Osteoporosis

Osteoporosis translates to “porous bone.” People with osteoporosis have weakened bones and an elevated risk of bone fractures, particularly in the spine, hip, forearm, and wrist. While traumatic events like falls and auto accidents can cause broken bones in many people, someone with severe osteoporosis may develop a bone fracture after simply bumping into a piece of furniture or coughing forcefully.

You may be surprised to learn that your bones are not solid. Instead, they feature a honeycomb-like center with small holes that keep them light. Osteoporosis causes these small holes to become bigger, lowering the density of your bones and increasing the risk of fractures. The condition also thins out and weakens the outside of the bone, which is naturally denser than the inside.

In addition to the estimated 10 million U.S. adults who live with osteoporosis, another 44 million have low bone density, which increases the risk of eventually developing osteoporosis. Low bone density is sometimes referred to as osteopenia (a less severe version of osteoporosis). 

The Bone Health & Osteoporosis Foundation (BHOF) reports that one in two people assigned female at birth (AFAB) and up to one in four people assigned male at birth (AMAB) will break a bone due to osteoporosis in their lifetimes.  

What’s more, according to the BHOF:

• Osteoporosis is the cause of an estimated two million bone fractures every year.   
• Approximately half of all adults over age 50 have an increased risk of breaking a bone due to osteoporosis or osteopenia.
• A person AMAB is more likely to experience an osteoporosis-related bone fracture than they are to get prostate cancer, and a person AFAB’s risk of a bone fracture is equal to their combined risk of ovarian, uterine, and breast cancer.

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Known as a “silent disease,” osteoporosis rarely causes obvious symptoms in its initial stages. It’s usually diagnosed after a person breaks a bone from a seemingly minor event that wouldn’t typically hurt them. This might include swinging a golf club, falling from standing height, or bending over to pick up a heavy object.

As bones weaken and collapse or break, signs of osteoporosis can include:

• Back pain, usually in the low back, if spinal bones (vertebrae) are affected
• A gradual loss of height, often an inch or more
• A stooped or hunched-over posture (kyphosis) 
• Breathlessness, if osteoporosis-related shortening in the spine reduces lung capacity  

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Bones are active, living structures. The body breaks down old bone and replaces it with new bone to keep the skeleton strong. When more bone is broken down than replaced over time, osteoporosis can occur.   

Your bones slowly lose their ability to regenerate as you age. Before age 30, more bone is created than lost. Most people experience peak bone mass around this time. After age 35, bone is lost quicker than it can be produced. This results in gradually declining bone mass that can eventually lead to osteoporosis.

While losing some bone mass is a natural part of the aging process, not everyone develops osteoporosis. How much bone mass a person acquires in youth and young adulthood can influence their individual osteoporosis risk, as can several factors that tend to slow bone production or accelerate bone loss.

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A risk factor is a trait, behavior, or environmental influence that can increase your likelihood of developing a certain condition. There are several established risk factors for osteoporosis, including:

Sex assigned at birth

The biggest risk factor for osteoporosis is being assigned female at birth (AFAB). According to the Centers for Disease Control and Prevention (CDC), osteoporosis occurs in nearly 20 percent of people AFAB aged 50 and older (1 in 5) and in around 5 percent of people AMAB in this same age group (1 in 20). 

People AFAB are more likely to experience osteoporosis largely because of menopause-related changes in hormone levels. Estrogen—a female hormone—plays a key role in bone health. Menopause causes estrogen levels to dip, which can lead to a significant loss of bone density. 

People AFAB have an even greater risk of osteoporosis if they:

• Didn’t have a menstrual period for more than six months due to factors like excessive physical activity or poor diet (sometimes related to an eating disorder)
• Experienced menopause before age 45 (referred to as early menopause)
• Received a hysterectomy (surgical removal of the uterus) with ovary removal before age 45   

Underlying medical conditions

Some medical conditions can impact bone health and increase a person’s risk of osteoporosis, no matter their sex assigned at birth. These include, but aren’t limited to:

• Autoimmune disorders like ankylosing spondylitis (spinal arthritis), lupus, and rheumatoid arthritis
• Blood cancers like leukemia, lymphoma, and multiple myeloma
• Hormonal disorders such as diabetes, Cushing disease, hypogonadism (low testosterone levels) and thyroid disorders (like hyperthyroidism) 
• Gastrointestinal disorders like inflammatory bowel disease (IBD) and celiac disease
• Liver or kidney disease  

