Your Guide to Osteoporosis

Medically Reviewed By Stella Bard, MD
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Osteoporosis is a condition in which bone density deteriorates and decreases over time, causing weak and brittle bones. This means your bones are more likely to fracture, particularly bones in the hips, spine, and wrists. Osteoporosis means porous bone. It develops when new bones fail to form. The condition can develop gradually over time, and you may not realize that you have osteoporosis until you have a broken bone or fracture.

Read on to learn more about osteoporosis. This guide includes information about the different types of osteoporosis, their symptoms, and how to treat them.

Key facts about osteoporosis

  • Osteoporosis means porous bone, as your body does not replace bone quickly enough.
  • The condition develops gradually and may not present symptoms for years.
  • Your doctor will typically prescribe medication for the treatment of osteoporosis.
  • You may not know you have osteoporosis until you have a fracture or broken bone.
  • Around 10 million people over the age of 50 in the United States have osteoporosis.
  • Females are around four times more likely to get osteoporosis than males.

Read the full article for more information. You can find more articles in our osteoporosis hub.

What are the types of osteoporosis?

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Doctors classify osteoporosis into two main types. These are primary osteoporosis and secondary osteoporosis.

Primary osteoporosis occurs when the condition develops on its own. With secondary osteoporosis, the condition is a result of a separate medical condition or medication that can cause bone loss.

Juvenile osteoporosis refers to a thinning of the bones that begins in childhood.

What are the symptoms of osteoporosis?

You may not experience any symptoms of osteoporosis for many years. This is why it is known as a “silent” condition.

Many people do not realize that they have osteoporosis until they have a fracture or a broken bone.

Symptoms of a vertebral fracture, or fracture of the spine, include:

Osteoporosis causes bones to become so fragile that you could experience a break or fracture from a minor fall, or simply from bending, lifting, or coughing.

Sex and gender exist on a spectrum. This article uses the terms “female” and/or “male” to refer to sex that was assigned at birth. 

Learn more about the difference between sex and gender here.

How is osteoporosis treated?

Your doctor will typically prescribe medicine for osteoporosis. The type of medication will depend on your sex, age, overall health, and how much bone you have lost. They may include:

  • bisphosphonates, such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast), which can decrease bone loss and possibly increase bone density
  • calcitonin, which can slow the rate of bone loss and help minimize pain
  • denosumab (Prolia), which works to increase bone mass in people at high risk for fracture from osteoporosis
  • romosozumab-aqqg (Evenity), which is for females who have been through the menopause and who have severe osteoporosis
  • raloxifene (Evista), which prevents and treats osteoporosis in postmenopausal people, and can make bones stronger and reduce the risk of fractures
  • teriparatide (Forteo), which contains a parathyroid hormone, and encourages new bone tissue growth

Hormone replacement therapy may also be an option in some cases. However, researchers recommend this only at its lowest dose due to possible side effects.

Learn more about osteoporosis treatments.

What diet should I have with osteoporosis?

Eating a healthy, balanced diet rich in calcium, vitamin D, and other nutrients that promote bone health can help to prevent the development of osteoporosis or help to slow the progression of symptoms.

How much calcium do I need?

Around 99% of the body’s calcium is in the skeleton, so it is important to have a calcium-rich diet. The amount of calcium you will need depends on your age and sex.

Recommended daily intake of calcium may also differ depending on which country you live in; the information in the table below is a guide only.

AgeRecommended daily intake
0–6 months200 milligrams (mg)
6–12 months260 mg
1–3 years700 mg
4–8 years1,000 mg
9–13 years1,300 mg
14–18 years1,300 mg
19–50 years1,000 mg
51–70 years1,200 mg for females
1,000 mg for males
70+ years1,200 mg

Contact your doctor for information about how much calcium you should be getting per day.

Foods to eat with osteoporosis

Foods that are good for your bones and help prevent or slow osteoporosis symptoms include:

  • dairy products, such as:
    • cheese
    • yogurt
    • low fat milk
    • fat-free milk
  • fish, for example:
    • salmon
    • mackerel
    • tuna
    • sardines
  • foods containing vitamin C, such as:
    • oranges
    • grapefruits
    • red and green peppers
    • broccoli
    • strawberries
    • papaya
    • pineapples
  • leafy green vegetables containing vitamin K, including:
    • kale
    • collard greens
    • mustard greens
    • turnip greens
    • Brussels sprouts
  • foods containing magnesium, such as:
    • okra
    • beet greens
    • artichokes
    • tomato products
    • plantains
    • potatoes
    • sweet potatoes
    • raisins
  • foods containing potassium, including:
    • potatoes
    • tomato products
    • raisins
    • sweet potatoes
    • papaya
    • oranges
    • bananas
    • plantains
    • prunes
  • foods containing calcium, for example:
    • turnip greens
    • collard greens
    • kale
    • okra
    • dandelion greens
    • Chinese cabbage
    • broccoli
    • mustard greens

Foods to avoid with osteoporosis

Certain foods can affect the way your body absorptions calcium, which can lead to loss of bone density. Try to avoid the following or consume them in moderation:

  • beans, which you can soak in water for several hours before cooking to reduce phytate levels
  • salty foods, including processed and canned foods
  • meat and other foods high in protein
  • foods high in high in oxalates, such as spinach and rhubarb
  • wheat bran
  • alcohol
  • caffeine, including tea, coffee, or soft drinks

Contact your doctor before making any significant changes to your diet.

Learn more about foods to avoid with osteoporosis.

