, wrist etc., as illustrated in the image above).
3. Symptoms include a tendency to repeatedly suffer from fragility fractures; even a normal slip-and-fall incident can end up in a fracture.
4. Causes can be many and varied (even menopause-related osteoporosis is observed in women)
Do not take that too literally - osteoporosis does not mean you actually have 'porous bones'! But indeed the bones of a person suffering from this disorder are weaker and more susceptible to breakage (fractures) than those of a normal person; they are brittle. Speaking in terms of T-scores, the T-score of a person suffering from osteoporosis is lower than -2.5.
Bones are made up of a lot more than just bone marrow. Bone cells are known as osteocytes. They make up the major chunk of the bone. They originate from osteoblasts. Osteoblasts synthesize a number of bone proteins collectively known as osteoid. All these and many more structures are arranged in a particular way to make up the architecture of the bone.
In osteoporosis, this architecture of the bone becomes loose. There are a number of causes of this bone disorder, many reasons why you may be afflicted by the disease. It is best to educate yourself about them, so that you can asses if your lifestyle conforms to any of them.
Treatment of this condition is more rigorous than that of osteopenia. Vitamin D supplements are beneficial in treating osteoporosis. The relationship between calcium deficiency and bone density (as explained above) will elucidate why calcium treatment has also shown remarkable improvement in patients. Apart from this, the commonly prescribed drugs to treat this condition include - Calcitonin, Strontium ranelate and Raloxifene.

Where Are You?

I do hope you are among the healthier half of the population. But are you sure? I am quite sure you already know if you have osteoporosis or not (for you cannot be suffering from osteoporosis and NOT know it). However, you could be heading towards one of the two medical conditions unaware of it.
As I mentioned earlier, osteopenia has been recognized by the WHO as one of the precursors to osteoporosis. So why not gift yourself a checkup? It would suffice to take the time out and assess yourself for any symptoms of osteopenia that you may be exhibiting.
Both osteopenia and osteoporosis can be very painful conditions to live with. They limit us in ways more than a few. This is why it is essential to educate ourselves about essential care of the skeletal system. Next step after modifying your lifestyle would be to take the bone density test, especially if you are 50 years or older.
In general, be it something as grave as bone deficiency or something as minor as a cough and cold, a healthy diet, and good amount of exercise can keep the body fit and in perfect condition till the end of our days! It is indeed necessary to have a healthy body, for it is the only one that can host a healthy and happy mind to help us make the most of life.