Osteopenia is the process of bone thinning that occurs before full-blown osteoporosis occurs, and if caught in time, can prompt us to take action before succumbing to the damaging effects of osteoporosis.

Osteoporosis is extremely common in older adults and affects more than half of all adults over the age of 50. It is a skeletal disease that is diagnosed when bone density weakens to the point where fractures easily occur.

However, osteopenia isn’t as detectable to the average person as osteoporosis, and many people mistake osteoporosis with arthritis. This process of bone thinning and loss of bone mass can occur without any obvious symptoms. That’s why our friends at caring.com compiled a list of 10 warning signs to look out for, along with helpful  suggestions of what to do about it.

10 Warning Signs of Thinning Bones

1. You’ve had at least one fracture in the last two years, or an unusually severe fracture. On any given day, your bones should be able to sustain regular impact. Fractures that occur with little stress on the bones are apparent symptoms of osteopenia.

A suggestion for these occurrences: Get a Bone Density Test (also called DXA Scan or Densitometry). This is an x-ray that measures calcium levels and other important bone hardening minerals and is also a great predictor of fracture risk.

2. You are naturally thin or small-framed. Those who are small-framed or thin are more inclined to develop osteoporosis, since there is naturally less bone to lose. Adults reach their peak bone mass at the age of 20-25 years, while adults between 30-40 years will begin to lose bone density. Although small-framed or thin individuals are genetically inclined to be at risk, other factors causing osteoporosis include hormones, diet, and exercise.

Suggestion for individuals in their 30’s: It is recommended that you do everything you can to build strong bones during this time. This might include a calcium-enriched diet and high impact exercise.

Suggestion for individuals 40+ years old: It is important to maintain a healthy diet and regular exercise. Strength training exercises have been shown to prevent bone loss.

3. You take autoimmune medications, such as Prednisone or other Corticosteroids. The medications for autoimmune diseases, i.e. Crohn’s disease, when taken continuously for an extended period of time, begin leaching calcium, vitamin D, and other nutrients from your bones. Thus increasing the risk of fracture and osteoporosis.

Suggestions for individuals on corticosteroids to treat health conditions: You may ask your doctor for a Bone Density Scan after regular use of corticosteroids. Moreover, a 24-hour urine calcium analysis and vitamin D test might also show any bone loss. Many doctors will prescribe Biphosphonates, which are bone building medications.

4. You smoke. Studies have shown a strong relationship between smoking cigarettes and osteoporosis. Although a causal relationship has yet to be established, it is obvious that smoking compromises your bones.

Suggestions for smokers: It is never too late to quit smoking. No matter what age you are when you quit, it will give your body a chance to recuperate and a chance for you to strengthen your bones.

5. You consume at least two alcoholic drinks per day. Alcohol deteriorates the calcium, magnesium and other essential minerals from bones.

Suggestions for these drinkers: Quite simply reduce or eliminate alcohol from your diet. You can try switching to wine and then replace alcohol altogether with herbal tea, pure juices, and water.

6. You are lactose intolerant or don’t drink milk. Milk contains plenty of calcium and vitamin D that are essential to building strong bones. Many adults are severely vitamin D-deficient which makes them at a higher risk for weak bones and particular cancers.

Suggestions for milk-interolance: A great alternative for lactose intolerance is soy milk or rice milk that’s enriched with vitamin D and calcium. Supplements are also a great alternative; you can try the three minerals that work together to build and protect your bones: calcium, magnesium, and vitamin D.

7. You’ve battled an eating disorder. Hormone levels react accordingly with weight. So a low body weight will accordingly lower hormone levels. Elizabeth Shane, an endocrinologist at Columbia University, explains, “Anything that lowers estrogen will interfere with bone building.”

Suggestions for these individuals: It is recommended that you bring it to the attention of your doctor or therapist, even if you’ve won the battle with this disorder. There are many effective treatment programs for those who struggle with an eating disorder. Moreover, you can incorporate calcium, magnesium, and vitamin D into your daily routine.

8. For Women Only: You have an irregular or infrequent menstrual cycle. Again, this due to changing hormone levels. Women who often miss periods or have an irregular cycle likely have a low estrogen level, which directly affects bone loss.

Suggestions for these women: Women who have irregular menstrual cycles and are underweight may have a condition called Polycystic Ovary Disease (PCOS). Fortunately, this hormone-related condition is easily treatable with a prescribed low-dose birth control regimen. It is important to talk to your doctor if you have an infrequent or irregular menstrual cycle since this could be due to other factors such as menopause.

9. You have a family history of osteoporosis. You may be at high-risk if you have first- or second-degree relatives who developed osteoporosis before the age of 50 – whether it was formally diagnosed or not.

Suggestions for this genetic-based risk: Check your family history or recall parents, grandparents, and other relatives who may have had osteoporosis. Family history is an essential component to reveal to your doctor.

10. You are a Caucasian or Asian female over 50. Any of these components may put you at risk; however, there is a greater risk of fracture and osteoporosis for those who have all three qualities. Bone thinning risk increases with age; studies show 90 percent of women will suffer a fracture after 75 years of age.

Suggestions for these females: If you belong to one of these at-risk categories, this should make you more aware and take steps to prevent bone thinning. It is always recommended that you talk to your doctor but you may also incorporate calcium, magnesium, and vitamin D into your diet.

Related Reading: Build strong bones for healthier aging and reverse osteoporosis