Pre Menopause and Osteopenia

1. Is there a relationship between osteopenia/osteoporosis and arthritis? A recent dexascan revealed I have osteopenia in my lumbar bones, but I also have chronic lower and mid back pain near that same area.

2. I am already doing everything that is suggested to maintain healthy bone density diet and exercise wise, yet I have osteopenia at age 40, while I am still pre-menopausal. Can you suggest anything else I can do to halt, or even reverse, bone loss? Also, I don't smoke and take Calcium Carbonate with Vitamin D daily...

[Machelle Seibel, MD]

Check your vitamin D level. The dose you take in the calcium might not be enough. Any level 30 or below should be treated with additional vitamin D. Doses of 400IU to 800IU daily are typical. If  your history is appropriate, some doctors will also check a person's parathyroid hormone level.

If the vitamin D is not low, talk with your doctor about going on a bone building medication such as Fosomax, Actinel or Boniva. One doesn't usually have to go on a medication with osteopenia. Get another bone density in a year after the first one. You might have to pay for it as some insurances require a two year wait between scans. But if it is dropping at that time, many doctors feel it is time to treat.

There is a relationship between ostroporosis and arthritis only in that they are both common, especially in women, and both are related to the bones. One doesn't necessarily cause the other. Treatments for osteoarthritis can lead to osteopenia. So can medications such as dilantin and steroids, aluminum containing over the couter medications, excess coffee, colas and alcohol.
Machelle Seibel, MD