Expected Range
This is generally considered within the expected range for healthy young adults.
A result in this range does not eliminate every source of fracture risk.
Personalized Bone Health Care
Osteoporosis & Bone Health Management
A comprehensive, physician-led approach to understanding bone density, identifying contributing factors, reducing fracture risk, and protecting long-term strength and mobility.
- DXA and fracture-risk review
- Hormonal and metabolic evaluation
- Individualized long-term monitoring
Beyond a Single Score
A Comprehensive Approach to Bone Health
Bone health reflects more than a DXA result. Age, hormones, nutrition, medications, physical activity, kidney function, falls, previous fractures, and underlying medical conditions all influence risk.
Our providers review the full clinical picture to identify modifiable risks, investigate possible secondary causes, and create a plan aligned with your health history and goals.
Bone Density & Fracture Risk
DXA trends, fracture history, falls, posture, height loss, and FRAX when appropriate.
Laboratory Evaluation
Selected testing for nutritional, hormonal, metabolic, kidney, and other contributing factors.
Personalized Treatment
Lifestyle measures, fall prevention, medication review, hormonal evaluation, and referrals.
Long-Term Monitoring
Individualized DXA timing, laboratory follow-up, treatment response, and transition planning.
Protect Strength and Independence
Why Bone Health Deserves Attention
Osteoporosis makes bones less dense and more vulnerable to fracture. Because bone loss often develops without noticeable symptoms, a fracture may be the first visible sign.
Hip, spine, wrist, pelvis, and shoulder fractures can affect comfort, mobility, independence, and future fracture risk. Timely screening and clinical assessment may identify risk earlier and create an opportunity to address contributing factors.
Important: A DXA score is one part of the assessment. Fracture history, fall risk, rate of bone loss, medical conditions, medications, and possible secondary causes also matter.
Could You Be at Risk?
Consider a bone-health evaluation if one or more of these factors applies to you.
- A fracture after a minor fall or low-impact injury
- Osteopenia or osteoporosis reported on a DXA scan
- Height loss, upper-back curvature, or unexplained back pain
- Early menopause or prolonged estrogen deficiency
- Low testosterone or confirmed hypogonadism
- Long-term corticosteroid exposure
- Thyroid, parathyroid, kidney, gastrointestinal, or inflammatory disease
- Low body weight, undernutrition, or substantial weight loss
- Family history of hip fracture or osteoporosis
- Smoking, excessive alcohol use, frequent falls, or limited activity
- Medications or cancer treatments associated with bone loss
- A previous hip, spine, wrist, pelvis, or shoulder fracture
Current USPSTF guidance recommends osteoporosis screening for women age 65 and older and for younger postmenopausal women at increased fracture risk. Evidence remains insufficient for universal screening in men, so screening decisions should be individualized. Higher-risk men may still benefit from clinician-directed assessment.
Bone Density and Fracture Risk
These general T-score categories help describe bone density, but treatment decisions depend on overall clinical risk.
Osteopenia
Osteopenia describes low bone mass that has not reached the bone-density threshold for osteoporosis.
Medication is not automatic; overall fracture risk guides the decision.
Osteoporosis
A result at or below this threshold at an appropriate site generally meets the bone-density definition.
A hip or vertebral fragility fracture may indicate high clinical risk regardless of T-score.
Hormonal and Metabolic Context
The Role of Hormones in Bone Health
Bone is living tissue that is continually broken down and rebuilt. Hormones help regulate this process throughout life, but hormone treatment is only one consideration within a complete fracture-risk plan.
Menopause and Estrogen
Declining estrogen can accelerate bone loss. Menopausal hormone therapy may be considered for selected patients after individualized review of benefits and risks.
Testosterone in Men
Confirmed hypogonadism may contribute to lower bone density and muscle mass. Testosterone treatment does not replace indicated osteoporosis medication in a high-risk patient.
Thyroid Health
Excess thyroid hormone can accelerate bone loss, including from over-replacement. Treatment and laboratory results should be monitored appropriately.
Parathyroid and Calcium Regulation
Hyperparathyroidism and other disorders of calcium regulation can contribute to bone loss and may require specialized evaluation.
A Comprehensive Osteoporosis Evaluation
Your evaluation is tailored to your history and may include the following components.
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Medical and Fracture History
Prior fractures, falls, family history, hormones, medications, nutrition, activity, smoking, alcohol, and medical conditions.
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DXA and Imaging Review
Current and prior scans, change over time, measured sites, vertebral assessment, and additional imaging when indicated.
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Laboratory Assessment
Selected calcium, vitamin D, kidney, liver, blood-count, thyroid, parathyroid, and hormone testing.
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Fracture-Risk Assessment
Bone density considered alongside age, prior fractures, falls, medical history, and FRAX when appropriate.
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Personalized Management
Nutrition, exercise, fall prevention, medication, hormonal evaluation, referrals, and follow-up testing.
Key Strategies for Stronger Bones
Lifestyle measures support bone and muscle health, but they do not replace indicated medical treatment.
Resistance and Weight-Bearing Exercise
Use resistance training, walking, stair climbing, and balance work when appropriate. Exercise may need modification for fractures, severe osteoporosis, pain, or limited mobility.
Calcium and Vitamin D
Review diet, supplements, laboratory results, kidney function, and medical history before selecting an individualized amount.
