About APCO

The Asia Pacific Consortium on Osteoporosis (APCO) comprises Osteoporosis experts from several countries in Asia Pacific, charged with developing tangible solutions to the substantive challenges involving osteoporosis management and fracture prevention in this most populated and fastest growing region of the world.

Representing multiple medical and surgical specialties, the Consortium has developed a pan-Asia Pacific “Framework” for the introduction and implementation of minimum clinical standards for the screening, diagnosis and management of osteoporosis targeting a broad range of high-risk groups.

APCO became a free standing legal entity in October 2021 and we are registered as Asia Pacific Consortium on Osteoporosis HK Limited.

APCO strives to ensure equitable geographic representation of APCO members throughout Asia Pacific, to accommodate the wide variation in national population numbers in the region.

Osteoporosis in APAC

  • Osteoporosis and its dreaded complication of fragility fractures, compound the burden of Asia Pacific’s rapidly ageing societies.1
  • More than 1.1 million hip fractures were estimated to have occurred in China, Chinese Taipei, Hong Kong SAR, India, Japan, Malaysia, Singapore, South Korea and Thailand in 2018 incurring an estimated direct cost of USD 7.5 billion.2
  • By 2050, the number of hip fractures are projected to increase by 2.3-fold, to more than 2.5 million cases each year, resulting in staggering projected costs of almost USD 13 billion.2

Mission

To engage with relevant stakeholders, including healthcare providers, policy makers and the public, to help develop and implement country and region-specific programs for the prevention and treatment of osteoporosis and its complication of fragility fractures, in Asia Pacific.

Vision

To move towards reducing the burden of osteoporosis and fragility fractures in the Asia Pacific region
This will be achieved by:
  • Securing stakeholder acceptance of osteoporosis as a key public health priority
  • Creating solutions to minimise the burden of osteoporosis and reduce fragility fractures
  • Enabling healthier ageing through fewer fractures

Disrupting the status quo in osteoporosis management in the Asia Pacific – The Asia Pacific Consortium on Osteoporosis (APCO) and The APCO Framework

VIEW THE VIDEOS

The APCO expert video series captures the individual voices of four key APCO members. These members  represent the diverse make up of APCO – a unique organisation comprising 62 osteoporosis experts from 24 countries and regions in the Asia Pacific, whose collective ideology crosses political boundaries and barriers.

Each expert reflects on the osteoporosis landscape in their respective country, outlines various efforts underway to address the burden of osteoporosis, and explains how The APCO Framework can be implemented across the region to improve the screening, diagnosis, and management of osteoporosis.

In addition, the Chairperson of APCO, Professor Manju Chandran, reflects on the establishment of APCO and its altruistic intent. The CEO of the International Osteoporosis Foundation (IOF) and APCO Executive Committee Member, Dr Philippe Halbout, discusses the unique perspective the IOF brings to APCO.

APCO-KOL-video-series-_6SEPT21-2

Membership

Launched in Singapore on May 4, 2019, APCO currently comprises clinical expert representatives from the following countries and regions:
  • Australia
  • Bangladesh
  • Bhutan
  • Brunei
  • Cambodia
  • China
  • Chinese Taipei
  • Hong Kong SAR
  • India
  • Indonesia
  • Japan
  • Korea
  • Malaysia
  • Mongolia
  • Myanmar
  • Nepal
  • New Zealand
  • Pakistan
  • Philippines
  • Singapore
  • Sri Lanka
  • Switzerland
  • Thailand
  • Vietnam

Governance

APCO Executive Committee Chair

APCO Chairperson, Prof (Dr) Manju Chandran is a Senior Consultant Endocrinologist and Director of the Osteoporosis and Bone Metabolism Unit, that she established at Singapore General Hospital in 2007.

Prof Chandran holds a Fellowship in Endocrinology and Metabolism from the University of California San Diego School of Medicine, USA. She is a Board Member and Chair, Fracture Working Group, Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF). She is also the Vice President of the International Society for Clinical Densitometry (ISCD), Past Chair of its Asia Pacific panel, past President of the Endocrine and Metabolic Society of Singapore (EMSS) and a Past Chairperson of the Chapter of Endocrinologists, College of Physicians Singapore. She is also a member of the Bone Health Expert Group (BOHEG) of the World Health Organisation (WHO).