Medications

Long-term use of certain medications can make osteoporosis more likely. Some of the most notable of these medications include:

• Progesterone 
• Corticosteroids (prednisone and cortisone)
• Thyroid hormones
• Antiseizure medications (phenytoin and phenobarbitone) 
• Certain cancer drugs
• Selective serotonin reuptake inhibitors (also known as SSRIs, such as escitalopram, citalopram, sertraline, and fluoxetine)
• Antacids that contain aluminum

These aren’t all the drugs that are linked to osteoporosis. To learn if a medication you’re taking could be increasing your osteoporosis risk, talk to your healthcare provider (HCP). They may adjust your dosage or suggest ways to help protect your bone health while taking medication.

Other risk factors

Sex assigned at birth, underlying medical conditions, and use of certain medications are just a few of the known risk factors for osteoporosis. Others include:

• Having a family history of osteoporosis or broken bones    
• Breaking a bone after age 50  
• Being white or having Asian descent  
• Having an eating disorder  
• Not consuming enough calcium, vitamin D, or protein
• Not getting enough physical activity, possibly due to a sedentary lifestyle or a long period of bed rest  
• Smoking cigarettes  
• Being thin, petite, or underweight     
• Having gastrointestinal (GI) or weight loss surgery, such as a gastrectomy or gastrointestinal bypass procedure  
• Drinking alcohol in excess (this entails consuming more than one standard drink a day for people AFAB and two standard drinks for people AMAB)

The National Institutes of Health (NIH) defines one standard drink as a beverage that contains around 0.6 fluid ounces of pure alcohol. This translates to:

• 12 ounces of regular beer 
• 5 ounces of table wine
• 8 to 10 ounces of malt liquor or a flavored malt drink, like a hard seltzer 
• 1.5 ounces of distilled spirits, such as gin, rum, tequila, whiskey, or vodka

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There are a few types of osteoporosis. This bone disease may be categorized as:

Primary osteoporosis 

By far the most common type, primary osteoporosis tends to occur in older people AMAB and people AFAB after menopause. It develops spontaneously, usually because of age-related bone loss. This bone loss tends to occur rapidly in people AFAB around the time of menopause, (usually between the ages 45 and 55), then it slows. People AFAB and AMAB usually experience bone loss at the same rate once they reach age 65 or 70.

Primary osteoporosis that doesn’t have an identifiable cause is known as idiopathic osteoporosis. Idiopathic osteoporosis typically occurs in people AFAB who are premenopausal and people AMAB who are younger than 50.

Secondary osteoporosis

Secondary osteoporosis is the result of another health problem, such as cancer, rheumatoid arthritis (RA), hyperthyroidism (overactive thyroid), AIDS, and the eating disorder anorexia nervosa.

Certain medications may also contribute to secondary osteoporosis if taken for an extended period. These include, but aren’t limited to:

• Anticonvulsants used to treat seizures
• Corticosteroids (also called glucocorticoids or steroids) used to treat a wide range of conditions, including RA and asthma
• Hormone therapy for breast cancer and advanced (metastatic) prostate cancer
• Proton pump inhibitors used to treat heartburn and gastroesophageal reflux disease
• Selective serotonin reuptake inhibitors used to treat depression
• Thiazolidinediones used to treat type 2 diabetes

Juvenile osteoporosis 

Osteoporosis that occurs in a child or teenager is known as juvenile osteoporosis. This is uncommon and usually related to taking medication or having an underlying medical condition such as an eating disorder, juvenile arthritis, kidney disease, and celiac disease (a digestive and immune disorder triggered by eating foods with gluten). Lifestyle factors such as a poor diet or too little or too much exercise may also contribute to juvenile osteoporosis.

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Diagnosing osteoporosis usually begins with a series of questions from your HCP, who may ask about your personal and family medical histories, physical activity levels, diet, medication use, menstrual cycle, and other factors that can influence bone health. A physical exam to check for visible signs of osteoporosis (such as hunched posture and loss of height) may also be performed, possibly along with blood tests to measure calcium and vitamin D levels.

