Bone Health

14 questions that help determine your risk of osteoporosis

Physicians today are encouraged to look for signs of osteoporosis just as they do for heart disease, diabetes and other problems during the yearly physical. “This assessment of your overall health routinely includes checking height, weight and spinal contour,” says Abby Abelson, MD, FACR, Chair of the Department of Rheumatic and Immunologic Diseases within Cleveland Clinic’s Orthopaedic & Rheumatologic Institute, and author of The Cleveland Clinic Guide to Osteoporosis (Kaplan Publishing).

Below, Dr. Abelson lists some of the questions your doctor may ask to determine your risks for osteoporosis.

Do you have an immediate relative who has suffered a fracture? The risk of hip fracture doubles for women whose mothers have had a hip fracture.

Do you have an immediate relative with osteoporosis or osteopenia? Bone fragility or fracture in a first-degree relative means that you may have inherited that same susceptibility.

Have you suffered recent fractures or falls? Three or more falls in one year raise your risks of fracture, particularly of the hip, and any woman who suffers a fracture after age 50 increases her risk of a hip fracture. Fractures, however, may be caused by other medical conditions, so a full evaluation by your doctor is critical.

Do you have an endocrine, kidney or gastrointestinal disorder? Certain diseases and conditions are associated with loss of bone density.

Are you taking steroids or synthetic thyroid hormone? Taking prednisone in doses of 5 milligrams or more per day for more than three months to treat a medical condition can reduce your bone mass. Taking thyroid hormone for Graves’ disease can raise risks of bone thinning if the dose is too high.

How much alcohol do you drink? Alcohol consumption of two or more drinks per day reduces bone density.

Do you smoke? Tobacco smoking – currently or in the past – is known to reduce bone mass, along with causing many other health problems.

Have you ever had an eating disorder? Anorexia nervosa or bulimia, especially during adolescence and young adulthood, can prevent you from achieving peak bone mass.

What is your menstrual history? Prolonged absence of periods due to excessive exercise, an eating disorder or menopause can cause estrogen deficiency, which hastens loss of bone density. Premature menopause is an additional risk factor for osteoporosis. Late onset of menses may predispose a woman to low peak bone mass.

What is your diet like? Lifelong insufficient intake of calcium, vitamin D or other nutrients can weaken your bones.

How much coffee do you drink? Excessive caffeine intake can rob the bones of key minerals.

What kind of exercise do you get? A sedentary lifestyle does nothing to strengthen bones; exercise must involve bearing weight to have a positive impact on bone health.

Have you ever had bariatric surgery? Gastric bypass and stomach stapling procedures can hamper absorption of calcium, vitamin D and other nutrients our bones rely on.

Do you have chronic neck or back pain? Although there can be many causes of back and neck pain, these are sometimes symptoms of vertebral fracture.

If your answers to these questions suggest that you may be at increased risk for osteoporosis, your doctor likely will recommend bone mineral density testing.

Excerpted with permission from The Cleveland Clinic Guide to Osteoporosis by Abby Abelson, MD, FACR. Published by Kaplan Publishing, © 2010 Kaplan Publishing. Available on

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