She has won numerous international awards including the IOF Olof Johnell Science award 2021, ISCD Oscar S. Gluck Humanitarian Award 2025, the ISCD International Clinician of the Year award 2023, the IOF Award for Outstanding Achievements in the Asia Pacific, the IOF CNS (Committee of National Societies) Medal of Excellence in 2015, and the IOF Young Investigator Award in 2013. Prof Chandran is a fellow of the American Society of Bone Mineral Research (ASBMR), American College of Physicians (ACP), American College of Endocrinology (ACE) and the Academy of Medicine Singapore (AMS).

Dr Manju Chandran
APCO Executive Committee members
(as of June 2026)
  • 1 Dr Philippe Halbout, International Osteoporosis Foundation, Nyon, Switzerland
  • 2 Dr Greg Lyubomirsky, Healthy Bones Australia, Sydney, Australia
  • 3 Professor Peter Ebeling, AO, University of Toronto, Toronto, Canada
  • 4 Professor Tuan Nguyen, University of Technology Sydney, Sydney, Australia
  • 5 Professor Sanjay K. Bhadada, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • 6 Adjunct Professor Paul Mitchell, School of Medicine, University of Notre Dame Australia, Australia
  • 7 Dr Aysha Habib Khan, Aga Khan University, Karachi, Pakistan
  • 8 Dr Sarath Lekamwasam, University of Ruhuna, Matara, Sri Lanka
  • 9 Clinical Assistant Professor David Lui, The University of Hong Kong, Hong Kong SAR
APCO Scientific Advisory Board members
(as of June 2026)
  • 1 Dr Cae Tolman, Amgen, Sydney, Australia
  • 2 Dr Nigel Gilchrist, Canterbury District Health Board, Christchurch, New Zealand
  • 3 Professor John Eisman, AO, Garvan Institute of Medical Research, Sydney, Australia
  • 4 Dr Tiu Kwok Leung, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR
  • 5 Professor Minhaj Rahim Choudhury, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 6 Associate Professor Md. Abu Shahin, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 7 Dr Yung Chee Kwang, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
  • 8 Professor Weibo Xia, Peking Union Medical College Hospital, Beijing, China
  • 9 Dr Zhao Yanling, Beijing United Family Hospital, Beijing, China
  • 10 Professor Qun Cheng, Huadong Hospital affiliated to Fudan University, Shanghai, China
  • 11 Professor Derrick Chan, National Taiwan University Hospital, Taipei, Chinese Taipei
  • 12 Dr Edith Lau, Hong Kong Orthopaedic and Osteoporosis Center for Treatment and Research, Hong Kong, Hong Kong SAR
  • 13 Professor Ambrish Mithal, Max Super Speciality Hospital - Saket, New Delhi, India
  • 14 Professor Liu Jianmin, Shanghai Ruijin Hospital, Shanghai, China
  • 15 Dr Tai-Pang Ip, Tung Wah Hospital, Hong Kong, Hong Kong SAR
  • 16 Dr Usha Sriram, Voluntary Health Services (VHS) Hospital, Chennai, India
  • 17 Dr Thomas Paul, Christian Medical College, Vellore, India
  • 18 Professor Manoj Chadha, P. D. Hinduja Hospital & Medical Research Centre, Mumbai, India
  • 19 Dr Gunawan Tirtarahardja, Indonesian Osteoporosis Association, Jakarta, Indonesia
  • 20 Professor Akira Taguchi, Matsumoto Dental University, Nagano, Japan
  • 21 Professor Atsushi Suzuki, Fujita Health University, Toyoake, Japan
  • 22 Dr Hew Fen Lee, Puchong Specialist Centre and Subang Jaya Medical Centre, Selangor, Malaysia
  • 23 Dato’ Dr Lee Joon Kiong, Beacon Hospital, Petaling Jaya, Malaysia
  • 24 Dr Tet Tun Chit, Yangon General Hospital, Yangon, Myanmar
  • 25 Professor Tint Swe Latt, Shwe Baho Hospital, Yangon, Myanmar
  • 26 Dr Dipendra Pandey, National Trauma Center, National Academy of Medical Sciences (NAMS), Kathmandu, Nepal
  • 27 Professor Ian Reid, CNZM, University of Auckland, Auckland, New Zealand
  • 28 Dr Irewin Tabu, University of the Philippines - Philippine General Hospital, Manila, Philippines
  • 29 Professor Leilani Asis, University of the Philippines, Manila, Philippines
  • 30 Professor Yoon-Sok Chung, Ajou University School of Medicine, Suwon, Republic of Korea
  • 31 Dr Dong Ock Lee, National Cancer Center, Goyang, Republic of Korea
  • 32 Professor Kee Hyung Rhyu, Kyung Hee University, Seoul, Republic of Korea
  • 33 Dr Lau Tang Ching, National University Hospital, Singapore, Singapore
  • 34 Dr Tanawat Amphansap, Police General Hospital, Bangkok, Thailand
  • 35 Dr Thanut Valleenukul, MD, Bhumibol Adulyadej Hospital, Bangkok, Thailand
  • 36 Associate Professor Vu Thanh Thuy, Bach Mai Hospital, Hanoi, Vietnam
  • 37 Dr Lan Ho-Pham, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
  • 38 Associate Professor Nicholas Pocock, St Vincent's Hospital, Sydney, Australia
  • 39 Dr Myadagmaa Jaalkhorol, Mongolian Naran Society for Osteoarthritis and Musculoskeletal Health, Ulaanbaatar, Mongolia
  • 40 Professor Moe Wint Aung, Yangon General Hospital affiliated to University of Medicine 1, Yangon, Myanmar
  • 41 Dr Kinzang Dorji, Eastern Regional Referral Hospital, Mongar, Bhutan
  • 42 Prof Jawl-Shan Hwang, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Chinese Taipei
  • 43 Dr Paulus Rahardjo, Indonesian Osteoporosis Society (PEROSI), Jakarta, Indonesia
  • 44 Associate Professor Julie Tan Li-Yu, University of Santo Tomas, Manila, Philippines
  • 45 Professor Rosy Setiawati, Faculty of Medicine (Universitas Airlangga), Dr. Soetomo General Hospital, and Surabaya Orthopedic and Traumatology Hospital, Indonesia
  • 46 Assoc. Prof. Natthinee Charatcharoenwitthaya, Thammasat University, Thailand
  • 47 Prof Yumie Rhee, Yonsei University College of Medicine, Republic of Korea
  • 48 Dr Lakshmi Nagendra, JSS Medical College, JSS Academy of Higher education and Research, India
  • 49 Dr. Ronald M.Y. Wong, The Chinese University of Hong Kong, Hong Kong SAR
  • 50 Dr Sibtain Ahmed, Aga Khan University, Karachi, Pakistan
  • 51 Prof Sum Satha, Internal Medicine Unit - Calmette Hospital, Phnom Penh, Cambodia
  • 52 Dr Chandrika J Subasinghe, Colombo North Teaching Hospital, Ragama, Sri Lanka

