Our bones often become less dense as we age, which can lead to osteoporosis and potentially to fractures, should bone loss continue. Women who are past menopause are at greatest risk for osteoporosis, statistically, but thinning bones can affect anybody. A loss in bone density can also start earlier in life, so it’s good to be aware of your bone health even while you’re young. The more bone mass you have early in life, the better off you’ll be as you get older.
But that doesn’t mean that everyone needs a bone density test. As with all screening tests, there are pros and cons to getting one. (And if you’re thinking of your smart scale as a shortcut—a lot of them give a “bone mass” measurement just from standing on the scale every morning—you can ignore that. It’s not very accurate.)
Do you need a bone density test?
Bone density tests are recommended for women over age 65. If you are younger or not a woman, you may still want to talk to your provider about whether a test makes sense for you.
Some things that increase your risk of osteoporosis—and that may make a bone density test worthwhile for you—include a history of fractures from minor accidents, smoking, rheumatoid arthritis, a family history of hip fractures, unusually low vitamin D levels, early menopause, and using corticosteroids for three months or more.
So why not get a test just in case? As Choosing Wisely points out, these tests have downsides. One is the small amount of radiation that they use, which is not dangerous on its own but can add up if you’re getting tested often. (Bone density tests use DEXA, which is a form of X-ray scan.) If your bone density is low, you may be prescribed drugs that are expensive and that have their own side effects. The drugs don’t always help very much, and may not help at all if your bone loss is very mild. Ultimately, it’s up to you and your doctor to decide if a bone density scan is worth it for you.
If you’re concerned about your bone health, great news—no matter your age, there are things you can do that will help you have denser bones and possibly stave off osteoporosis as you get older.
One is to make sure you’re eating plenty of calcium and getting plenty of vitamin D. The evidence is mixed on whether calcium supplements—as in pills—help very much. But a diet rich in calcium is a good idea, especially since you’ll be getting other vitamins and nutrients from those foods. Besides dairy, other good sources of calcium include greens, tofu, and beans. Vitamin D can come from dairy foods, from getting sunlight on your skin, and from supplements.
Another biggie is to do exercise that puts stress on your bones. Bones grow in response to the pressure put on them, so it’s actually good to go for a run and let your feet hit the pavement. If running isn’t your thing, or if you’re not ready for that level of intensity, anything where you’re standing up and supporting your own weight counts as “load-bearing exercise,” including walking and dancing. (Cycling and swimming would not count.) Strength training is another great option, especially since bones in your upper body don’t get a workout from walking.
These are some of the most important things you can do for your bones. Others include getting plenty of potassium and protein in your diet and avoiding excess alcohol and smoking.