In a nutshell (TL;DR)
Osteopenia indicates reduced bone density with a T-score between -1.0 and -2.5. It is a measurement category, not yet osteoporosis. What you should do depends less on the T-score alone than on the risk of fracture within the next three years, which the DVO guideline calculates based on age, risk factors, and bone density.
For most women with osteopenia, the focus is on basic measures: strength training, a calcium intake of about 1,000 mg per day through diet, at least 800 IU of vitamin D (from diet, sunlight, or supplements if necessary), avoiding smoking, and limiting alcohol. According to the guidelines, medication is only considered when the 3-year risk is approximately 5% or higher.
Important: According to IQWiG analyses, calcium and vitamin D tablets do not prevent bone fractures in most people who are not deficient. Exercise improves bone density only moderately, but it has the best supporting data. In this context, supplements are only intended as an addition when a documented deficiency exists.
Important medical notice
This article provides health information and does not replace a medical examination, bone density measurement, or therapy decision. If you have experienced a bone fracture without an appropriate accident, suddenly have severe back pain, have lost body height, or if you are taking cortisone, aromatase inhibitors, or other bone-relevant medications, this must be clarified by a doctor.
Osteopenia, osteoporosis, and any pharmacological treatment are medical topics. Dietary supplements are not medicines and do not treat either osteopenia or osteoporosis.
What is osteopenia – and is it already a disease?
Osteopenia refers to a reduction in bone density compared to young, healthy adults, with a T-score between -1.0 and -2.5. According to the WHO classification cited by the *Pharmazeutische Zeitung* regarding the 2023 DVO guidelines, a T-score of -1.0 or better is considered normal, between -1.0 and -2.5 is osteopenia, and -2.5 or lower is osteoporosis.
→ Source: Pharmazeutische Zeitung: Therapy according to individual risk (2023)
The *DocCheck Flexikon* describes osteopenia as a possible precursor to osteoporosis, primarily affecting postmenopausal women due to falling estrogen levels. It also mentions the ICD-10 code M85.8-—a frequently searched piece of information that is only relevant to you in everyday life on doctor's reports.
→ Source: DocCheck Flexikon: Osteopenia
Osteopenia is not a distinct disease in the strict sense. *Gesundheitsinformation.de*, the portal of the IQWiG, describes reduced bone density without a fracture primarily as a risk factor for bone fractures. Only when fractures occur or the calculated risk is high does the measurement become a matter for treatment.
→ Source: IQWiG, Gesundheitsinformation.de: Osteoporosis
A detail in the guideline itself is notable: the word "osteopenia" does not appear at all in the 2023 user version of the DVO guideline. It speaks only of "low bone density values" and calculates the fracture risk based on multiple factors. Therefore, the term osteopenia is primarily a conversational term between practices and patients, not a treatment threshold.
→ Source: DVO Guideline 2023, user version (AWMF 183-001)
Osteopenia symptoms and pain: What you feel – and what you don't
Osteopenia generally causes no pain and no noticeable symptoms. This is also true for osteoporosis: *Gesundheitsinformation.de* states that it often remains silent until a fracture occurs, especially in the spine, wrist, or hip.
→ Source: IQWiG, Gesundheitsinformation.de: Osteoporosis
Back pain, joint pain, or muscle tension are therefore not automatically signs of low bone density. They can have many other causes, such as tension, osteoarthritis, or hormonal changes during menopause—more on this in our article Joint pain during menopause.
Warning signs that should be checked by a doctor include sudden, severe back pain for no apparent reason, a loss of body height, and a bone fracture after a harmless fall. In such cases, a vertebral fracture may be present, which fundamentally changes the assessment.
What the T-score says – and what it doesn't
The T-score compares your bone density to the average of healthy young adults. According to *Gesundheitsinformation.de*, a T-score of 0 corresponds to the mean of healthy young adults, and the femoral neck is considered the most reliable measurement site, while the lumbar spine is less informative because it can change with age for other reasons.