To definitively diagnose or rule out osteoporosis, an HCP uses a bone density test (sometimes called a DEXA or DXA scan, which stands for dual-energy X-ray absorptiometry). This imaging test compares your bone density to that of the average young, healthy adult. Results of the bone density test are then measured as a “T-score.” T-scores range as follows: 

• -1 to +1 indicates healthy bone density
• -1 to -2.5 indicates low bone density (osteopenia)
• -2.5 or lower indicates osteoporosis

People AMAB younger than 50 and premenopausal individuals who undergo bone density testing may be given a “Z-score.” A Z-score compares your bone density to that of a healthy adult of your same age, race, and sex assigned at birth. A Z-score less than -2.0 could indicate osteoporosis.

A bone density test is painless and usually takes around 10 to 15 minutes to complete. During the test, you’ll lay on a table as a scanner takes high- and low-energy X-rays. These varying types of X-rays help show bone density on imaging results. An HCP may focus the bone density test on the spine and hip bones, as these areas are most likely to be affected by osteoporosis.  

Bone density tests may also be used to monitor the effectiveness of osteoporosis treatment or to calculate a fracture risk assessment (FRAX) score. The results of your FRAX score, combined with risk factors like smoking habits and family history, can help determine your risk of bone fracture.  

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Osteoporosis is a slowly developing bone disease that can be categorized into four stages. These include:

Stage 1 osteoporosis

Bone production and bone loss may occur at the same rate between the ages of 20 and 40. Because new bone growth no longer outpaces bone loss, HCPs view this as stage 1 osteoporosis. (Still, bone density is healthy and there are no symptoms at this stage.)

Stage 2 osteoporosis

Stage 2 osteoporosis occurs when bone loss starts to outpace bone production. Someone in this stage may have lower bone density than other people their age. Stage 2 osteoporosis is sometimes called osteopenia, which is mild bone loss.

Stage 3 osteoporosis

Stage 3 is largely considered the true beginning of osteoporosis. Bone loss is outpacing bone production to the point where bone fractures are more likely. Someone in this stage may be unaware something is wrong until they break a bone from a seemingly minor fall.

Stage 4 osteoporosis

Noticeable changes start to take place in stage 4 osteoporosis, such as hunched posture or lost height. Many people in this stage have experienced at least one bone fracture due to severe loss of bone density. Pain may also occur when performing everyday activities.

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If you’re a person AFAB who is 65 or older, the U.S. Preventive Service Task Force recommends you visit your HCP for regular osteoporosis screening. You may also want to consider screening for osteoporosis if you’re younger than 65 and have an increased risk of bone loss due to factors like an underlying medical condition or a family history of bone disease. If you’re a person AMAB, screening may be appropriate if you’re 70 or older or have low bone density.

Osteoporosis screening involves receiving a bone density test, which is simple, quick, and painless. This test can identify osteopenia and osteoporosis before bone fractures and visible signs of bone disease occur.

If you’re unsure about osteoporosis screening, it’s still a good idea to speak with your HCP about your risk. This is especially true if:

• You’re experiencing possible osteoporosis symptoms, such as stooped posture or back pain
• You or a parent has broken a hip
• You’ve taken one or more medications that raise the risk of osteoporosis (such as corticosteroids) for an extended period
• You went through menopause before age 45

Of course, it’s also important to promptly call 911 or go to an emergency room if you or someone around you has possibly broken a bone. Signs of a bone fracture can include:

• Sudden, intense pain
• A visible deformity, such as an out-of-place joint or misshapen limb  
• Notable bruising, swelling, or discoloration
• Difficulty moving or putting weight on the affected area
• Numbness or tingling sensations  
• A bone that breaks through the skin (called an open or compound fracture), although in most fractures the skin remains intact (called a closed or simple fracture)

What questions should you ask your healthcare provider?

Whether you’re simply curious about osteoporosis screening or you’ve already received a diagnosis, it can be helpful to jot down any questions you have before speaking with your HCP. This can help you get the most out of your appointments and make informed, confident decisions about your care.  

A few basic questions to get you started include:

• Am I at risk for osteoporosis?
• How often should I receive a bone density test? 
• How can I strengthen my bones? Can bone density be improved?
• How will osteoporosis affect my everyday life?   
• What likely caused my osteoporosis?
• How can I manage osteoporosis with other health conditions I have?
• What are my osteoporosis treatment options? What are the benefits, risks, and side effects of each treatment?
• Should I consider taking supplements such as vitamin D or calcium to strengthen my bones?
• What activities should I avoid to help keep my osteoporosis from getting worse?
• Do I need to adjust my diet?
• What exercises can I do to improve my bone health?