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Low Calcium Intake

Reference 1: This review examined calcium intake among adults around the world and found that many populations do not consume enough calcium to support good bone health. The authors highlight that low calcium intake is particularly common in many Asian countries, where average intakes are often well below recommended levels. Because calcium is essential for building and maintaining strong bones, inadequate intake may increase the risk of osteoporosis and fractures. The study emphasises the importance of promoting calcium rich foods and other practical ways to help people meet their daily calcium needs.

Citation: Balk EM, Adam GP, Langberg VN, et al. “Global dietary calcium intake among adults: a systematic review.” Osteoporos Int. 2017 Dec;28(12):3315-3324. doi: 10.1007/s00198-017-4230-x. Epub 2017 Oct 12. Erratum in: Osteoporos Int. 2018 May;29(5):1223. doi: 10.1007/s00198-018-4447-3. PMID: 29026938; PMCID: PMC5684325.

Reference 2: This review explores the important role of calcium in maintaining healthy bones throughout life. The authors explain that adequate calcium intake helps build and maintain bone strength, while long term low intake may contribute to bone loss and increase the risk of fractures. The paper also discusses the importance of obtaining calcium from a balanced diet, with supplements considered when dietary intake is insufficient. Overall, the review reinforces that meeting daily calcium needs is an important part of supporting lifelong bone health.

Citation: Cormick G, Belizan JM. “Calcium Intake and Health.” Nutrients. 2019 Jul 15;11(7):1606. doi: 10.3390/nu11071606. PMID: 31311164; PMCID: PMC6683260.