→ Source: IQWiG, Gesundheitsinformation.de: Osteoporosis
However, the guideline places its own emphasis on risk calculation: it uses the lower T-score of the total hip from bilateral measurements. The T-score at the femoral neck alone must explicitly not be used for risk calculation. If the T-score is better than -1.0, the diagnosis of osteoporosis should be questioned from a differential diagnostic perspective.
→ Source: DVO Guideline 2023, user version (AWMF 183-001)
Crucial for understanding: according to the *Pharmazeutische Zeitung*, the T-score is not a threshold value for deciding on medication, because efficacy is not tied to a fixed limit, and many active ingredients work above -2.5 as well. It is primarily useful for monitoring progress over time.
→ Source: Pharmazeutische Zeitung: Therapy according to individual risk (2023)
| T-score | Classification (WHO) | What this means in practice | Source |
|---|---|---|---|
| -1.0 and better | Normal bone density | No immediate action required based on the measurement; basic measures are still sensible | PZ, DVO |
| Between -1.0 and -2.5 | Osteopenia (reduced bone density) | Risk is calculated from age, risk factors, and measurement; usually basic measures and progress monitoring | PZ, IQWiG, DVO |
| -2.5 and lower | Osteoporosis | Medical therapy decision based on 3-year risk; with fracture, it is manifest osteoporosis | PZ |
| Total hip measurement | Basis for guideline risk calculation | Lower value of both sides; do not use femoral neck T-score | DVO user version |
When is a bone density measurement useful – and who pays?
A bone density measurement (DXA) is useful if there is a relevant risk constellation, after certain bone fractures, from the age of 70, or during prolonged cortisone intake. The DVO user version lists triggers including glucocorticoids of at least 7.5 mg prednisolone equivalent for more than three months.
→ Source: DVO Guideline 2023, user version (AWMF 183-001)
For women under 65 without risk factors, *Gesundheitsinformation.de* views the measurement as an individual health service (IGeL) somewhat critically, because radiation exposure and anxiety can do more harm than good. Public health insurance covers the measurement when medically necessary, e.g., after a bone fracture, with long-term steroid use, or if medication is being considered.
→ Source: IQWiG, Gesundheitsinformation.de: Osteoporosis
Is osteopenia curable? What can be improved and what cannot
Low bone density cannot be "repaired" in the sense of a cure, but training can measurably improve it or at least brake further loss. This is shown by the Cochrane review on exercise in postmenopausal women, which we discuss in detail below. The emphasis is on "moderate": it is about a few percentage points, not a return to the bone density of a 30-year-old.
The *DocCheck Flexikon* summarizes therapy by stating that lifestyle measures (exercise and diet) take priority, and pharmacological treatment, such as with bisphosphonates, usually only occurs in the presence of an increased fracture risk. Whether treatment is necessary at all for osteopenia is a subject of debate.
→ Source: DocCheck Flexikon: Osteopenia
When is medication needed for osteopenia? The 3-year risk logic
According to the 2023 DVO guidelines, medication is not determined by the T-score but by the fracture risk over three years: a specific osteoporosis therapy is recommended starting at about 5%, at 3–5% it can be considered in the case of strong or irreversible risk factors, and at around 10% and higher, osteoanabolic agents are considered. A change from earlier versions is that the risk is no longer calculated for ten years, but for three.
→ Sources: Pharmazeutische Zeitung: Therapy according to individual risk (2023) · DVO Guideline 2023, user version (AWMF 183-001)
| 3-year fracture risk (spine/hip) | Guideline consequence | Typical context |
|---|---|---|
| Below approx. 3% | The guideline mentions no specific medication below these thresholds; basic measures apply to everyone | Editorial classification from the threshold values, not a guideline quote |
| 3 to 5% | Medication can be considered for strong or irreversible risk factors | e.g., long-term cortisone therapy, aromatase inhibitors – individual medical decision |
| Approx. 5% and above | Specific pharmacological osteoporosis therapy recommended | Advanced age, low bone density, additional risk factors |
| Around 10% and higher | Osteoanabolic substances (romosozumab, teriparatide) recommended | High to very high risk |
Regarding the classification of active ingredients: The *MSD Manual* (patient edition) names bisphosphonates as usually the first choice, often taken for three to five years, in addition to denosumab as an injection every six months, as well as romosozumab or teriparatide for more severe cases. Which option is appropriate is purely a medical decision.