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Osteoporosis treatment focuses on slowing or stopping bone loss and preventing bone fractures. Your HCP will likely recommend a combination of osteoporosis treatment approaches, including:

A bone-friendly diet

Various foods can nourish and strengthen your bones and help you better manage osteoporosis. While everyone needs a varied, nutrient-rich diet that includes plenty of vegetables, fruits, and lean proteins, people with osteoporosis should place special emphasis on getting enough calcium and vitamin D from the foods they eat. 

Calcium is a mineral that’s essential to bone health. It also supports healthy teeth, blood clotting, heart rhythm, nerve function, and muscle contraction. Around 99 percent of the body’s calcium is stored in bones. If calcium levels dip too low, the body’s parathyroid hormone instructs the bones to release calcium into the bloodstream. This can lead to bone loss and eventual osteoporosis.

To help ensure your body has the calcium it needs to slow bone loss and sustain other vital functions, try incorporating more of the following into your diet:

• Leafy green vegetables like kale, collard greens, spinach, mustard greens, and bok choy
• Dairy products like milk, cheese, and yogurt
• Almonds
• Salmon (with bones) and sardines
• Edamame (soybeans)
• Broccoli
• Winter squash
• Calcium-fortified items like orange juice, plant-based milks, tofu, and cereals

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) recommends adults between the ages of 19 and 50 consume around 1,000 milligrams (mg) of calcium each day. After age 50, the recommendations are:

• 1,000 mg/day for people AMAB between the ages 51 and 70
• 1,200 mg/day for people AFAB between the ages 51 and 70
• 1,200 mg/day for adults ages 71 and older

Vitamin D is both a nutrient and a hormone made by the body. It’s produced in the skin (the body’s largest organ) through sunlight exposure and is also available in some foods. Getting adequate amounts of vitamin D through sunlight and diet is important for people with osteoporosis, as it helps the body better absorb and retain calcium from food in the intestines. 

Dietary sources of vitamin D include:

• Fish, including salmon, sardines, tuna, and swordfish
• Cod liver oil 
• Beef liver
• Egg yolks
• Vitamin D-fortified milks, cereals, and orange juice

NIAMS recommends that people between the ages of 1 and 70 consume around 15 micrograms (mcg) of vitamin D daily. After age 70, people AMAB and AFAB should aim for 20 mcg per day. In international units (IU), that equates to 600 IUs daily for people between the ages of 1 and 70, then 800 IUs after age 70.

People with osteoporosis should also prioritize getting plenty of potassium from their diet as well as lean protein. Potassium, a mineral that improves calcium metabolism, is found in fruits and vegetables like bananas, spinach, raisins, lima beans, skin-on potatoes, and prunes. Lean protein from both plant and animal sources promotes strong, healthy bones and may support bone healing.

While there are general guidelines regarding how much calcium, vitamin D, and other nutrients you should consume in a day, everyone is different. (For example, people with kidney failure may need to limit their calcium intake.) Be sure to follow your HCP’s recommendations regarding diet and how much of each nutrient to consume. Your HCP may recommend taking a calcium or vitamin D supplement, depending on your needs.

Osteoporosis medications

Medication can help some people with osteoporosis manage their disease and prevent fractures. Certain osteoporosis medications work by slowing bone loss, while others help rebuild bone. 

Some commonly used medications for osteoporosis include:

• Bisphosphonates: The most prescribed type of osteoporosis medication, bisphosphonates reduce the risk of hip fractures by 50 percent and spinal fractures by as much as 60 percent, according to Johns Hopkins Medicine. Examples of this medication include alendronate, ibandronate, risedronate, and zoledronic acid. Bisphosphonates can be given as a once-yearly intravenous (IV) injection or as a daily or monthly pill.
• Denosumab: Denosumab helps improve bone density and is administered as a shot once every six months. Similar to bisphosphonates, denosumab can lower the risk of spinal fractures by as much as 60 percent and hip fractures by 50 percent.
• Calcitonin: Calcitonin is made from a hormone produced by the thyroid gland. Some studies suggest it can reduce spinal fractures by as much as 25 percent. Calcitonin is available as a once-a-day nasal spray. 
• Raloxifene: This once-a-day pill provides some of the bone-strengthening effects of estrogen without the risks involved in estrogen therapy (such as an increased risk of breast cancer).
• Parathyroid hormone (PTH): Forms of parathyroid hormone like teriparatide and abaloparatide can help stimulate bone growth and reduce the risk of fractures by up to 53 percent (65 percent for spinal fractures). These medications are available in shot form.
• Bone-building drugs: People with more severe forms of osteoporosis may benefit from bone-building medications like romosozumab, teriparatide, and abaloparatide. Romosozumab is given as a shot once a month in an HCP’s office, while teriparatide and abaloparatide require daily injections, which can be completed at home.

