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Let's Begin at the Beginning
I knew very little about osteoporosis 2 or osteopenia 3 before the age of 60. It was then that I decided to become a fitness instructor after retiring from a 32-year career in teaching. I was beginning to develop adult-onset diabetes and I had been told for years that my risk of heart disease was high (mostly due to family genetics and cholesterol scores that had been too high since my 30's).
In my training to teach fitness to older adults, I learned about the many conditions that seniors face. That included osteoporosis and osteopenia, and I quickly learned that I might be at greater risk since I had been post-menopausal for thirteen years.
Based on my medical history, I asked my doctor if it might not be wise to have a bone density test. Although I had not had a fracture, I was concerned that my bone density might not be as good as it could or should be. My doctor agreed and ordered the tests immediately. 4
The First Test: December 2010
The first bone density test revealed that I had osteoporosis in both femoral necks.
The hip is a ball-and-socket joint. The head of the femur acts as the ball and fits into the rounded socket of the hip bone. The femoral neck is just below the ball of the hip joint; it is tested for osteoporosis because it is one of the largest sections of bone in the body.
After getting the results, I was prescribed medication (mostly calcium and Vitamin D) and encouraged to continue weight-bearing exercises.
I did just that. I continued to teach fitness four times a week, and usually accomplished at least 10,000 steps a day. The challenge, obviously, was to build enough bone to be free of osteoporosis.
The Second Test: December 2013
There was a clear improvement in my bone density in 2013. I no longer had osteoporosis in both femoral necks — a clear sign of progress. Now, I had osteoporosis only in the right femoral neck, but I had osteopenia in all of the other areas.
I approached the next three years with the same determination as the previous three. However, I did not change my routine in any significant way, since clearly improvement had occurred. However, he test results of the third density test would cause me to believe that I had not done enough.
The Third Test: December 2016
The third set of tests revealed that I no longer had osteoporosis, but all the numbers for the hip and femoral necks remained in the osteopenia category. While improvement had occurred, I was still not at peak bone density.
Bone density is measured in T scores which are the number of units — called standard deviations — that bone density is above or below the average:
- A "normal" score is greater than -1. This is sometimes referred to as "peak density."
- Osteopenia is -1 to -2.5.
- Osteoporosis occurs when the score is lower than -2.5.
My spine (L1-L4), both femoral necks, and both hips were tested each time.
Here are the scores I received in each of the three years I was tested:
Reading the results in the above chart: The area which was tested is listed first. It is followed by the three scores, in order, as they occurred in the three separate tests, three years apart. If it is ostepenia it is in blue; if it osteoporosis, it is in red. A normal score would be in green, but none of these scores fall in the peak density category.
Clearly, after six years of prescription calcium, plus Vitaman D supplements, and regular daily exercise, I had improved my bone density. As well, one can easily speculate how much worse my condition might have become if I had not taken the medication and exercised.
So where is the challenge? Don't I just keep doing what I've been doing and eventually my bone density will improve to peak density?
Or so my doctor says.
My doctor tells me that I am not likely to ever achieve scores better than the ones I currently have. As a 71-year-old woman, I am losing bone density every day. Therefore, he says, I will only be able to maintain my current bone density with medication and exercise. In other words, I am succeeding in replacing what I'm losing, but it's unlikely I can increase it.
This seemed like a challenge to me, although the doctor did not phrase it that way. I have researched the topic and there is some indication that my doctor may be right. However, there is also some indication that weight-bearing exercise can indeed improve the T-scores. One study in particular (although small in number) showed that post-menopausal women could indeed increase bone density as long as they exercised regularly.
So, that's my challenge: Three more years of trying to improve those scores. Can I be osteopenia-free in three years by exercising more than I already do? I am increasing my daily exercise routine and I have purchased a 10-lb weighted vest and two-and-a-half-pound ankle weights to help me do that.
I'll update this article in three years' time — in January of 2020.
Other articles that may interest you:
I am a BCRPA-certified fitness instructor in Vancouver, BC. I teach four classes at the West End Community Centre in Vancouver, BC, mostly designed for the older adult. The Inevitable Disclaimer: Everything published here expresses only my opinion, based on my training and research. What you do with the information is entirely your own responsibility. I am not liable for any injury you suffer that seems to be related to anything you read here. Always consult your doctor before beginning an exercise program. For other articles, return to the table of contents.
These three dots behave exactly like a footnote. Click on them and you will get more information about the topic. ↩
Osteoporosis is "a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D." ↩
The diagnostic difference between osteopenia and osteoporosis is the measure of bone mineral density. Osteoporosis, the "fragile bone disease," is characterized by a loss of bone mass caused by a deficiency in calcium, vitamin D, magnesium and other vitamins and minerals. Osteopenia refers to bone density that is lower than 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 osteopenia. ↩
I could write another article about why bone density screening exams done for all women, especially after menopause. Like a mammogram, it can warn a person that bone density is being lost and do something about it before it gets worse. ↩