→ Source: MSD Manual, patient edition: Osteoporosis
Causes of osteopenia in women: Estrogen, medications, underweight
The most common cause is the drop in estrogen during and after menopause, but it is not the only one. The *Pharmazeutische Zeitung* lists risk factors such as older age, female gender, diabetes (types 1 and 2), hyperthyroidism, rheumatic diseases, high alcohol consumption, smoking, systemic glucocorticoids, proton pump inhibitors, and aromatase inhibitors.
→ Source: Pharmazeutische Zeitung: Therapy according to individual risk (2023)
After menopause, bone density normally decreases by about 1–2% per year, primarily in the first ten years, according to the *Bundesselbsthilfeverband für Osteoporose* (2024 brochure, scientifically advised by, among others, Prof. Dr. med. P. Hadji); with additional risk factors, the loss can be significantly higher.
→ Source: Bundesselbsthilfeverband für Osteoporose 2024
For young women with osteopenia (a frequently asked question), the list of causes is weighted differently. Dr. Nicolas Gumpert describes on his patient platform that persistent underweight (BMI under 18.5) lowers bone density through estrogen deficiency; young women with eating disorders like anorexia are particularly affected.
→ Source: Dr. N. Gumpert: Osteoporosis due to underweight
If your period is absent for months or there is a suspicion of an eating disorder, this is not a topic for dietary supplements, but for prompt medical clarification.
Strength training for osteopenia: What Cochrane and the LIFTMOR study show
Exercise is the measure with the best supporting data—with a moderate effect. The Cochrane review by Howe et al. (2022) evaluated 43 randomized studies with a total of 4,320 postmenopausal participants. Combined training programs reduced bone loss in the lumbar spine by about 3.2%, and in the hip, high-load strength training for the legs had the greatest effect (mean difference 1.03).
At the same time, the review shows the limits: there was no statistically significant effect on bone fractures (odds ratio 0.61; confidence interval 0.23 to 1.64; 7 versus 11 fractures per 100 women), and the reporting quality of many studies was rather low. The authors describe it as a relatively small but potentially important effect.
→ Source: Cochrane-Review Howe et al. 2022 (CD000333)
Of particular interest for women with low bone density is the LIFTMOR study (Watson, Beck, and colleagues, Journal of Bone and Mineral Research 2018): 101 postmenopausal women (average age 65, T-score below -1.0) performed supervised, high-intensity training twice a week for 30 minutes each (5 sets of 5 repetitions at over 85% of their one-rep max) plus impact exercises for eight months. Bone density in the lumbar spine increased by 2.9%, while it decreased by 1.2% in the home-program control group. At the femoral neck, the difference was +0.3% compared to -1.9%.
→ Source: Watson et al., LIFTMOR study, J Bone Miner Res 2018
What does not follow from this: LIFTMOR was closely monitored, under supervision. High-intensity programs are therefore not a DIY project, especially if the spine is already compromised; Orthinform explicitly advises seeking proper guidance from professionals.
In everyday life, for beginners, it is enough to follow what the orthopedic information service Orthinform (Professional Association for Orthopedics and Trauma Surgery) recommends: at least 30 minutes of physical activity on three days a week, prioritizing regularity and variety over intensity, including strength training for the legs, core, back, and shoulders, as well as coordination and mobility exercises.
→ Source: Orthinform (BVOU): Strength Training
You can find suitable additions in our articles Muscle Loss in Menopause and Gentle Training After 40.
Calcium for Osteopenia: How much is enough and are pills necessary?
The DGE (German Nutrition Society) states a reference value of 1,000 mg of calcium per day for all adults, including those over 65. The DVO guideline adopts this target as total intake: 1,000 mg daily through diet, supplemented if necessary. Pills are therefore a stopgap if the diet does not reach the goal, and not a primary component of therapy.
→ Sources: DGE Reference Value Calcium · DVO Guideline 2023, User Version (AWMF 183-001)
The study situation regarding calcium tablets is rather sobering. Gesundheitsinformation.de notes that calcium or vitamin D supplements do not prevent bone fractures for most people and are not routinely recommended by independent specialist societies; they can also increase the risk of kidney stones and cause constipation. They are considered more useful for people in long-term care who have little physical activity and get little sun exposure.
