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Osteoporosis: The Silent Disease

Tammy Barnard andWendy Dahl

Osteoporosis affects nearly 10 million Americans, most often adults over the age of 50. In osteoporosis, bones become brittle and can easily fracture. It is referred to as “the silent disease” because there are no symptoms, but it could lead to joint pain, loss of stature, and increased risk of fractures of the hip, wrist, and spine (National Institutes of Health, 2023). Currently, there is no cure for osteoporosis. However, with early detection, lifestyle changes and medications can help the disease from progressing further.

A side-by-side comparison of bone structure. The left side, labeled "Normal Bone," shows a dense, tightly packed structure with small pores. The right side, labeled "Osteoporosis," shows a bone with larger pores and a less dense, more fragile appearance.
Figure 1. What a normal bone would look like (left image; bone is dense with small pores) compared to a bone that has lost density to osteoporosis (right image; bone has larger pores).
Credit: © AG Photography/Adobe Stock.

Osteoporosis vs. Osteopenia

Osteopenia is a precursor to osteoporosis. In osteopenia, there is mild to moderate loss of bone density, as opposed to the more severe osteoporosis. If managed properly, bone fractures and osteoporosis can be prevented.

Three cylindrical structures resembling bone tissue are shown side by side, demonstrating the progression of osteoporosis. The left cylinder is the most solid, with a dense, compact appearance. The middle cylinder has moderate porosity, and the right cylinder is the most porous, with a sparse, open structure.
Figure 2. 3D illustration of normal bone and bone with osteoporosis. As bone density decreases, bones become more porous and fragile, raising the risk for fractures.
Credit: © adimas/Adobe Stock.

Causes of Osteoporosis

Osteoporosis happens when bone mass declines and the structure of bone tissue changes. Risk factors are unavoidable; however, there are specific actions to take now to help your bones become stronger.

Uncontrollable Risk Factors

  • Age (risk increases as you get older)
  • Being female, especially after menopause
  • Family history of osteoporosis
  • Small, thin body frame
  • Ethnicity (White and Asian individuals have higher risk)

Medical Conditions and Treatments

  • Low hormone levels (estrogen in women, testosterone in men)
  • Thyroid problems, especially overactive thyroid
  • Rheumatoid arthritis
  • Eating disorders
  • Diabetes
  • Celiac disease
  • Bariatric surgery
  • Inflammatory bowel disease
  • Medications, such as:
    • Anticonvulsants (seizure medications)
    • Hormone therapy for cancer treatment
    • Long-term corticosteroid use (3+ months)

Lifestyle Factors (Modifiable)

  • Nutrition, especially calcium, vitamin D, and protein intake (Table 1) (National Institutes of Health, 2023)
  • Sedentary lifestyle/lack of weight-bearing exercise
  • Smoking
  • Excessive alcohol consumption

Table 1. Recommended dietary allowances for calcium, vitamin D, and protein intake.

Life Stage

Calcium Required

(mg/day)

Vitamin D

(IU/day)

Protein Intake

(grams/day)

Youth, ages 9–13

1,000

600

34

Girls, ages 14–18

1,000

600

46

Boys, ages 14–18

1,000

600

52

Men, ages 19–70

1,000

600

46

Women, ages 19–50

1,000

600

56

Women 50+

1,200

600

56

Women 70+

1,200

800

57

Men 71+

1,200

800

56

How to Determine If You Have Osteoporosis

Your doctor is key to monitoring your health and leading you to a proper diagnosis. By tracking your height, weight, current medications, and any fractures in your medical history, your doctor can screen you to determine if further testing is necessary. A current test for measuring bone density is dual-energy X-ray absorptiometry (DXA). This test measures the bone mineral density of your skeleton and at various sites that are prone to fracture, such as the hip and spine, and is currently considered the most reliable way to predict future fracture risk (NIAMS, n.d.). In this test, you lay down on a cushioned table while a scanner passes over your body. If you are diagnosed, your doctor will recommend lifestyle changes and medications to help lower your chance of further bone breakage.

Researchers are currently developing new ways to track and monitor bone health, including new scanning technologies that utilize AI to measure bone changes more accurately as we age (Adami et al., 2022).

Making Bone Health Your Priority

Everyone loses some bone density as they age. Over 10 million Americans suffer from osteoporosis. To help prevent osteoporosis and improve your strength without putting too much stress on your bones, make sure you stay physically active, eat healthy and nutritious foods, and consume adequate calcium, protein, and vitamin D.

References

Adami, G., Fassio, A., Gatti, D., Viapiana, O., Benini, C., Danila, M. I., Saag, K. G., & Rossini, M. (2022). Osteoporosis in 10 years time: A glimpse into the future of osteoporosis. National Library of Medicine. Retrieved July 18, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC8941690/

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). (n.d.). Osteoporosis: Diagnosis, treatment, and steps to take. Retrieved August 18, 2025, from https://www.niams.nih.gov/health-topics/osteoporosis/diagnosis-treatment-and-steps-to-take

National Institutes of Health. (2023). Calcium. Retrieved July 25, 2025, from https://ods.od.nih.gov/factsheets/Calcium-Consumer/