Osteopenia in hips (not spine) in early 20s

[MaitlandGirl]

DD2 has just been diagnosed with osteopenia via a Dexa Bone scan and as the title says she’s only in her early 20s.

Her GP isn’t great but will give her referrals to whichever specialists she needs, she just has to ask for them. Who should she be seeing for advice?

The dr at the X-ray centre said a nutritionist but is that it?

We’re not in the UK and everything happens very quickly here so she’s not had much time to adjust to it all. She’s gone from “that bone density doesn’t look great on the X-ray” to “your hips are what we’d expect to see in a 90 year old” in 18 days and she’s had an MRI in the meantime as well.

I’d be grateful for any suggestion for specialists and how she moves forward with this.

Potentially has time to build up bones. Probably have malabsorbtion explored eg coeliac disease and crohns. I've had this since a similar age. It's not great but there are things that can help.

What symptoms did she have? Do you know why this would have happened at such a young age?

@AutumnColours9 sorry hear you’ve also had this diagnosis but it’s encouraging that things can be done to help. There is a history of malabsorption issues within the family so will get her to ask about that.

@lljkk shes had 4 incidents of broken bones in fairly unexpected circumstances. She banged her wrist on a table and broke it, she tripped over her own feet and broke her foot, clunked her chest into the shopping trolley and broke her ribs and broke her wrist vaulting a fence. There’s a history of osteoporosis within both family at the grandparent level but nothing in mine or her dads generation. She had an X-ray on 2nd Oct for a knee injury and the technician commented on her poor bone density then. The injury needed an MRI and they commented again then that her bones didn’t look good, hence the Dexa scan yesterday.

As for why it happened I’ve no idea, we’re thinking it’s just bad luck on her part with some crappy genetics maybe as well.

If it was me I would want to see a nutritionist about malabsorption, supplementation and diet and a physio who specialises in this for exercises to support bone regrowth or lack of further loss as a minimum as well as strengthening exercises to support bones against further breaks. Can’t believe there is no advice about who you should be seeing. You also need to see a specialist who can prescribe any drugs that might help slow deterioration of which there are a few - but you need to discuss which is best esp as so young. I am no expert but have researched a bit online as I have a risk factor for getting osteoporosis younger than most.

Osteoporosis is a disease of old age.
Is your DD underweight or have a history of disordered eating?

She slim but not underweight and eats well. She eats a good range of foods and only excludes pork (allergy) from her diet.

Her results are :
L1 = -0.1
L2 = -0.1
L3 = -0.2
L4 = -0.4

Left femur = -2.4
Right femur = -2.3

Shes really shocked and concerned by the disparity between her spine and femurs (as was the technician).

Shes got a GP appointment this week and is asking for :

tests to exclude thyroid, chrons and coeliac
referrals to : physio, nutritionist, osteo orthopaedic specialist and endocrinologist.

Have we missed anything?

Dietician, not nutritionist. Dieticians need to be qualified but nutritionists here do not. You can get a health care plan from the GP which will cover most of the cost.

When DH was diagnosed with osteoporosis, he saw an endocrinologist who prescribed a yearly injection--it's not on the PBS for young people.

It sucks, DS had a scan a week or so ago and the GP has been ringing me and I've missed her calls. Pretty certain she is ringing to tell me it has progressed to osteoporosis. He has major food intolerances and malabsorption but it still sucks.

In the UK and Australia a nutritionist is not a regulated profession. Look for a dietitian.
Check the registration boards for your region to work out which one is a regulated profession in your country.

Disordered eating or unmanaged reflux that she has been chewing antacids all day every day would be my thoughts.

@LovelaceBiggWither thank you!! I’ll make sure it’s a dietician. She’s a full time student so has a low income health care card but if the PBS won’t cover medications it’s going to be a bit of a challenge.

@Missingthegore theres no eating disorder or disordered eating gong on at all, and no reflux or antacids or anything like that. She has a full and varied diet, with the exception of no pork at all due to an allergy. She eats a sensible amount and does a normal amount of exercise (she has a large breed dog so walks him regularly and does Pilates).