Some medications for osteoporosis can cause withdrawal symptoms or serious side effects if they’re stopped abruptly. Others should only be taken for a limited amount of time. Make sure to speak with your HCP before stopping, starting, or adjusting the dosage of any medication.

Exercise for osteoporosis

Children, teens, and young adults can increase bone mass through regular exercise. While exercise doesn’t boost bone mass in older adults, it does serve an important purpose.

Research shows that mild weight-bearing exercises—from dance aerobics to light weightlifting—can help build and fortify the muscles that support bones. This can improve coordination and balance and minimize the risk of falls. Even a simple walk around the block can help you stay strong and active while living with osteoporosis.    

Other examples of weight-bearing exercises for people with osteoporosis include:

• Resistance band workouts
• Stair climbing
• Low-impact aerobics
• Elliptical training  
• Pilates
• Tai chi
• Yoga

Many experts recommend doing around 30 minutes of weight-bearing exercise every day. Generally speaking, high-impact exercises like jogging, running, and jumping should be avoided if you have osteoporosis. Movements that involve twisting or bending at the waist (such as sit-ups and certain yoga poses) may also be harmful.

As always, check with your HCP before starting a new workout regimen. They can suggest exercises that are appropriate for your age, specific health needs, and stage of osteoporosis. You may also be referred to a physical therapist or clinical exercise physiologist, who can teach you how to exercise safely and improve your musculoskeletal health.

Fall prevention techniques

Fall prevention is a central part of osteoporosis management. A seemingly minor slip can easily lead to fractured bones, hospitalization, and serious complications in someone with osteoporosis. Unfortunately, more than one in every four people over age 65 fall every year in the U.S., according to the National Institute on Aging (NIA).

To help minimize your risk of falls and stay (safely) on the move, try implementing these fall-prevention tips from the NIA:  

• Get physically active. Exercises that focus on building muscle and improving balance can keep you nimble, flexible, and strong.  
• Learn about your medication. Familiarize yourself with the possible side effects of medications you take, such as fatigue, dizziness, and drowsiness, and alert your HCP if they occur.
• Prioritize sleep. Accidents are more likely to happen when you’re tired. 
• Have your vision and hearing checked regularly. Even a slight decline in vision or hearing raises your risk of falling. If you’ve been prescribed glasses, contact lenses, or a hearing aid, be sure to wear it as instructed.
• Limit or avoid alcohol. Drinking alcohol can impair balance and coordination, making falls more likely.
• Fall-proof your home.: Reduce the risk of falls inside by leaving walkways tidy, removing unnecessary furniture or loose area rugs, and using nonslip rugs and bathmats where necessary. Make sure your home is well-lit and consider plugging in a few nightlights in dim areas.
• Wear sensible shoes.: Support your feet and lower the chances of a fall by wearing rubber-soled, nonskid, low-heeled shoes that fit properly. Avoid walking around in socks or smooth-soled slippers. 
• Rely on an assistive walking device.: If your HCP has recommended you use a walking aid such as a cane, walker, or rollator (rolling walker), use it as instructed and make sure it’s the right size for you. 
• Go hands-free.: Keep your hands free and ready to grab onto railings by taking advantage of fanny packs, small backpacks, or shoulder bags. Just be sure not to overpack these, as the extra weight may cause you to lean forward and lose your balance.
• Consider the weather.: If possible, stay inside if the weather is rainy, windy, or icy. If you need to pick up groceries or medicine, look into using a delivery service.  
• Stand up slowly.: Standing up too fast after sitting or lying down can cause a temporary drop in blood pressure that may leave you feeling dizzy and faint. 
• Keep your HCP informed.: Tell your HCP about any falls you’ve experienced since your last visit, even if there was only a minor slip and you didn’t feel pain.

