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Understanding the Difference Between Osteopenia and Osteoporosis: What You Need to Know to Keep Your Bones Strong

Osteopenia is a condition in which bone mineral density is lower than normal but not low enough to be classified as osteoporosis. Osteoporosis is a bone disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures, particularly in the hip, spine, and wrist.

In more technical terms, osteopenia is defined by a bone mineral density (BMD) score that falls between 1 and 2.5 standard deviations below the average BMD for young, healthy adults of the same sex.  Osteoporosis is 2.5 or more standard deviations below the average BMD for young, healthy adults of the same sex.

Both can occur when the body loses too much bone tissue, makes too little bone tissue, or both. They often progress silently, without symptoms, until a fracture occurs, which can cause pain, deformity, and loss of function. They are more common in women than men.

Several factors can contribute to the development of osteopenia and osteoporosis, including:

  • Age – As people age, their bones naturally become less dense, which can lead to osteopenia and eventually osteoporosis.
  • Hormonal changes – Changes in hormone levels can affect bone density, particularly in women after menopause when estrogen levels decrease.
  • Nutritional deficiencies – A lack of calcium, phosphorus, zinc, vitamin D, and other bone minerals can lead to weakened bones and increase risk.
  • Sedentary lifestyle – Lack of weight-bearing exercise can lead to weaker bones and increase risk.
  • Certain medications – Long-term use of certain medications, such as glucocorticoids, can increase risk.
  • Medical conditions – Certain medical conditions, such as celiac disease, hyperthyroidism, or malabsorption issues can increase risk.

Recommendations to Help Prevent or Reverse Osteopenia and Osteoporosis

Several minerals are essential for bone health, including:

  • Calcium – Calcium is the primary mineral that makes up bone tissue. It is essential for building and maintaining strong bones and teeth. Adequate calcium intake throughout life is important for bone health, as the body continuously breaks down and rebuilds bone tissue.
  • Phosphorus – Phosphorus is another mineral that is important for bone health. It works together with calcium to form hydroxyapatite, a mineral complex that gives bone its strength and rigidity.
  • Magnesium – Magnesium is important for bone health because it plays a role in the formation and maintenance of bone tissue. It helps to regulate calcium levels in the body, and it also stimulates the production of calcitonin, a hormone that helps to regulate bone turnover.
  • Vitamin D – Vitamin D is essential for bone health because it helps to regulate calcium and phosphorus levels in the body and promotes bone formation and remodeling.
  • Vitamin K – Vitamin K is important for bone health because it helps to activate osteocalcin, a protein that is necessary for the mineralization of bone tissue.
  • Zinc – Zinc is important for bone health because it helps to stimulate bone growth and mineralization. It also plays a role in the production of collagen, a protein that provides the framework for bone tissue.

A balanced diet that includes foods rich in these minerals, such as organic, grass-fed dairy products, leafy green vegetables, and nuts/seeds, can help to support bone health. In some cases, supplementation may be recommended to ensure adequate intake of these nutrients.

If you are concerned, or have received an osteopenia or osteoporosis diagnosis, the following recommendations can support you in building better bone density.


  • Osteo-B II from Biotics Research – A comprehensive bone support formula that utilizes phosphorylated forms of B vitamins and supplies calcium and magnesium in a 1:1 ratio.
  • Bio-D-Mulsion Forte from Biotics Research – Vitamin D is essential for bone health because it plays a critical role in regulating calcium and phosphorus levels in the body. Calcium and phosphorus are important minerals that are essential for building and maintaining strong bones. Vitamin D also plays a role in bone formation and remodeling. It helps to promote the differentiation and maturation of bone cells, as well as the mineralization of the bone matrix. This process helps to build and maintain strong bones. In addition to its role in bone health, vitamin D also plays a role in immune function, muscle function, and many other processes in the body.

Weight-Bearing Exercises

These type of exercises are important because they place stress on your bones, which helps to stimulate the production of new bone tissue.  New bone tissue helps improve your bone density.  The following are some exercises to add to your routine in order to support health bone density:

  • Weightlifting – Lifting weights is highly effective at building and maintaining bone density. This type of exercise places stress on your bones, which helps to stimulate the production of new bone tissue. Resistance training with weights, such as dumbbells, barbells, or weight machines, can be done in a gym or at home.
  • Walking – Walking is a weight-bearing exercise that can help improve bone density as you support your body weight, which places stress on your bones, which can help improve bone density over time.  The National Osteoporosis Foundation recommends at least 30 minutes of walking most days of the week to help improve bone density and reduce the risk of fractures.
  • Lunges – Lunges are considered a weight-bearing exercise and can help support healthy bone density.  Lunges specifically target the bones in your legs, hips, and spine, which are some of the most important bones for overall mobility and strength. By working these areas, you can help support healthy bone density throughout your body and reduce the risk of fractures as you age. Here’s a good video if you’re just learning how to do a lunge:
    Stand closer to the wall and reach your arm out for support, if needed.


The T-score is a measure used to diagnose osteopenia and osteoporosis when you have a DEXA, or bone density, scan.

A T-score between +1 and -1 is considered normal bone density. A T-score between -1 and -2.5 is classified as low bone density or osteopenia, which can increase the risk of developing osteoporosis. A T-score of -2.5 or lower indicates osteoporosis, which is a condition characterized by weak, brittle bones that are more susceptible to fractures.

It’s important to note that the T-score is just one factor used to diagnose osteoporosis, and other factors such as age, family history, medical history, and lifestyle factors should also be considered, as mentioned above.

Dr. Kalaba is a chiropractor in Tucson, AZ, practicing gentle chiropractic care and providing health tips to help you live the best rest of your life.

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