Low Bone Density: Who’s at Risk?

Some of you were curious about osteoporosis and how to help yourself. After all, low bone mineral density leading to bone fractures can be not only debilitating, but deadly.

While it is most common in women, men and children can also have low bone density. It is considered a silent disease because you don’t know your bones are thinning until you fracture something.

I’m investigating this topic, but there is soooo much information that I need to break it down into more digestible chunks. So, this will be a series. I am going to keep it simple and not get bogged down in excessive details or technical information. If something peaks your curiosity, I suggest you dig deeper. Remember, I am not a doctor, nor do I play one on television.

I have only just entered this phase of life and I’m learning along with you.

If you have experience with low bone mineral density and/or have been successful in building stronger bones, please share your wisdom with us, so we can benefit from it as well.

This first post discusses who is a risk for bone fractures and osteoporosis. Should you be concerned? Do you need a wake- up call?


What is Low Bone Mineral Density?


The majority of your bone mass is developed by age 18. Your bone mass peaks in your late 20’s. These are very important years.

Everyday, your bones naturally breakdown old bone and form new bone.

Low bone mineral density is created for two reasons:

  1. You didn’t build enough bone mass during your peak years, so you’re starting at a deficit.
  2. In your later years, you are losing more bone than you are making.


Your bones become less dense and more brittle, making it more likely that you will fracture a bone. One fracture as an adult makes it more likely you will get another. Breaking a hip has been deadly for many.  You may not even realize you have some fractures, like in your spine. You might just know your back hurts. With more severe osteoporosis, you can even cause a fracture just by sneezing.


All the sources I came across agree that the following impact your risk of bone fracture and osteoporosis.


What Are The Risk Factors?

Things We Have No Control Over


Gender– Women have it more than men, because they are generally smaller and lighter.

Age– The older you are, the higher your risk regardless of being at low risk in other areas.

Ethnicity– Caucasians have the highest risk. Asians come in second. African Americans have the lowest risk.

Family History – You have a higher risk if low bone density or bone fractures run in your family. Know your family history.

Previous Fracture– If you’ve had a bone fracture not as a result of trama, like an accident, you are more likely to have another.

Size– Those with small frames/bones are at higher risk.

Surgeries– Some surgeries can have an impact on your bones such as gastric bypass, thyroidectomy and hysterectomy with ovaries removed.

Delayed puberty- reduced hormones

Menopause /hysterectomy- reduced hormones

Rheumatoid arthritis- Chronic inflammation, meds and inactivity

Glucocorticoid therapy (long term) -Increased risk of bone fractures.

Gastrointestinal conditions -Such as IBD, Crohn’s disease, Celiac disease, Ulcerative colitis



Risk Factors We Can Control


While we have more control over these things, we can’t change what was done in the past. We can only control these things moving forward. That’s why being informed is important. Most of these risk factors are due to diet and lifestyle choices that directly impact bone break down and build up.


Low Hormones– Low estrogen in women and low testosterone in men.

Low calcium intake

Low vitamin D– Helps absorb calcium.

Alcohol – Limit to 2 servings  a day.

Smoking– Lowers estrogen, speeds bone breakdown.

Sedentary lifestyleNot putting the physical stress on your bones to cause new bone formation.

Low BMI <20   Thin women with little muscle are at higher risk. Thin women with good muscle mass have less of a risk.  If you weigh less than 127 pounds, you have a higher risk. Thin people also have less cushioning on their bones when they fall. However, having a BMI >30 is also harmful to your bones.

Long term bed rest – sedentary lifestyle

Drug use/ medication use – See common harmful medications below.

Excessive dieting– Poor nutrition.

Heavy caffeine use – Up to 3 cups a day is okay.

Diet high in nightshades – Nightshades are foods such as potatoes, peppers, eggplant, tomatoes, paprika and other spices containing peppers. Disturbs calcium metabolism and removes calcium from bones. Not everyone agrees that nightshades are harmful to bone density. I think the jury is still out.


Diets high in sugar– Strips the body off nutrients, replaces needed nutrients in the diet, causes inflammation, affects insulin metabolism, increases cortisol.

Daily soft drinks– Colas and other sodas are high in caffeine. Some believe the phosphoric acid may play a role, but studies are mixed. They are also high in sugar.


High daily salt intake– Salt can remove calcium from your body through your urine. They say to keep your salt intake below 2400 mg. Other studies say if your calcium intake is good salt doesn’t effect BMD. Still others say if your potassium intake is adequate salt isn’t a problem. However, your salt intake should not go too low.

Diets high in processed foods -Tend to be high in salt and sugar.

Chronic antacid use– Less stomach acid causes less nutrient absorption.

Low magnesium intake– Many people are deficient in magnesium, needed for bone remineralization.

Excessive exercise– Leading to menstruation stopping which lowers estrogen production.

Insufficient protein– Protein is an important nutrient for bone health along with calcium and vitamin D.

Poor nutrition– Such as anorexia and bulimia.

Frequent falls– Due to balance, vision, and other physical issue that increase your likelihood of falling.

Chronic stress– Raises your cortisol which inhibits bone formation.


Anyone else feeling a little discouraged already?



Common Medications That Have Harmful Effects on the Bones


  • Proton pump inhibitors
  • Antacids (with aluminum)
  • Steroids like prednisone
  • Anti-depressants, SSRI  – Zoloft, Prozac, Lexapro
  • Lithium
  • Methotrexate
  • Diuretics
  • Heparin
  • Long term antibiotic use
  • Corticosteroids (long term use- 6 months or more)
  • Excess thyroid hormone
  • Heartburn meds such as Prevacid, Nexium, Prilosec
  • Certain cancer drugs
  • ….among others


How’s your risk?

How did you do?

If you have no risk factors, they recommend you get a screening around age 65.

If you have higher risk factors, you should get screened earlier. Talk to your doctor.

Next time, how to be tested properly.



Some Sources:

Better Bones

International Osteoporosis Foundation, Who’s At Risk?

Not Salt But Sugar As Aetiological in Osteoporosis: A Review

Schneider, Diane MD. The Complete Book of Bone Health.

Simpson, Lani. DC, CCD. Dr. Lani’s No-Nonsense Bone Health Guide.

Sodium Intake and Osteoporosis. Findings From the Women’s Health Initiative

Who’s at Risk? International Osteoporosis Foundation.

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