What it is
Bones become thin and fragile, so they can break from a minor fall or even a cough. Common sites are the spine, hip and wrist.
Risk factors
- Women after menopause, especially early menopause
- Older age
- A previous fracture from a minor fall
- A parent who broke a hip
- Low body weight, smoking or heavy alcohol use
- Long-term steroid tablets
- Overactive thyroid or parathyroid glands, low testosterone, coeliac disease, type 1 diabetes or rheumatoid arthritis
Who should have a scan?
A bone density (DEXA) scan of the spine and hip is generally advised for women from 65 and men from about 70, and earlier for people with risk factors or a fracture from a minor fall. Recommendations vary between guidelines.
Reading the scan
In postmenopausal women and men over 50, a T-score of −2.5 or lower means osteoporosis. In younger people a Z-score is used, and the diagnosis is not made from the scan alone.
Looking for a cause
Blood tests check calcium, vitamin D, parathyroid hormone, kidney and thyroid function, and testosterone in men, because treating an underlying cause can improve bone strength.
Treatment
- Enough calcium and vitamin D
- Weight-bearing and strength exercise
- Preventing falls at home
- Medicines that slow bone loss or build bone, chosen according to your fracture risk
When to see a specialist
Consider an endocrinology opinion if you are young with low bone density, have had fractures, or have abnormal calcium or hormone tests.
This guide is general information and is not a substitute for a consultation.