Bone health at every age

Bones can lose strength without hurting. Osteoporosis makes bones more likely to break, but it often causes no symptoms until a bone breaks. You can talk to your doctor about bone health before you have any pain.

Building and maintaining bone

Bone is living tissue. Old bone is removed and replaced with new bone. During childhood and the teenage years, more bone is added than taken away. Bones get bigger and denser. Calcium and vitamin D help bones reach peak bone mass, which is the most bone you build while growing.

In young, healthy adults, the bone that’s removed and the bone that’s replaced are roughly in balance. Later in life, bone can be lost faster while new bone grows more slowly. What you eat and how active you are still matter as you get older.

Make room for calcium and vitamin D

Foods with calcium, vitamin D and protein help keep bones healthy. Sources of calcium include dairy foods, vegetables such as broccoli and bok choy, and fish eaten with their bones. Soya milk and tofu with added calcium are options too. Check the label, rather than assuming every milk alternative has calcium added.

Vitamin D helps your gut take in calcium. If it’s hard to get enough calcium or vitamin D from food, ask a clinician about supplements. The US National Institutes of Health advises talking to your healthcare professional about the type and amount, so you can choose what suits you.

In the UK, NHS public health advice is to think about taking a daily supplement with 10 micrograms of vitamin D in autumn and winter. Advice for pregnancy now gives a more exact time: early October to late March. This advice changed recently, and the newer wording is on the NHS pregnancy page.

If you’re choosing a supplement, take the label to a pharmacist, GP or doctor. Ask how it fits with anything else you take. If you live outside the UK, ask for local advice on when to take vitamin D.

Movement that supports bones

Weight-bearing activity, where your body carries its own weight, includes walking. Strength or resistance training is another useful kind of activity for your bones. Ask which activities would suit you and how to fit them into your day.

If you have osteoporosis or bone loss, talk to your doctor or a physiotherapist before you start an exercise programme. They can help shape it to suit you. Preventing falls also helps prevent broken bones, so ask about this too.

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. This includes when periods stop because of hormone problems or very intense exercise. Mention any changes to your periods when you talk about bone health.

A parent who had osteoporosis or a broken hip is relevant. Some medicines can raise the risk of bone loss, including steroid medicines (glucocorticoids) and some cancer treatments. Ask your prescriber whether your treatment means you need bone health checks. Don’t change a prescribed medicine because of this article.

What a bone-density scan is for

A bone density scan measures how dense your bones are. It’s often called a DXA or DEXA scan. It’s a quick, painless test that uses low doses 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 check your risk of breaking a bone and refer you for a scan. In the US, USPSTF recommends screening women 65 years or older. It also recommends screening younger women after menopause who are found to be at higher risk once a clinician has assessed them. This doesn’t mean everyone needs scans on the same 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 talk about a broken bone in the past, losing height for no clear reason, or worries about your risk. Bring details of your medicines, any family members who’ve broken bones, and your period history. Ask whether you need a check, a scan or advice on moving more safely.