Bone health at every age

Bones can lose strength without hurting. Osteoporosis makes bones more likely to break, yet often causes no symptoms until a fracture happens. You can discuss bone health with your doctor before there is any pain.

Building and maintaining bone

Bone is living tissue: old material is removed and replaced. During childhood and the teenage years, more bone is added than taken away. Bones become larger and denser. Calcium and vitamin D help bones reach peak bone mass, the high point of the bone built during growth.

In young healthy adults, bone removal and replacement are roughly balanced. Later in life, bone loss can happen faster while new growth slows. Food and activity continue to matter as you get older.

Make room for calcium and vitamin D

Foods containing calcium, vitamin D and protein help keep bones healthy. Calcium sources include dairy foods, vegetables such as broccoli and bok choy, and fish eaten with their bones. Calcium-fortified soya milk and tofu are options too. Look for the fortification information rather than assuming every alternative milk contains calcium.

Vitamin D helps your gut absorb calcium. If getting enough calcium or vitamin D through food is difficult, ask a clinician about supplements. The US National Institutes of Health advises discussing the type and amount with your healthcare professional, so you can choose what fits your circumstances.

In the UK, NHS public-health advice is to consider a daily supplement containing 10 micrograms of vitamin D during autumn and winter. Pregnancy guidance now uses the more specific wording early October to late March. Advice has changed recently: that newer seasonal wording is on the NHS pregnancy page.

If you are choosing a supplement, bring the label to a pharmacist, GP or doctor and ask how it fits with anything you already take. If you live outside the UK, ask for local advice about when to take vitamin D.

Movement that supports bones

Weight-bearing activity includes walking. Strength or resistance training is another useful type of activity for bone health. Ask which activities would suit you and how to fit them into your day.

If you have osteoporosis or bone loss, speak with your doctor or a physiotherapist before beginning an exercise programme. They can help tailor it to your circumstances. Preventing falls also helps prevent fractures, so ask about this alongside exercise.

Hormones and other reasons to ask

Bone loss speeds up in the first few years after menopause. Low oestrogen can also affect bones before menopause, including when periods are absent because of hormone disorders or extreme physical activity. Mention changes in your periods when discussing bone health.

A parent’s history of osteoporosis or hip fracture is relevant. Some medicines, including glucocorticoid steroids and certain cancer treatments, can increase the risk of bone loss. Ask your prescriber whether your treatment calls for bone-health checks; do not change a prescribed medicine on the basis of this article.

What a bone-density scan is for

A bone-density scan measures bone mineral density. It is often called DXA or DEXA. It is a quick, painless test using low levels of X-rays while you lie on a padded table. Ask your clinician to explain the result alongside your health history.

In the UK, a GP may assess fracture risk and refer for a scan. In the US, USPSTF recommends screening women 65 years or older and younger postmenopausal women found to be at increased risk after clinical assessment. These recommendations do not mean everyone needs the same scan schedule.

Bring your history to an appointment

Get help today from NHS 111 or an urgent GP service (UK), your doctor or urgent care (US), or your local urgent-care service elsewhere for severe back pain that starts suddenly or gets worse quickly.

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, to discuss a previous fracture, unexplained loss of height or concerns about your risk. Take details of medicines, family fractures and your menstrual history. Ask whether you need an assessment, a scan or advice on safer movement.