Healthy lifestyle choices

Relatively small lifestyle choices can make a big impact if you have osteoporosis. To help preserve your bone health, try:

• Avoiding alcohol or limiting consumption to no more than two standard drinks a day for people AMAB and one standard drink for people AFAB
• Quitting smoking and avoiding secondhand smoke 
• Regularly checking in with your HCP and attending all recommended medical appointments  

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Bone fractures, particularly in the hip and spine, are the main complication of osteoporosis. Broken bones in older adults have the potential to impact quality of life and shorten life span.

Research links hip fractures in people older than 65 to reduced mobility and earlier death, particularly in the first year following the injury. (More than 300,000 people in this age group break a hip every year in the U.S.) Spinal fractures can lead to complications like stooped posture, shortness of breath, chronic pain, and an increased risk of developing severe respiratory infections like pneumonia.

Additionally, bone fractures in older adults with osteoporosis may not heal correctly. This can cause chronic pain that reduces mobility and makes leading an active, independent life difficult.

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While a slight reduction in bone density is an expected part of aging, osteoporosis (severe bone loss) can be avoided. A few simple but effective steps you can take to help preserve your bone health as you grow older include:

• Exercising: Regularly engaging in weight-bearing exercises such as brisk walking, light weight lifting, and resistance band training helps build and strengthen bones. Around 85 to 90 percent of adult bone mass is accumulated by age 18 in people AFAB and age 20 in people AMAB, according to the Bone Health and Osteoporosis Foundation (BHOF), so regular physical activity in childhood and adolescence is especially helpful in preventing osteoporosis later in life.
   
• Getting proper nutrition: Nourishing your bones by consuming enough calcium (found in many leafy green vegetables and dairy products) and vitamin D (produced by the sun and found in some fish, egg yolks, and supplements) is key to preventing osteoporosis. If you have one or more osteoporosis risk factors, consider asking your HCP about taking a calcium or vitamin D supplement.  
   
• Avoiding or quitting smoking: Smoking hinders the production of bone-forming cells (osteoblasts) and disrupts calcium absorption, which accelerates bone loss and makes osteoporosis more likely. If you’re a smoker, consider joining a smoking cessation program.

It’s important for people in all stages of life to be mindful of their bone health. No matter your age, implementing these preventive measures can help you avoid osteoporosis and achieve good bone health now and into the future.

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Osteoporosis isn’t curable, but the condition itself is highly manageable and doesn’t inevitably impact life expectancy. The outlook for osteoporosis is favorable, especially when it’s diagnosed and treated early. Even severe bone loss can be stabilized and improved (to some extent) with adequate treatment.  

That said, osteoporosis that’s poorly managed or left untreated can lead to repeated bone fractures and complications like chronic pain and reduced mobility. This may result in a loss of independence that can impact a person’s life span as well as their quality of life. Receiving timely osteoporosis treatment and implementing fall-prevention techniques can help ensure positive outcomes for people with this bone disease.

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Following your HCP’s treatment guidance and making healthy lifestyle choices are key to optimizing your bone health and living well with osteoporosis. In addition to reducing the risk of fractures, osteoporosis treatment measures like exercise and good nutrition can boost your mood and improve your overall well-being.

Prioritizing your mental health is important if you have osteoporosis. This disease affects far more than bone health. Many people with osteoporosis develop feelings of anxiety over the possibility of falling and breaking a bone. Others experience feelings of depression, hopelessness, or reduced self-esteem after osteoporosis-related bone fractures, often due to a loss of mobility or independence.  

Attending social activities and continuing cherished hobbies like gardening, reading, or painting may help you feel better and let you focus on the things you love. If you enjoy playing a sport, your HCP, physical therapist, or clinical exercise physiologist can suggest ways to modify the activity to make it safer. Sharing your frustrations or concerns with loved ones or a licensed mental health provider (such as a psychiatrist, psychologist, or counselor) can also improve your mood and help you better cope with anxiety and depression related to living with osteoporosis.

Finally, many people find it helpful to connect with others who face similar challenges in support groups. Your HCP may be able to direct you to an osteoporosis support group in your area, or you can browse online and in-person support groups by visiting the Bone Health and Osteoporosis Foundation website. Remember, osteoporosis is common, and many people can relate to the emotions and challenges of living with this bone disease. 

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