Is Osteoporosis Genetic?

What is osteoporosis?

Osteoporosis is a condition in which bone density becomes too low. This makes bones more fragile and prone to breaks (fractures).

Bone is a living tissue that our bodies constantly replenish by breaking down old bone and replacing it with new bone. As we get older, we start to lose bone faster than we can rebuild it. As a result, bones become more porous, and bone density declines. If bone density gets too low, it’s called osteoporosis. When bone density is lower than normal but not yet considered to be osteoporosis, it’s called osteopenia. This process happens to some extent for everyone but progresses to osteoporosis more commonly in females.

Icon of a bone
Comparison of cross-sections of healthy bone (normal bone density) and bone with osteoporosis (low bone density). Viewed under a microscope, the inside of bone resembles a honeycomb. In osteoporosis, the walls of the honeycomb (the bone) get thinner and the holes (pores) get bigger.

How can osteoporosis impact your health?

Osteoporosis usually has no symptoms until people break a bone — most commonly in the spine, hip, or wrist. These fractures can be caused by minor falls, normal activities like bending or lifting, or can even occur spontaneously. For example, the bones in the spine can develop small fractures, called compression fractures, just from the pressure of gravity. This can lead to severe back pain, loss of height, and a hunched posture. Fractures in the hip are especially serious because they can make it hard to live independently and can cause complications that reduce life expectancy.

In the U.S., about half of females and up to a quarter of males will break a bone due to low bone density. So it’s important to keep bones strong as well as take steps to prevent falls that can cause fractures.

Estimate your chances of developing an osteoporosis-related fracture based on non-genetic factors. (This tool can estimate risk for individuals who are at least 40 years old.)

image of icons. First row is "Most common fracture sites:" Spice, Hip, Writs - Row 2 is "Some complications of fractures:" Severe back pain, Loss of height and hunched posture, Loss of independence and reduced life expectancy

Ways to take action 

Experts agree that certain lifestyle habits are especially helpful for lowering the chances of developing osteoporosis and its complications. Building these habits early in life is ideal, but it’s never too late to get started.

  • Make exercise part of your daily routine — including weight-bearing exercise (like walking, running, and dancing), strength training, and exercises that improve balance and stability.
  • Eat a healthy diet with plenty of vitamin D and calcium.
  • Don’t smoke, or get help quitting if you do.
  • Avoid heavy alcohol consumption.
  • Maintain a healthy weight (being underweight is associated with increased risk).
  • Reduce your chance of falls that can cause fractures. For example, remove tripping hazards in your home, make sure walking areas are well lit, and wear shoes with non-slip soles.

Screening for osteoporosis is recommended for all females over age 65, as well as females younger than 65 with certain risk factors. Screening may also be recommended for males who are over 70 or have certain risk factors. Screening is typically done with a scan of the hip and spine that measures bone mineral density. Talk to a healthcare professional about whether osteoporosis screening is appropriate for you.

Learn more from the International Osteoporosis Foundation

Other factors that can impact your chances of developing osteoporosis

In the U.S., more than 10 million people have osteoporosis, and another 40+ million have less severe loss of bone density. Besides genetics and lifestyle, some factors that can increase a person’s chances of developing osteoporosis and osteoporosis-related fractures include:

  • Age (risk increases with age, and those over age 65 are at highest risk)
  • Birth sex (osteoporosis is more common in females, and risk increases dramatically after menopause)
  • Family history of osteoporosis or hip fractures
  • Small body frame
  • Certain medications (including corticosteroids like prednisone and cortisone, and some medications used to treat acid reflux, seizures, and cancer)
  • Certain health conditions (including celiac disease, hormone disorders, and cancer)

What do your genes say about osteoporosis?  

The Osteoporosis PRS report* can help you learn what your genetics have to say about your likelihood of developing osteoporosis, as part of the 23andMe+ Premium Membership. 23andMe+ Premium includes everything in our Health + Ancestry Service plus new premium reports and features throughout the year.

Please note:

  • The Osteoporosis PRS report (Powered by 23andMe Research) does not diagnose osteoporosis and should not be used to make medical decisions.
  • The report was developed by 23andMe scientists using data and insights gathered from thousands of customers who consent to participate in our research. Reports based on 23andMe research provide an estimate of your likelihood of developing a condition based on your genetics and other factors. This report does not account for lifestyle or family history.
  • The report does not account for every possible genetic variant that could affect your likelihood of developing osteoporosis.

*The 23andMe Osteoporosis PRS report is based on a genetic model that includes data and insights from 23andMe consented research participants and incorporates more than 22,000 genetic variants to provide information on the likelihood of developing osteoporosis. The report does not describe a person’s overall likelihood, does not account for lifestyle or family history and has not been reviewed by the US Food and Drug Administration. The Osteoporosis PRS report is not intended to tell you anything about your current state of health, or to be used to make medical decisions or determine any treatment.

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