Osteoporosis and Bone Health

Osteoporosis is loss of bone density and quality that makes bones break after minor falls. It is silent until the first fracture. A bone health service identifies people at risk, measures bone density, looks for underlying causes and starts treatment to prevent fractures.

Treatment lowers fracture risk by roughly a third to two thirds depending on the drug and the site; it does not make bones unbreakable. It works only with long term adherence, adequate vitamin D and calcium, exercise and falls prevention.

Conditions this service looks after

• Postmenopausal osteoporosis
• Osteoporosis in men
• Steroid induced bone loss
• Fragility fractures of the wrist, hip, spine, shoulder and pelvis
• Vertebral compression fractures with height loss
• Osteopenia with high calculated fracture risk
• Bone loss from early menopause, eating disorders, coeliac disease, thyroid or parathyroid overactivity
• Bone loss from aromatase inhibitors or androgen deprivation therapy
• Vitamin D deficiency and osteomalacia

Tests you may be offered

• DEXA bone density scan: Hip and spine T score; at or below minus 2.5 defines osteoporosis.
• Fracture risk calculation (FRAX): Combines age, risk factors and density into a 10 year probability that guides treatment.
• Spine X-ray or vertebral fracture assessment: Finds silent vertebral fractures, which change treatment.
• Blood tests: Calcium, vitamin D, kidney function, thyroid, parathyroid hormone, blood count, and testosterone in men.
• Tests for secondary causes: Coeliac antibodies and myeloma screen when indicated.
• Bone turnover markers: Sometimes used to monitor response.

Treatments available

• Oral bisphosphonates: Alendronate or risedronate weekly; first line for most people, usually for 5 years before review.
• Intravenous zoledronic acid: A yearly infusion for those who cannot tolerate tablets.
• Denosumab: An injection every 6 months; must not be stopped or delayed without a follow-on drug, because rebound vertebral fractures can occur.
• Bone building agents: Teriparatide or romosozumab for very high risk, followed by a bisphosphonate to keep the gain.
• Vitamin D and calcium: Diet first, supplements to fill the gap.
• Exercise and falls prevention: Weight bearing and resistance training, balance work, vision and medication review, home hazards.
• Vertebroplasty or kyphoplasty: Cement into a painful fresh vertebral fracture for selected patients whose pain is not settling.

When to ask for a specialist opinion

• Any fracture from a standing height fall after age 50
• Height loss of more than 4 cm or a developing stoop
• Steroid tablets for 3 months or longer
• Menopause before age 45
• A parent who had a hip fracture
• Conditions or medicines known to thin bone

Travelling to Türkiye for this care

Osteoporosis is a long term condition managed near home, so it is a poor reason to fly on its own. It fits well into a check-up visit: DEXA scan, blood tests and a specialist consultation can be done in a day or two, with a written treatment plan for your own doctor. Drugs given every 6 or 12 months need a dependable local schedule. A dental check is advised before starting bisphosphonates or denosumab.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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