This leaflet discusses this rare condition which can occur in children, as the result of another illness or disease (secondary osteoporosis), or have no known cause (idiopathic juvenile osteoporosis). It outlines the symptoms, diagnoses and treatment available for it as well as the longer term outlook including the impact on growth, recovery, help and support at home and in school.

This leaflet covers specific information on scans and tests. The role of dual energy x-ray absorptiometry (DXA) scan of the hip and spine as the most common method of measuring bone density to diagnose osteoporosis is explained and how a peripheral DXA (pDXA) scan may sometimes be used. The T score result is explained in relation to normal bone density, osteopenia and osteoporosis. Who might benefit from having a scan and when scans are used to monitor bone density levels are discussed. The use of the fracture risk assessment tool called FRAX which can be used to identify people at highest risk of fracture is also mentioned. The roles of quantitative ultrasound scanning (QUS) and computed tomography (CT) scanning in measuring bone strength or density are described, and the use of magnetic resonance imaging (MRI), radioisotope bone scanning and normal x-rays in identifying spinal and other fractures are discussed. Blood and urine tests to measure biochemical bone markers, calcium and vitamin D levels and kidney function are explained.

Sex hormones, oestrogen and testosterone necessary for bone health, as once they decline or are stopped (as in hormone therapy for a transsexual person) bone density begins to be lost. The transsexual person is treated with sex hormones and is at risk of developing osteoporosis if the sex hormones are discontinued.

The thyroid gland in the neck produces thyroid hormones that regulate the speed at which our body cells work. If the thyroid gland is overactive and thyroid hormone levels are high, hyperthyroidism occurs. Excess thyroid hormone hastens the rate of bone turnover which can increase the risk of osteoporosis.

This leaflet looks at how the parathyroid glands control the levels of calcium and phosphorus in the blood, and how hyperparathyroidism (an over active parathyroid gland) can draw increasing amounts of calcium from the bones into the blood stream and be a possible cause of osteoporosis.

This leaflet gives information on the effect of the contraceptive injection medroxyprogesterone acetate (Depo Provera) on bone health.

Coeliac disease is a condition that affects the small intestine and reduces the ability to absorb gluten. Foods containing gluten can cause inflammation of the gut resulting in diarrhoea and weight loss. As a result of this, minerals such as calcium may be poorly absorbed. If untreated this condition can lead to osteoporosis.

This leaflet explains how anti-epileptic drugs (such as sodium valproate, carbamazipine, phenytoin, gabapentin and lamotrigine), might affect bone and risk of fracture. It explores how these drugs effect the way vitamin D is absorbed and what can be done to help prevent bone density loss.

Anorexia nervosa and bulimia nervosa (eating disorders) can lead to lower bone mineral density (osteoporosis) linked to lower oestrogen levels and loss of menstrual periods (amenorrhoea). Some young women in particular may be at risk of osteoporosis. Hormone replacement therapy (HRT) and the combined oral contraceptive pill are inconclusive treatments. Excessive exercise with loss of normal periods will also affect bone.

This leaflet discusses the link between breast cancer treatments and osteoporosis. It contains information on breast cancer drugs including tamoxifen and those from the aromatase inhibitor group such as anastrazole (Arimidex), letrozole (Femara) and exemestane (Aromasin) and explains their effect on bone health.

This leaflet provides information about different nutrients and foods and their role in bone health. The reference nutrient intake of calcium is given for different age groups, a list of calcium rich foods is provided, and the effects of phytates and oxalates (also called phytic acid and oxalic acid) on calcium absorption are discussed. The debate around dairy products as a calcium source is explained and the problems of excessive amounts of caffeine, protein, fizzy drinks and salt in our diets are highlighted. Information on vitamin D is provided, including food and sunlight sources, as well as other minerals and vitamins involved in bone health. These include boron, copper, magnesium, manganese, potassium, vitamin B complex, vitamins C and K, silicon and zinc. The current situation on the known effects of Essential Fatty Acids (EFAs), phytoestrogens, isoflavones and vitamin A supplementation on bone health are also explained.

This leaflet discusses the different types of vibration therapy available. Whole Body Vibration (WBV) for example Power Plate and Galileo and Dynamic Motion Therapy (DMT) for example Juvent. The leaflet considers the impact of this type of exercise on bone density, muscle strength, balance and falls

Broken (fractured) hips are more common in older age. Risk of falling and fracture is greatest in women especially when poor balance and co-ordination is evident and loss of muscle strength. Often they fall sideways. Padded hip protectors can absorb the energy of the fall or moulded plastic protectors divert the impact away from the hip bone. They need to be properly fitted, and the soft padded versions may be more comfortable and likely to be worn. Other measures can reduce risk of falling and are discussed in the leaflet.

This leaflet covers information on complementary and alternative therapies which may be helpful for symptom and pain relief, for those people who have sustained fractures. It gives an overview of acupuncture, massage, aromatherapy, reflexology, homeopathy and herbal medicine. Also the practice of osteopathy and chiropractic are discussed. Exercise and movement therapies included are: The Alexander technique, Pilates, Tai Chi and Yoga. Finally it includes a section on natural progesterone.

This leaflet gives a wealth of information for those people living with fractures caused by osteoporosis. It includes practical hints and tips to help in the home, about equipment and aids for independent living, safety issues to prevent falls and information on Disabled Living Centres. Holidays and insurance and information on accessibility whilst travelling are discussed. A section on benefits and financial assistance includes attendance allowance, disability living allowance, carer’s allowance and pension credit. Finally it covers community care and social services -including how to get a community care assessment and paying for services via direct payments.

Vertebral compression fractures (spinal compression fractures) can cause severe muscular spasm and nerve pain, disability, and adversely affect quality of life. Percutaneous vertebroplasty and balloon kyphoplasty are two surgical procedures usually undertaken following a recent spinal fracture (within 12 months). They involve the injection of surgical cement into the vertebra. These techniques are used to relieve pain and stabilise the fractured vertebrae. Risks with percutaneous vertebroplasty and balloon kyphoplasty can include cement leaks, pulmonary embolus and new fractures.