→ Source: IQWiG, Gesundheitsinformation.de: Osteoporosis
The US Preventive Services Task Force (USPSTF) reached a similar conclusion in 2018 and advises against the daily supplementation of up to 400 IU of vitamin D and up to 1,000 mg of calcium for fracture prevention in community-dwelling postmenopausal women (Grade D). Exceptions apply to women with previous fractures, increased fall risk, osteoporosis, or vitamin D deficiency; the recommendation is currently being updated.
→ Source: USPSTF Recommendation 2018
| Source | Calcium | Vitamin D | Classification |
|---|---|---|---|
| DGE Reference Values | 1,000 mg/day for adults, including 65+ | 20 µg = 800 IU/day, if no endogenous production is assumed | Reference values for healthy people |
| DVO Guideline 2023 | 1,000 mg total intake, diet prioritized | at least 800 IU/day; supplementation not exceeding 2,000–4,000 IU cholecalciferol | Basic measures independent of medication |
| MSD Manual (Patients) | at least 1,000 mg; after menopause 1,200–1,500 mg possible; food preferred | 400–800 IU for osteoporosis, more if deficient after blood test | For existing osteoporosis; international data |
| USPSTF 2018 | against ≤ 1,000 mg for fracture prophylaxis | against ≤ 400 IU for fracture prophylaxis | Does not apply to osteoporosis, vitamin D deficiency, previous fractures |
Vitamin D for Osteopenia: Basic supply instead of a miracle cure
Vitamin D helps the body absorb calcium and incorporate it into bones (IQWiG); a deficiency should therefore be avoided. The DGE cites 20 µg (800 IU) per day as an estimate when there is no endogenous production so that the blood level (25(OH)D) reaches at least 50 nmol/l, as only about 2–4 µg is obtained through diet.
→ Source: DGE Reference Value Vitamin D
The DVO guideline calls for at least 800 IU daily from diet or sun exposure up to the age of 70 and advises not to exceed 2,000 to 4,000 IU of cholecalciferol per day when supplementing. The IQWiG health portal mentions about 15 minutes of daily outdoor time as a rough guideline.
→ Sources: DVO Guideline 2023, User Version (AWMF 183-001) · IQWiG, Gesundheitsinformation.de: Osteoporosis
The limit of evidence is important: The Cochrane analysis by Gillespie and colleagues (2012) found that vitamin D overall does not reduce falls (13 studies, 26,747 participants, risk ratio 0.96; confidence interval 0.89 to 1.03). A benefit is possible for people with low baseline levels – i.e., where a deficiency actually exists.
→ Source: Cochrane Review Gillespie et al. 2012 (CD007146)
If a measurement of the 25(OH)D level shows a low level, or you get little sun in winter, a supplement can close the gap. The VEYT Lumina D3 K2 drops contain 1,000 IU of vitamin D3 and vitamin K2 (all-trans MK-7) according to the product label. The exact daily amount is on the product page; the guideline advises not to exceed 2,000 to 4,000 IU per day for supplements, and for higher doses, the blood level matters. You can read more about the correct amount in Vitamin D3 Dosage and Vitamin K2 Dosage.
Protein, Alcohol, Smoking: What diet does for bones
For protein, the following applies: There is no robust evidence that an intake above the DGE reference value (0.8 g per kg of body weight for 19- to 65-year-olds, 1.0 g per kg for those 65+) improves bone density or fracture risk in the general population. Prof. Bernhard Watzl, President of the DGE and chair of the guideline commission, stated according to a DGE press release on the protein guideline that there is no evidence for this; for people over 65, a higher intake might reduce the risk of hip fracture, but this is not a confirmed statement.
→ Source: DGE Press Release 2023 on Protein and Bones
Smoking and high alcohol consumption are risk factors that, according to the Pharmazeutische Zeitung, are included in risk calculations; the t-online editorial team also mentions diabetes and hormonal disorders in addition to physical inactivity. In practical terms, this means: Quitting smoking and reducing alcohol improves the baseline situation – an effect that no capsule can replace.
