Is Osteoporosis Genetic? Here’s How Your Genes Affect Your Bone Health

Osteoporosis is a medical condition that causes bone weakening. This increases the risk for fractures, which can have serious health effects.  

Many people don’t find out they have osteoporosis unless they break a bone or have a screening test for the condition, like a DEXA scan, which checks bone density. About 1 in 5 women and 1 in 20 men in the United States have osteoporosis. 

Some people are at high risk of developing osteoporosis. This includes people who have family members who’ve also developed osteoporosis. But does that mean osteoporosis is genetic? Here’s how your genetics can increase your risk for developing osteoporosis.  

Is osteoporosis hereditary?

Your genetics increase your risk of developing osteoporosis. 

That’s because your genes help determine your natural bone density. For example, some people naturally build stronger bones over their lifetime because of their genes. People with naturally denser bones may be less likely to develop osteoporosis. 

Your genes also determine other structural factors that affect your bone strength over the course of your life. This includes things like your height, your body frame, and even the shape of your bones. 

Hormone levels also affect your bone density. Your genes also play a role in determining how much of these hormones you make over your lifetime. 

How much of osteoporosis is genetic?

Unlike genetic conditions like sickle cell disease or cystic fibrosis, osteoporosis isn’t caused by a change in just one gene. 

Osteoporosis is likely caused by the interaction of several genes that influence bone growth and development over the course of a person’s lifetime. Researchers believe that there are yet to be discovered genes that also play a role in osteoporosis development. Until then, it’s hard to say how much of osteoporosis is determined by genetics. 

EXPERT PICKS: WHAT TO READ NEXT

• Bone density scan: A bone density scan can tell you if you have osteoporosis. Here’s what to expect from a DEXA scan and how to understand your results.

• Diet and osteoporosis: What you eat can make a big impact on your bone health. Here are foods to avoid if you have osteoporosis so you can build stronger bones.

• Medications can help restore your bone density. But if you don’t want to take osteoporosis medications, here are some tips on what to do instead.

There are studies trying to determine which genes put people at higher risk for developing osteoporosis. This can help people find out if they’re at risk for osteoporosis earlier in life. This allows people to make changes that can protect their bone health before osteoporosis starts.

At what age does osteoporosis start?

Osteoporosis can develop at any age, but bone loss usually starts to develop when people are 35 years old. The risk of developing osteoporosis goes up as you get older. Your bones naturally get weaker over time because your body builds less bone as you get older. 

People often get diagnosed with osteoporosis as they hit their 40s and 50s. Osteoporosis affects 1 out of 5 women and 1 out of 20 men over the age of 50. These numbers go up as people hit their late 60s and 70s. 

What are the risk factors for developing osteoporosis?

Your genes play a big role in whether you develop osteoporosis. But your genes aren’t the full story. There are other factors that can increase your risk for osteoporosis like: 

• Activity level

• Calcium and vitamin D levels

• Medical conditions

• Medications

• Smoking 

• Alcohol intake

You can’t control your genes. But you can control some of these other risk factors. Taking action can help you keep your bones strong and healthy. 

Tips if you’re at higher risk for developing osteoporosis

If osteoporosis runs in your family, there are steps you can take to keep your bones strong as you get older.  

1. Staying active

Studies show that weight-bearing exercise can slow the development of osteoporosis. When you exercise, muscles, and tendons apply tension to the bones. This encourages the bones to make more bone tissue, which improves your bone density. Weight-bearing exercises include things like:

• Walking

• Hiking

• Dancing

• Tai chi

• Yoga

• Golf

• Tennis 

Strengthening exercises and activities can also help you build up bone mass. Activities that focus on balance and posture can also improve coordination and balance, which help protect you from falls. 

If you already have osteopenia or osteoporosis, staying active can help your bone loss from getting worse. But it’s important to stay safe while exercising with osteoporosis. You’ll want to avoid high-impact activities and activities that put too much stress on your spine.  

2. Eating a bone-friendly diet

You need enough calcium, vitamin D, and protein to build bone mass. Switching up your diet to include foods that are high in these nutrients can help you protect your bone health. 

Some foods are naturally high in calcium like milk, yogurt, cheese, and other dairy products. But tofu, leafy green vegetables, and fish also contain calcium. So do certain grains and other calcium-fortified foods. 

You can also talk with your primary care provider about starting calcium and vitamin D supplements. It can be hard to get enough vitamin D from food. Vitamin D supplements can help you get the nutrients you need to keep your bones strong. 

You also want to eat enough protein each day to support your bone health. You should take in 0.4 g of protein per pound of body weight. If you’re a 170 lb person, you would need about 65 g to 70 g of protein per day. High-protein foods can help you get the protein you need each day. Protein shakes can also help you reach your daily protein needs. 

3. Not smoking and limiting alcohol

Smoking increases how quickly you lose bone mass. Alcohol can also increase bone loss. If you smoke, consider quitting. You should also limit your alcohol intake to 1 drink per day (or less) to support your bone health. 

4. Switching to bone-friendly medications

Some medications can affect your bone density. These include steroids, proton pump inhibitors (PPIs) for GERD, certain antidepressants, and some medications used to treat diabetes. Talk with your primary care provider or endocrinologist about your medications. They may be able to find alternative medications that won’t impact your bone density. 

5. Getting treatment for medical conditions 

Certain medical conditions can affect your bone density. In fact, some medical conditions can directly cause osteoporosis. This includes hyperparathyroidism, hyperthyroidism, and Cushing’s syndrome. Follow up with your healthcare team if you have any medical conditions and make sure to follow your care plan. Getting the right treatment can help keep your bones healthy.

Why trust our experts?

Written by:

Amy Walsh, MD, MDP

I have worked as an emergency physician for 15 years, including care at both rural hospitals and trauma centers. I am the former Global Emergency Medicine fellowship director at Health Partners.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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