Protein and Overall Nutrition
Adequate protein and energy intake support muscle, balance, and recovery. Undernutrition and rapid weight loss may adversely affect bone health.
Fall Prevention
Address strength, balance, vision, hearing, footwear, home safety, dizziness, neuropathy, and assistive-device needs.
Modify Avoidable Risks
Avoid smoking, limit excessive alcohol, review bone-loss medications, and address contributing endocrine or medical conditions.
Protect Long-Term Mobility
Pair bone-health planning with muscle strengthening, safe movement, and ongoing assessment of falls and functional status.
Individualized Medical Decisions
Treatment Based on Fracture Risk
There is no single medication that is right for every patient. Selection depends on fracture history, bone density, age, kidney function, cardiovascular history, dental considerations, previous treatment, cost, and patient preference.
Antiresorptive Options
- Oral bisphosphonates such as alendronate or risedronate
- Intravenous zoledronic acid
- Denosumab
- Selected estrogen-receptor therapies for appropriate patients
Bone-Building Options
- Teriparatide
- Abaloparatide
- Romosozumab
- Generally considered for very-high-risk patients after clinical evaluation
Medication transitions require planning. Some therapies must be followed by another medication to preserve bone-density gains. Denosumab should not be stopped, skipped, or substantially delayed without clinician guidance because bone loss and vertebral-fracture risk can increase. Kidney function, calcium status, cardiovascular history, and other individual risks must be reviewed before treatment.
Care for Women and Men
Bone Loss Is Not Only a Women’s Health Concern
Men can also experience serious bone loss and fractures. Risk increases with age, low testosterone, corticosteroid exposure, smoking, excessive alcohol use, low body weight, selected cancer treatments, and chronic medical conditions.
Men with a fracture after age 50, important risk factors, or confirmed hypogonadism may benefit from individualized evaluation. Treatment decisions should reflect fracture risk and the complete clinical picture—not gender alone.
Ongoing Monitoring
- Repeat DXA at an individualized interval
- Review new fractures, falls, height, and posture
- Monitor relevant laboratory results and medication response
- Reassess risk before a medication holiday or transition
Coordinated and Virtual Care
Telehealth may support result review, medication follow-up, side-effect assessment, nutrition and exercise counseling, and long-term monitoring. DXA scans, imaging, physical examinations, injections, and selected laboratory services require in-person care.
Bone Health FAQs
Clear answers to common questions about screening, risk, and treatment.
What is the difference between osteopenia and osteoporosis?
Osteopenia means bone density is below the expected range but has not reached the DXA threshold for osteoporosis. Management depends on overall fracture risk, not the T-score alone.
Does osteoporosis cause symptoms?
Often it does not cause symptoms until a fracture occurs. Height loss, new back pain, or a curved upper back may suggest a vertebral fracture and should be evaluated.
Who should receive a DXA scan?
Screening is generally recommended for women age 65 and older and for younger postmenopausal women at increased risk. Testing in men and other adults is individualized based on age, fractures, medications, and medical risk factors.
Can osteoporosis be reversed?
Bone density may improve with effective treatment, but the larger goal is to reduce fracture risk and maintain strength and mobility. Ongoing monitoring remains important even when measurements improve.
Is calcium enough to treat osteoporosis?
Calcium and vitamin D support bone health but are not substitutes for osteoporosis medication when medication is indicated. Needs should be individualized to diet, laboratory findings, kidney function, and medical history.
Can hormone therapy help bone density?
Menopausal hormone therapy may help preserve bone density in selected patients. The decision requires individualized review of symptoms, age, timing, cardiovascular and clotting risks, breast-health considerations, and other factors.
Can testosterone treat osteoporosis in men?
Treating confirmed hypogonadism may support bone and muscle health, but testosterone is not a replacement for osteoporosis medication when fracture risk is high.
How often should I repeat a DXA scan?
Timing is individualized according to baseline risk, treatment, age, prior results, and clinical changes. A universal annual DXA schedule is not appropriate for everyone.
Can I stop medication when my bone density improves?
Do not stop, skip, or delay medication without discussing it with the prescribing clinician. Some medicines require a carefully planned transition to prevent rapid bone loss or increased fracture risk.
Do you offer telehealth?
Telehealth may be appropriate for reviewing results, follow-up, counseling, and long-term monitoring. Imaging, physical examinations, injections, and selected laboratory services require in-person care.
Why Alpha Hormones
Bone Health in the Context of Your Whole Health
Our providers consider osteoporosis alongside hormonal health, muscle strength, balance, nutrition, medications, metabolic factors, and long-term fracture risk.
Physician-led, evidence-based care
Personalized fracture-risk assessment
Hormonal and metabolic evaluation
DXA and specialty-imaging coordination
Review of approved treatment options
Ongoing follow-up and care coordination
Educational information: This page does not replace individualized medical advice. Screening, diagnostic testing, medication selection, and follow-up should be based on a qualified clinician’s assessment of fracture risk, medical history, laboratory results, kidney function, and other relevant factors. Do not start, stop, skip, or delay an osteoporosis medication without consulting the prescribing clinician.
Take the Next Step Toward Stronger Bones
If you are concerned about osteopenia, osteoporosis, a previous fracture, height loss, menopause-related bone loss, low testosterone, or medication-related bone loss, meet with our Pasadena medical team for a comprehensive evaluation.