→ Sources: Pharmazeutische Zeitung: Therapy according to individual risk (2023) · t-online: Preventing Osteoporosis
You can find supplementary muscle and protein topics in the article Muscle Loss in Menopause. Those interested in collagen will find an assessment of the study situation in Collagen Dosage.
Vitamin K2, Magnesium, Collagen: What remains deliberately open here
We are making no efficacy claims regarding bone density for vitamin K2, magnesium, and collagen peptides here because we could not check the original studies (PubMed and PMC were unavailable). An assessment with further sources can be found in our article Preventing Osteoporosis After 50; it also shows that intervention data on vitamin K2 is inconsistent.
Hormone therapy and bones: What is under debate in menopause
Hormone therapy can reduce the risk of spinal and hip fractures, but this involves weighing risks. The Federal Self-Help Association for Osteoporosis describes in its menopause brochure (2024) that therapy started in the first five to ten years after menopause reduces osteoporosis risk, that combined preparations increase breast cancer risk slightly when used for more than five years, and that starting after age 65 usually does more harm than good.
→ Source: Federal Self-Help Association for Osteoporosis 2024
The Deutsches Ärzteblatt reported in August 2025 on an analysis in Lancet Healthy Longevity: After stopping hormone therapy, the fracture risk could temporarily increase, but remain lower in the long term compared to women without hormone therapy. Figures were not accessible in the freely available part.
→ Source: Deutsches Ärzteblatt, 07.08.2025
Evidence Map: What plays a role in osteopenia
| Approach | For what | Evidence | What does not follow |
|---|---|---|---|
| Strength training & exercise | Bone density, muscle strength, fall risk | Cochrane 2022: 43 RCTs, moderate BMD effects; LIFTMOR-RCT: +2.9% L-spine | No confirmed effect on fractures; high-load only with guidance |
| Calcium via diet | Basic supply (1,000 mg/day) | DGE reference value, DVO basic measure | More is not better; pills usually don't prevent fractures in healthy people |
| Calcium tablets | Closing a nutritional gap | IQWiG: no benefit for most, kidney stones possible; USPSTF Grade D (≤ 1,000 mg) | No therapy for osteopenia |
| Vitamin D | Basic supply, correct deficiency | DGE 800 IU, DVO at least 800 IU; Cochrane: no overall fall reduction | High-dose without blood test; no substitute for training |
| Protein | Muscle maintenance | DGE: no proven bone benefit above reference value; possibly for 65+ | No extra protein programs against osteopenia |
| Hormone therapy | Symptoms and bone protection | Patient organization 2024, Ärzteblatt 2025: Benefits and risks | No self-medication; decision in gynecology |
| Osteoporosis medication | High 3-year risk | DVO 2023: from approx. 5% | No routine use for every case of osteopenia |
The VEYT Bone Check: 5 steps in the right order
- Understand the reading: Which T-score was measured where (total hip, femoral neck, lumbar spine)? Have the findings explained to you and ask about your 3-year fracture risk.
- Collect risk factors: Cortisone, aromatase inhibitors, proton pump inhibitors, diabetes, smoking, underweight, early menopause, family history of fractures – and never stop taking medication on your own.
- Plan exercise: At least three days a week for 30 minutes, including strength training for legs, core, and back with proper guidance.
- Check your supply: Calcium through diet (target 1,000 mg), vitamin D through sun, food, and supplement if needed based on blood levels.
- Define follow-up: Clarify with your doctor when a new measurement makes sense and prevent falls (tripping hazards, light, vision aids).
The VEYT products for this article
VEYT products can compensate for a proven nutrient deficiency. They neither treat osteopenia nor osteoporosis and are no substitute for training or medical therapy. We therefore show only one product: Vitamin D, because its basic supply is anchored in the guidelines.
VEYT Lumina D3 K2
Vegan drops with 1,000 IU of vitamin D3 and vitamin K2 (all-trans MK-7) according to the product label. Suitable if a low vitamin D level has been measured or if there is not enough sun available in winter – not as an osteopenia treatment.
