How do I know whether my bones are strong enough (osteoporosis)?
With a bone density scan and, where appropriate, a fracture risk calculation, your GP can check whether your bones are strong enough, especially if you have risk factors or have previously broken a bone from a minor fall.
The most reliable way to find out whether your bones are strong enough is a bone density scan. This scan gives you a T-score. A score of -2.5 or lower confirms osteoporosis. This test is considered the gold standard and forms the basis of every diagnosis.
Have you ever broken a bone from a minor force, such as a fall from standing height? If so, osteoporosis can be diagnosed even without reaching that threshold. Such a 'fragility fracture' is itself a warning sign, even if your T-score has not yet reached -2.5.
Alongside the bone density scan, a doctor will often use a calculation that estimates your chance of a fracture over the next 10 years. Several factors are taken into account, including age, sex, weight, and any previous fractures. If the risk is high, treatment may be recommended even before you have reached the osteoporosis threshold.
Osteoporosis causes no symptoms for a long time. The first sign is often a sudden, severe back pain from a collapsing vertebra, or pain in the groin or upper leg from a hip fracture. Because you cannot feel it yourself, actively checking for it is worthwhile. Have you been taking prednisolone for a long time, do you regularly drink too much alcohol, or do you have a thyroid or hormone condition? If so, your risk is even higher, especially if you are a man: osteoporosis is often seen as a women's condition, but around 40% of all osteoporotic fractures affect men, and the consequences for men are on average even more serious.
A complete picture comes from a combination of a conversation about your symptoms and risk factors, a physical examination, blood tests to rule out other causes, a bone density scan, and possibly X-rays of the spine. If you have any doubts about your bone health, discuss them with your GP.
All claims are based on diagnostic guidelines and studies in people. The bone density scan as the gold standard and the T-score threshold of -2.5 are well supported.
How do I keep my bones strong after the menopause?
You can protect your bones well after the menopause with hormone therapy, adequate calcium and vitamin D through diet, and regular exercise. Discuss the best approach for your situation with your doctor.
Stronger bones and strength training: does it help?
Strength training measurably improves bone density, although the effect remains modest. For the strongest results, high-intensity training under supervision is recommended, even if you already have low bone mass.
Do you really need calcium supplements for strong bones?
Whether you need calcium supplements depends strongly on your age and situation: for healthy women before the menopause there is no evidence of benefit, while women over 50 may benefit from calcium plus vitamin D, provided you weigh the increased risk of kidney stones and the uncertain cardiac risk with your doctor.
How do I know if I am at risk of osteoporosis?
You can get a good sense of your risk based on age, sex, hormonal history, medication use and lifestyle. If you have multiple risk factors, ask your general practitioner for a bone density measurement.
Does vitamin D prevent me from breaking bones?
Vitamin D alone does not demonstrably reduce the chance of bone fractures. Combined with calcium it does help, especially in older adults and people with a deficiency.
How do you prevent bone loss when losing weight at an older age?
Strength training while losing weight is the best protection against bone loss, but cannot prevent it entirely. Combine it with adequate protein intake and discuss it with your doctor if you are losing weight quickly or in large amounts.