Although this does not necessarily mean that you have osteoporosis, positive answers mean that you have clinically-proven risk factors which may lead to osteoporosis and fractures.
Are you 60 years old or older?
Bones get thinner and more porous as we age, with bone tissue loss generally beginning after the age of about 40 years. Generally, the risk of osteoporosis rises with age. Even if you have no other clinical risk factors, if you are a women aged 60 years or over, or a man aged 70 years or over, you should discuss bone health at your next physical check-up.
Have you had a fracture after the age of 50?
If you’ve suffered a fracture after a minor fall, this may indicate that osteoporosis is the underlying factor which contributed to the fracture. You should consult your doctor.
Do you currently, or have you ever, smoked cigarettes?
You should be aware that smoking doubles the risk of osteoporosis.
Is your daily level of physical activity less than 30 minutes per day (housework, gardening, walking, running etc.)?
The idea is ‘move it or lose it’! Lack of exercise results in bone (and muscle) loss. Regular weight-bearing exercise helps build up and strengthen bones and muscles.
Do you regularly drink alcohol in excess of safe drinking limits (more than 2 units a day)?
Excessive alcohol use can have a detrimental effect on bone health and can also lead to frequent falls, which increases the risk of osteoporotic fractures. In addition, calcium and vitamin D intake is often reduced due to poor nutrition, which impacts negatively on bone metabolism.
Do you avoid, or are you allergic to milk or dairy products, without taking any calcium supplements?
Calcium is the most important mineral for your bones. It is contained mostly in dairy products. If you avoid or are allergic to dairy products and have not been taking supplements, you have probably been calcium-deficient and are at higher risk of osteoporosis.
Have you been diagnosed with an over-active thyroid, over-active parathyroid glands, diabetes or a nutritional/gastrointestinal disorder such as Crohn’s or celiac disease?
Overactive parathyroid glands produce too much parathyroid hormone, which leads to bone loss and osteoporosis. Both type 1 and type 2 diabetes have been associated with increased fracture risk, and conditions which lead to poor absorption of nutrients in food, such as Crohn’s and celiac disease, can also lead to osteoporosis.
Do you spend less than 10 minutes per day outdoors (with part of your body exposed to sunlight), without taking vitamin D supplements?
Vitamin D is made in the skin upon exposure to UVB rays from the sun. Vitamin D is necessary for the absorption of calcium. However, many people are unable to get enough vitamin D from sun exposure. For falls and fracture protection, IOF recommends supplementation at a dose of 800-1000 IU per day for the elderly or people at risk.
Were your ovaries removed before age 50 years, without you taking hormonal replacement therapy?
Your ovaries are responsible for estrogen production and lack of ovaries means that you have had estrogen deficiency – a factor which increases the risk of osteoporosis.
Did your menopause occur before the age of 45?
The female hormone estrogen affects bone mineral metabolism. Once menopause begins your body produces lower levels of estrogen and the rate of bone tissue loss increases quite substantially. Women who experience early menopause are therefore more likely to develop osteoporosis and related fractures.
Do you fall frequently (more than once in the last year) or do you have a fear of falling because you are frail?
As falls are the primary cause of fractures (although people with osteoporosis may suffer a vertebral fracture simply from lifting or bending) you are at higher risk of fracture if you tend to fall. Exercise to improve muscle strength and balance as well as fall prevention strategies at home (remove small carpets, wear slip-proof shoes etc.) may help reduce the risk of falls.
Did either of your parents have a stooped back (“dowager’s hump”)?
A “dowager’s hump” – a curved back – likely indicates spinal fractures due to osteoporosis.
Have either of your parents been diagnosed with osteoporosis or broken a bone after a minor fall (a fall from standing height or less)?
If there is osteoporosis in the family you may be at higher risk of developing osteoporosis yourself. Diagnosis of osteoporosis has only recently become common, so if your parents suffered fractures after a minor fall, this may indicate that they have, or had, osteoporosis.
After the age of 40 years, have you lost more than 3 cm in height (just over 1 inch)?
If you’ve lost more than 3 cm (just over 1 inch) in height, the cause is likely to be spinal compression fractures caused by osteoporosis.
Are you underweight (is your Body Mass Index less than 19 kg/m2)?
Being underweight can lead to lower estrogen levels in girls and women, similar to after menopause, which may contribute to the development of osteoporosis. At the same time, frail people are at higher risk of fracture.
Have you ever been diagnosed with rheumatoid arthritis?
Rheumatoid arthritis itself and the use of corticosteroids to fight this disease may lead to osteoporosis.
Have you ever taken corticosteroid tablets (cortisone, prednisone, etc.) for more than 3 consecutive months (corticosteroids are often prescribed for conditions like asthma, rheumatoid arthritis, and some inflammatory diseases)?
Osteoporosis may be a side-effect of long-term corticosteroid use (for example prednisolone). Use of corticoids may lead to bone loss, which is most rapid in the first 3-6 months of treatment. This results in an increased fracture risk, occurring even with low doses and rising further with increasing daily dose.
Have your periods ever stopped for 12 consecutive months or more (other than because of pregnancy, menopause, or hysterectomy)?
The lack of menstruation over a long period of time indicates low levels of estrogen production – a factor which favours the development of osteoporosis. People suffering anorexia nervosa, elite female athletes and ballet dancers are particularly at risk.
Take action today to lead a bone-healthy lifestyle and reduce your risk!
- If you have risk factors, talk to your doctor and seek a bone health assessment.
- Increase your levels of physical activity – aim to exercise for 30-40 minutes, three to four times each week with some weight-bearing and resistance exercises in the programme.
- Ensure a nutritious, balanced diet which includes enough dietary calcium–
- Dairy intolerance? Find out about calcium-rich alternatives, or explore which dairy products (yoghurt?) you can enjoy in moderation.
- Spend more time outdoors to ensure you are getting enough vitamin D, or take supplements if required.
- If you’re currently smoking – STOP
- Drink alcohol only in moderation.