View VEYT Lumina D3 K2 →Dietary supplements do not replace a balanced diet or medical treatment. In cases of osteoporosis, kidney disease, pregnancy, breastfeeding, or regular medication use, please check with a doctor first.
Expert Perspectives & Protocol Breakdown
Dachverband Osteologie (DVO)
What they advocate: The 2023 guideline assesses fracture risk over three years instead of ten, uses the lower total hip T-score, and sets calcium (1,000 mg), vitamin D (at least 800 IU), exercise, and the avoidance of smoking and risky alcohol consumption as a baseline, regardless of medication.
→ Source: DVO Guideline 2023, User Version (AWMF 183-001)
IQWiG – Gesundheitsinformation.de
What they represent: The independent institute classifies low bone density as a risk factor, tends to advise against routine measurements in women under 65 without risk factors, and does not view calcium and vitamin D tablets as protection against fractures for most people.
→ Source: IQWiG, Gesundheitsinformation.de: Osteoporosis
Cochrane author group led by Howe TE
What they represent: An evaluation of 43 studies identifies small, but potentially important, effects of exercise on bone density, without confirmed fracture-preventing benefits, and calls for better reporting quality.
→ Source: Cochrane Review Howe et al. 2022 (CD000333)
Belinda Beck and team (LIFTMOR study)
What they represent: Supervised, high-intensity strength and impact training improved lumbar spine bone density in women with low bone mass compared to a home program; only one adverse event was reported, a mild lower back cramp in the training group.
→ Source: Watson et al., LIFTMOR study, J Bone Miner Res 2018
US Preventive Services Task Force (USPSTF)
What they represent: Against low-dose calcium/vitamin D supplementation for fracture prevention in community-dwelling postmenopausal women without osteoporosis or deficiency (Grade D, 2018, update in progress).
→ Source: USPSTF Recommendation 2018
None of these sources present dietary supplements as a treatment for low bone density; calcium and vitamin D are considered basic care. In the case of existing osteoporosis, therapy is a medical responsibility, and alternative methods are not a replacement.
Four common misconceptions about osteopenia
"Osteopenia is the same as osteoporosis."
No. By WHO definition, osteopenia corresponds to a T-score between -1.0 and -2.5, and osteoporosis to -2.5 and lower. According to clinical guidelines, the decision on whether and when to treat is based on the calculated fracture risk, not the label.
"With enough calcium tablets, bone density will return to normal."
There is no evidence for this. According to IQWiG, calcium and vitamin D supplements do not prevent bone fractures in most people, and calcium may promote kidney stones and constipation.
"Cycling and walking are enough for strong bones."
Only to a limited extent. Physician Prof. Hans-Christof Schober is quoted in t-online as saying that exercise is the most important factor, but that cycling and walking alone are not sufficient and that strength training with light weights strengthens muscles and bones.
→ Source: t-online: Preventing osteoporosis
"With osteopenia, you automatically need medication."
No. According to the 2023 DVO guidelines, medication only comes into play at a 3-year fracture risk of approximately 5%, or at 3 to 5% only if strong risk factors are present.
Conclusion
Osteopenia is a measured value, not a fate. The decisive factor is the fracture risk, which reflects age, risk factors, and bone density together. For most women, this means: physical activity including strength training, an adequate supply of calcium and vitamin D, smoking cessation, limited alcohol, and a medical risk assessment.
Dietary supplements can fill gaps but do not replace exercise or diagnostics. For young women with low bone density, missing periods, or being underweight, determining the underlying medical cause is the top priority.
Frequently asked questions about osteopenia
Osteopenia: what to do?
Exercise including strength training, a calcium intake of about 1,000 mg per day via diet, at least 800 IU of vitamin D (diet, sun, or supplement if necessary), quitting smoking, and limiting alcohol are the foundation. Whether additional medication is necessary is decided by the doctor based on the 3-year fracture risk.
Is osteopenia curable?
Low bone density cannot be cured in the strict sense, but exercise can improve it moderately or slow down the loss: The 2022 Cochrane Review found small, possibly important effects on bone density, but no confirmed effect on fractures.
Osteopenia diet: What should you eat?
