Osteoporosis

Also known as: Low bone density

A condition of thin, fragile bones that raises the risk of fractures, often without any symptoms until a bone breaks.

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Osteoporosis

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How it works · Osteoporosis

Bone is living tissue

Osteoclasts remove old bone while osteoblasts lay down new bone. In healthy adults the two stay in balance.

What it is

Osteoporosis develops when bone is lost faster than it is rebuilt. It affects about 1 in 5 women and 1 in 20 men over 50. Risk rises with menopause, age, low body weight, smoking, alcohol, steroid use, RA and some other illnesses.

Symptoms

Usually none. The first sign may be a fracture from a minor fall, loss of height, a stooped posture or sudden back pain from a spinal fracture.

How it’s diagnosed

A DEXA scan measures bone density, reported as a T-score. A T-score of -2.5 or lower, or a fragility fracture, means osteoporosis. The FRAX tool estimates 10-year fracture risk, and lab tests look for treatable causes.

Treatment

Bisphosphonates such as alendronate or zoledronic acid are common first choices. Denosumab, and bone-building drugs like teriparatide, abaloparatide or romosozumab, are used for higher risk. Calcium, vitamin D and exercise support every plan.

Living with it

Weight-bearing and balance exercise, enough protein and calcium, limiting alcohol, not smoking and fall-proofing your home all reduce fracture risk.

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