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Bone thins silently — measurable before anything breaks, and still influenceable at any age.
Also known as: osteoporosis · bone loss
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Bone is not a dead frame but tissue that is broken down and rebuilt lifelong. Until about thirty building wins, after that breakdown — in women accelerated in the first years after the menopause, because the oestrogen that brakes breakdown falls away. Osteoporosis means: so much substance lost that bones break on slight occasion. Typical sites are the wrist, the femoral neck and the vertebrae; vertebral fractures often happen without a fall and show only as back pain, a loss of several centimetres in height or a growing stoop. Bone density is measured with a low-radiation scan, DXA; the result is the T-score. It does not decide alone: age, a fracture already suffered, a hip fracture in a parent, smoking, alcohol, low body weight, long-term cortisone and the tendency to fall all count. A fracture after a fall from standing height from fifty onwards already counts as a warning in itself. It is treatable at any age, and most of the benefit lies in preventing the first fracture — after a second one the outlook is markedly worse.
Both decline in parallel with age, and both respond to the same thing: resistance training and enough protein. Treating only the bone leaves out the part that prevents the falls.
Load along the bone’s axis is the strongest stimulus for bone building.
Supply the building blocks of the bone matrix.
Vitamin D governs calcium uptake; a deficiency should be corrected.
Practise balance, check eyesight, remove rug edges and loose cables, light the way at night, review sleep-inducing medicines. Bone does not break by itself — usually a fall is needed.
Bone builds where it is pulled and struck: strength training, stairs, hopping, brisk walking. Swimming and cycling are good for the heart but too gentle for bone.
About a thousand milligrams a day, preferably from dairy, calcium-rich mineral water, greens and nuts. High-dose calcium tablets add little; vitamin D is supplemented when lacking.
The risk of the next one is highest in the first year afterwards. That is exactly when treatment does most — and exactly when it is most often forgotten.
Bisphosphonates slow the cells that break bone down. Bone becomes denser because less is removed — not because more is built. Strength training and vitamin D work by the other route, and both routes count together.
About one woman in three after menopause and one man in five over fifty are affected. Bone is lost without symptoms; the first sign is often a fracture from a fall that would earlier have done nothing.
Falling from standing and breaking a wrist — from fifty on, that is not bad luck but a reason to measure bone density.
More than four centimetres below your tallest height, or two within a few years, points to collapsed vertebrae. So it is worth measuring height.
An increasing stoop with back pain is often the only trace of vertebral fractures — two out of three go unnoticed.
From about three months of tablets the fracture risk rises markedly, and earlier than bone density shows it. Here treatment is often started preventively.
Low body weight and eating disorders, absent periods in young sportswomen, an overactive thyroid, coeliac disease, early menopause, smoking and a lot of alcohol. Some of this can be put right.
Bone only builds what is loaded — strength training works more here than any preparation.
Pulsed magnetic fields are used and studied for bone healing.
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