It is important to consume calcium-rich foods like dairy products, green leafy vegetables, and calcium-rich mineral water to reach about 1,000 mg per day, as well as adequate protein intake according to DGE reference values. The DGE has not found an additional benefit of higher protein intake for bone health in the general population.
Does osteopenia have symptoms or cause pain?
Usually not. Decreased bone density is generally silent; warning signs are a bone fracture following a minor fall, sudden severe back pain, or loss of height, all of which should be evaluated by a doctor.
What is the difference between osteopenia and osteoporosis?
Osteopenia describes a T-score between -1.0 and -2.5; osteoporosis describes a T-score of -2.5 or lower. The guidelines decide on treatment not based on the T-score, but on the calculated 3-year fracture risk.
When is medication needed for osteopenia?
According to the 2023 DVO guidelines, specific therapy is recommended at a 3-year fracture risk of approximately 5%, and can be considered at 3 to 5% if there are strong or irreversible risk factors. The decision is made by the treating physician.
Osteopenia in young women: Why does this happen?
Common causes include persistent underweight (BMI under 18.5), eating disorders and resulting estrogen deficiency, as well as certain medications and medical conditions. If menstruation stops or the patient is underweight, a timely medical evaluation is necessary.
How can you increase bone density without medication?
Strength training has the best evidence: In the LIFTMOR study, lumbar spine bone density increased by 2.9% after eight months of supervised high-load training, while it decreased by 1.2% in the control group. Supplementing this with adequate calcium and vitamin D, smoking cessation, and limited alcohol consumption is also important.
Which ICD-10 code applies to osteopenia?
The DocCheck Flexikon lists the ICD-10 code M85.8- for osteopenia. The deciding factor is how the treating practice codes the finding.
Is osteopenia in the lumbar spine (LWS) serious?
Not automatically. Gesundheitsinformation.de notes that the lumbar spine is a less reliable measurement site because it can change for other reasons as one ages; the guidelines calculate the risk based on the T-score of the total hip. Have a doctor interpret the finding.
Read more at VEYT: Preventing osteoporosis from 50: What really counts for strong bones · Vitamin D3 dosage: How many IUs per day · Muscle loss in menopause: Creatine, protein, and strength training · Dietary supplements in menopause: What studies show · Joint pain in menopause: What guidelines show
References & Scientific Citations
- DVO Guideline 2023, User Version (AWMF-Register 183-001, Version 2.1, Nov 13, 2023)
- Pues M: Osteoporosis – Therapy based on individual risk, Pharmazeutische Zeitung (Oct 25, 2023)
- IQWiG: Osteoporosis and bone fractures, Gesundheitsinformation.de
- Howe TE et al.: Exercise for preventing and treating osteoporosis in postmenopausal women, Cochrane Database Syst Rev 2022, CD000333
- Watson SL et al.: LIFTMOR randomized controlled trial, J Bone Miner Res 2018;33(2):211
- DGE: Calcium reference values
- DGE: Vitamin D reference values
- USPSTF: Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures (2018)
- Gillespie LD et al.: Interventions for preventing falls in older people living in the community, Cochrane 2012, CD007146
- MSD Manual, Patient Edition: Osteoporosis
- DGE press release 2023: Protein intake and bone health
- Orthinform (BVOU): Strength training for osteoporosis prevention
- Bundesselbsthilfeverband für Osteoporose: Osteoporosis and menopause (2024)
- Gumpert N: Osteoporosis and being underweight (as of March 30, 2024)
- Deutsches Ärzteblatt: Menopause – fracture risk rises temporarily after ending hormone therapy (2025)
- DocCheck Flexikon: Osteopenia
- t-online: Recognizing and preventing osteoporosis
Transparency regarding sources: The mentioned institutions and authors are used as sources of perspective. Statements regarding diagnosis and treatment are classified primarily based on guidelines, Cochrane reviews, and randomized studies; expert opinions, patient organizations, and observational data are not equated with clinical evidence of efficacy. PubMed and PMC were not accessible during the research; data is derived from publisher websites, guideline portals, and professional resources where they have been verified. This article was written independently and does not replace medical advice.
