Question by jeb g: What is the difference between Osteopenia, Osteoporosis, and Osteomalasia?
Ok so I think osteoporosis I and II with age, osteomalasia is like rickets in adults, due to nutrition like D and calcium. Then what is the difference between osteopenia and osteoporosis?
Answer by Jared
Osteopenia is simply what occurs before Osteoporosis.
Basically our bones have a mineral density — which peaks around age 30 to 35.
When our bone mineral density (bone density) is lower than average for your ‘age’ but not severely low, it is termed osteopenia. Generally osteopenia is completely reversible .. especially in those under 55 with nutritional protocols, exercise, and so forth.
Osteoporosis , likewise, is just an advanced more severe form of bone mineral density lowering. It is Osteopenia but more significant.
Sort of like if your bone density is 20 normally, with osteopenia it would be 15, with osteoporosis it would be 10 (or lower).
Osteopenia is treated more with lifestyle and supplements, Osteoporosis is treated the same way, but some designer drugs are utilized to treat the more severe ailment.
Osteomalacia is what you considered — It is sort of ‘rickets’ in adults, but without the deformation. It is specifically a Vitamin D deficiency in adults, that results in bone deformation/density issues. Which results in pain, fragile bones, and other problems. This is different from the other two because it is ALWAYS a deficiency with vitamin D… either in the amount in the diet, or an absorption problem with the person.
Osteomalacia generally produces more symptoms that the other two — as it commonly causes pain, that is difficult to diagnose.. and only goes away with resolution of the vitamin D deficiency (which can take 6months to a year).
Ie: I’ve had patients with muscle, joint and bone pain that had , at best, a Dx of fibromyalgia — when tested, their vitamin D levels were under 20 out of a reference range of 35-100. Usually below 15. This is severely deficient, and many had been deficient, likely, for many years.
After treatment and having their levels return to a normal range, they still experienced many symptoms even 3-4 months after treatment — but with consistency of treatment I found their main complaints of pain and weakness resolved within 6months to a year. Apparently the body has a great deal of ‘rebuilding’ to do before these types of symptoms resolve in something like Osteomalacia.
Though keep in mind there is not always pain or any symptoms with any of these conditions — but they are fairly easy to diagnose if the right tests are performed. Generally a Bone density scan will detect the first two, and sometimes Osteomalacia — combining the scan with a Vit. D test will nearly always detect Osteomalacia and even if the individual is in normal range, but on the ‘low’ end I will still Dx Osteomalacia if they exhibit the symptoms that correspond with it. IE: D level of 35-40, and a bit less density than I would like to see for their age. I’ve seen 30yr olds with the density of 60yr olds. The good side is the 30yr old can rebuild that bone quickly and usually suffer no permanent effects due to their age.
Hope that helps in some regard..
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