What do we know about Osteoporosis?

Botanica Rx
Dec 16, 2025
2 min read

Is Osteoporosis inevitable in old age?

The short answer to this question is NO.

The longer answer is that, yes, the risk does increase with age, but the inevitability of it is mostly in our hands.

Osteoporosis - Useful Definitions and Diagnosis

The diagram below shows the various stages of bone health

From left to right: Normal bone, Osteopenia, Osteoporosis, Severe Osteoporosis

Osteoporosis: - low bone mineral density caused by altered bone microstructure, leading to an increased risk of low-impact, fragility fractures. Such fractures may lead to a significant decrease in quality of life, with increased disability, morbidity, and mortality.

Osteopenia: - a condition where your bones have low bone density. They are not as strong as they should be, but they are not as fragile as in osteoporosis. Osteopenia is the first stage of bone loss, often referred to as a “silent” disease since most people with the condition experience no symptoms at all. It typically affects people over age 50.

Diagnosis: - a bone density test using either X-rays, dual-energy X-ray absorptiometry

(DEXA or DXA), or a special CT scan, which uses computer software determine the bone density and mineral content of the hip and/or spine.

Understanding the bone density test results.

A bone density index (or T-score) measures bone mineral density to help diagnose osteoporosis by comparing your bone density to that of a healthy young adult.

A T-score of -1.0 or higher is considered normal, between -1.0 and -2.5 indicates low bone density, osteopenia, -2.5 or lower signifies osteoporosis.

Why osteoporosis is not inevitable and what you can do to help prevent or delay osteoporosis?

Many older adults maintain normal bone density throughout life. Bone loss happens naturally with age, but osteoporosis specifically refers to bone loss severe enough to increase fracture risk. By maintaining a healthy lifestyle and taking additional supplementation when indicated bone loss may be prevented or delayed.

There are many factors that influence risk:

Genetics: family history increases risk but does not guarantee osteoporosis.
Hormones: oestrogen or testosterone decline accelerates bone loss.
Nutrition: low calcium, low vitamin D, and low protein intake worsen bone loss.
Lifestyle: inactivity, smoking, and excess alcohol increase risk.
Medications or medical conditions: some conditions (e.g., hyperthyroidism, rheumatoid arthritis) or long-term steroid use increase risk.

Evidence-supported prevention strategies include:

Weight-bearing exercise (walking, jogging, resistance training).
Adequate calcium (food first; supplements if needed).
Sufficient vitamin D (sunlight + supplements if recommended).
Avoiding smoking and limiting alcohol.
Maintaining a healthy body weight.
Screening (DXA scans) starting around age 65 for women and 70 for men, or earlier if you have predisposing risk factors.
Medications for people at elevated risk or with confirmed low bone density.

The Bottom line

Aging is one of the guaranteed things in life. With it comes the increased risk of many things - wrinkles, loss of hearing and eyesight to mention but a few!

However, an increased risk of osteoporosis is NOT a guaranteed part of getting older.

By taking care of yourself now, hopefully low bone density will not be something else you have to deal with!