Test Yourself: Are You at Risk for Osteoporosis?

Bones are high up on the list of things we take for granted -- until they fail us. Having weak bones, a condition doctors call low bone mass, makes you vulnerable to fracture -- and not just, say, a broken arm. Bone fractures that result from osteoporosis are often in the hips or spine, and they can incapacitate you for months. Even worse, fractures can trigger what experts call a "cascade" of health symptoms, ending in lifelong disability or even death.

While osteoporosis might sound like an older person's disease, it's actually the end product of a long, gradual process that affects every adult from the teenage years on. Believe it or not, we stop building bone when we're between 20 and 25 years old, a point at which we reach what's called "peak bone mass." We start losing bone sometime between 30 and 40, depending on how vigilant we are about diet, exercise, and other factors that keep our bones strong.

How do you know if your bones will hold you up for many years to come? Test yourself by using this list of 12 common risk factors for osteoporosis. If you meet two or more of these criteria, talk to your doctor about whether you should have a bone density scan.

1. Have you ever suffered from an eating disorder?

A history of anorexia is one of the biggest red flags for osteoporosis, says Columbia University endocrinologist Elizabeth Shane, who studies osteopenia -- the early stage of osteoporosis -- in younger women. That's because when a woman's body weight drops too low, it lowers hormone levels, and she typically starts skipping periods. "Anything that lowers estrogen levels interferes with bone building," Shane says.

2. Do you have a first- or second-degree relative who developed osteoporosis before the age of 50 or before menopause?

Family history is a major risk factor for poor bone health. If you come from a family where the older adults have histories of fractures, poor posture, loss of height, or similar problems, bring this to your doctor's attention.

3. Do you smoke?

Statistically, smoking has a high correlation with osteoporosis, though experts have not yet pinned down the exact process by which smoking sabotages bones. "Smoking is one of the worst lifestyle factors for brittle bones," says Robert Recker, a physician and director of the osteoporosis research center at Creighton University in Nebraska.

4. Do you drink more than two alcoholic drinks a day (three if you're a man)?

Alcohol is a bone-weakener; it leaches calcium, magnesium, and other minerals out of your bones. The more you drink, the more likely that it's happening. Women are more vulnerable to this type of bone loss than men, perhaps because they're more vulnerable to the effects of alcohol in general.

5. Have you had one or more fractures, particularly fractures that seem worse than you'd expect from the cause?

One of the most common ways people find out they have osteoporosis is when a minor fall leads to an injury that's more serious than you'd expect. Your bones need to be strong enough to sustain some impact, and if they aren't, you want to know about it. Osteoporosis experts suggest that any adult who's had more than one fracture, or a fracture that seemed surprisingly severe, should ask about having a bone density test.