What causes osteoporosis?

Osteoporosis occurs when you lose too much bone mass or if your body does not make enough bone. The exact cause of osteoporosis is unknown, but factors that may make you more likely to develop osteoporosis include:

  • aging
  • reduced levels of estrogen
  • excessive use of cortisone or thyroid hormone
  • lack of physical activity
  • heredity
  • smoking
  • drinking alcohol

What causes secondary osteoporosis?

Secondary osteoporosis can occur as a result of certain medications or medical conditions.

Medical conditions that can result in osteoporosis include:

Medications that can cause osteoporosis include:

  • glucocorticoids and adrenocorticotropic hormone
  • antiepileptic medication
  • cancer medication
  • proton pump inhibitors
  • selective serotonin reuptake inhibitors (SSRIs)
  • thiazolidinediones

Does menopause cause osteoporosis?

After menopause, the ovaries produce very little estrogen. Estrogen prevents bone loss.

Females can experience a period of rapid bone loss that begins around 1 year before their final menstruation. This rapid bone loss can last for around 3 years.

How common is osteoporosis?

Osteoporosis affects around 10 million people aged 50 and over in the United States. Around 8 million are female and 2 million are male. Osteoporosis is five times more likely to affect females.

Around 43 million people also have low bone mass. This means that they are at an increased risk of osteoporosis.

How is osteoporosis diagnosed?

Your doctor may diagnose osteoporosis during a routine screening, particularly if you are a female and over the age of 65.

If you experience a break or fracture after a minor fall, your doctor can carry out examinations to see if you have osteoporosis. They may carry out a physical exam to check for:

  • loss of height
  • weight loss
  • changes in your posture
  • your ability to walk
  • your balance
  • muscle strength

BMD and DXA tests

Your doctor may arrange for a bone mineral density (BMD) test, which typically involves dual energy X-ray absorptiometry (DXA or DEXA). During this test, you lie down while a scanner scans your body using low energy X-rays to measure your bone mineral density. It typically takes measurements from your wrist, hip, and spine.

DXA scores are presented as T-scores. If you have a negative T-score, this means that your bones are thinner than those of an average 30-year-old female. A positive score means that your bones are stronger. A T-score of between -1 and -2.5 means that you have low BMD and are at risk of osteoporosis.

Are there any risk factors for osteoporosis?

While anybody can get osteoporosis, risk factors including age and sex make you more likely to develop the condition.

You are more likely to get osteoporosis if you are female and over the age of 50. It is also more prevalent among non-Hispanic white and Asian females, though it can affect any ethnic group.

Other risk factors for osteoporosis include:

  • consuming a diet low in calcium
  • vitamin D deficiency
  • smoking cigarettes
  • being physically inactive
  • early menopause, typically before the age of 45
  • loss of menstrual period due to reduced production of estrogen
  • alcohol intake, particularly if you drink each day
  • caffeine intake, including drinking more than three cups of coffee per day

What are the complications of osteoporosis?

The main complications of osteoporosis are broken bones and fractures. These can occur from even just a minor fall.

Fracture as a result of osteoporosis may also increase mortality. For example, around 20% of people could die within the first year following a hip fracture.

Other individuals who experience a hip fracture may lose independence, with around 40% of people unable to walk independently.

Taking steps to prevent osteoporosis and reduce the risk of falls can help to prevent complications such as loss of independence or life.

Can I prevent osteoporosis?

You can take steps to prevent or reduce the likelihood of osteoporosis. These steps can include:

  • eating a balanced diet rich in vitamin D and calcium
  • staying physically active with weight-bearing exercises such as walking
  • doing exercise that can improve your balance, such as yoga or tai chi
  • avoiding alcohol or drinking in moderation
  • quitting smoking

FRAX assessment

The FRAX tool helps to evaluate whether or not you are at risk of a fracture, providing information about how likely you are to have a fracture within the next 10 years.

To determine your FRAX score, your doctor will gather information about you that relate to risk factors including:

Depending on the score, they may offer treatment to help to prevent a future fracture.

How do I stop myself from falling?

If you do have osteoporosis, it is important to try to reduce the risk of falling. Even just a minor fall from a standing position can result in a fracture or broken bone.

Advice for preventing falls includes the following tips:

  • Stay physically active and flexible where possible.
  • Regularly have hearing and eye tests as even slight changes can affect your balance.
  • Avoid taking medications that make you drowsy or dizzy. Contact your doctor if you experience these side effects with your current medication.
  • Stand up slowly, as standing too quickly can cause your blood pressure to drop.
  • Use a cane, walking stick, or walking frame to provide you with extra stability if you are unsteady on your feet.
  • Wear low-heeled shoes with rubber or non-slip soles.
  • Avoid drinking too much alcohol.

Make sure your doctor is aware of any falls that you have experienced. Even if you do not experience an injury, it is important to recognize any patterns or changes in your health that might result in more frequent falls.

Learn more:

Discover more articles in our osteoporosis hub.

Summary

Osteoporosis is a condition where your bones become fragile and break easily. This most often occurs for females in later life, but it can affect anybody at any age.

Treatment for osteoporosis typically involves medication. Consuming a diet rich in calcium and vitamin D can help to strengthen bones and reduce the risk of the condition.

Contact your doctor to arrange a routine test for osteoporosis, particularly if you are over the age of 50. You may not know you have osteoporosis until you experience a broken bone or a fracture.

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Medical Reviewer: Stella Bard, MD
Last Review Date: 2022 May 27
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.