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As we age, our bones naturally lose density, which can result in osteoporosis and an increased risk of fractures if bone loss continues. Postmenopausal women are statistically at the highest risk for osteoporosis, but bone thinning can impact anyone. Bone density decline can even begin earlier in life, making it important to monitor your bone health from a young age. The more bone mass you build early on, the better your chances later in life.
However, this doesn’t imply that everyone needs to undergo a bone density test. Like any screening, there are advantages and drawbacks to taking one. (And if you’re considering your smart scale as a shortcut—many of them provide a ‘bone mass’ reading by simply standing on the scale each morning—don’t rely on that. It’s not particularly accurate.)
Should you get a bone density test?
Women over 65 are generally advised to undergo bone density tests. However, if you’re younger or not a woman, it may still be worth consulting your doctor to see if a test is necessary for you.
Certain factors can raise your risk of osteoporosis, and these may make a bone density test a good idea. These include having a history of fractures from minor falls, smoking, rheumatoid arthritis, a family history of hip fractures, low vitamin D levels, early menopause, and long-term use of corticosteroids (three months or more).
So why not opt for a test just in case? As Choosing Wisely highlights, there are some drawbacks. One is the minimal radiation exposure from the procedure, which is not harmful in small doses but could accumulate with frequent tests. Bone density tests use DEXA, a type of X-ray scan. If your bone density is low, medications might be prescribed, but they can be costly and have side effects. They don’t always show significant improvement, especially for mild bone loss. In the end, the decision about whether a bone density test is right for you should be made together with your doctor.
How to care for your bones, regardless of whether you get a test or not.
If you're worried about your bone health, the good news is that regardless of your age, there are steps you can take to strengthen your bones and potentially prevent osteoporosis as you age.
Make sure you're consuming plenty of calcium and vitamin D. While the research on calcium supplements (like pills) is inconclusive, getting calcium from your diet is beneficial, as you'll also be consuming other vital nutrients. Besides dairy products, good sources of calcium include leafy greens, tofu, and beans. Vitamin D can be found in dairy, from sunlight exposure, and through supplements.
Another key factor is engaging in weight-bearing exercise, which puts stress on your bones. Bones adapt and strengthen when subjected to pressure, so activities like running, where your feet hit the ground, can be beneficial. If running isn’t suitable for you, or if you prefer a gentler approach, any activity where you bear your own weight—such as walking or dancing—counts. (Cycling and swimming don’t qualify.) Strength training is also a great choice, especially for strengthening bones in your upper body, which don’t get much exercise from walking.
These are some of the most important actions you can take to support bone health. Additional factors include getting adequate potassium and protein, and steering clear of excessive alcohol consumption and smoking.