Reference 3: This review explores how common calcium deficiency is around the world and the impact it can have on health. The authors explain that many people do not consume enough calcium, particularly in low and middle income countries, increasing the risk of poor bone health and fractures. The paper highlights the importance of consuming enough calcium throughout life to help build and maintain strong bones. It also emphasises the need for practical strategies, such as improving access to calcium rich foods, fortified foods, and nutrition education, to help people meet their daily calcium needs.

Citation: Shlisky J, Mandlik R, Askari S, et al. “Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes.” Ann N Y Acad Sci. 2022 Jun;1512(1):10-28. doi: 10.1111/nyas.14758. Epub 2022 Mar 5. PMID: 35247225; PMCID: PMC9311836.

High Sodium Intake

Reference 1: This review explored whether eating too much salt affects bone health in postmenopausal women. The authors found that while high salt intake may increase calcium loss from the body, there is currently not enough high quality evidence to clearly determine its long term effects on bone mineral density or fracture risk. The paper highlights the need for more research to better understand this relationship. In the meantime, following general recommendations to limit excessive salt intake remains an important part of maintaining overall health.

Citation: Imash D, Gusmanov A, Chan MY. “High salt intake and bone health in postmenopausal women: exposing the lack of studies – a systematic review and meta-analysis.” Front Endocrinol (Lausanne). 2025 Nov 19;16:1694539. doi: 10.3389/fendo.2025.1694539. PMID: 41347127; PMCID: PMC12672310.

Reference 2: This study explored whether salt intake was linked to bone health in postmenopausal women in southern India. The authors found that women who consumed more salt were more likely to have weaker bones, poorer bone structure, osteoporosis, and vertebral fractures. These findings suggest that excessive salt intake may be associated with poorer bone health in this population. The study adds to growing evidence that a balanced diet, including limiting excess salt, may help support healthy bones.

Citation: John R, Cherian KE, Kapoor N, et al. “Excess dietary salt is associated with an altered bone strain index, degraded bone microarchitecture, vertebral fractures, and increased prevalence of osteoporosis in postmenopausal women – A study from a teaching hospital in southern India.” Aging Med (Milton). 2024 Oct 10;7(5):606-613. doi: 10.1002/agm2.12360. PMID: 39507226; PMCID: PMC11535168.

Lower Protein Intake Among Older Adults

Reference 1: This review explored how protein intake and regular exercise can help slow the progression of age-related muscle loss in older adults living in the community. The authors found that combining adequate protein with strength or resistance exercise was more effective than either approach alone in helping to maintain muscle strength and physical function. The paper highlights that preserving muscle health is important for reducing the risk of falls, fractures, and loss of independence. It also reinforces the value of healthy lifestyle habits in supporting active and healthy ageing.

Citation: Li L, He Y, Jin N, Li H, Liu X. “Effects of protein supplementation and exercise on delaying sarcopenia progression in Asian community-dwelling older adults.” Food Chem X. 2022 Jan 20;13:100210. doi: 10.1016/j.fochx.2022.100210. PMID: 35128383; PMCID: PMC8808080.

Reference 2: This consensus paper encourages a broader focus on maintaining muscle health throughout life rather than only identifying or treating sarcopenia after it develops. The authors explain that healthy muscles are essential for mobility, balance, independence, and overall wellbeing, especially as people age. The paper highlights the importance of regular physical activity, good nutrition, and early action to help preserve muscle strength and function. It also encourages healthcare professionals and the public to view muscle health as an important part of healthy ageing alongside bone health.

Citation: Chen LK, Hsiao FY, Akishita M, et al. “A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update.” Nat Aging. 2025 Nov;5(11):2164-2175. doi: 10.1038/s43587-025-01004-y. Epub 2025 Nov 4. PMID: 41188603.

High Prevalence of Lactose Intolerance

Reference 1: This review explores how lactose intolerance may affect bone health. The authors explain that people who avoid dairy because of lactose intolerance may miss out on important nutrients, particularly calcium, if these nutrients are not replaced from other foods. The paper highlights that getting enough calcium is important for maintaining strong bones and reducing the risk of fractures. It also emphasises that there are many ways to meet calcium needs, including lactose free dairy products and other calcium rich foods.

Citation: Hodges JK, Cao S, Cladis DP, Weaver CM. “Lactose Intolerance and Bone Health: The Challenge of Ensuring Adequate Calcium Intake.” Nutrients. 2019 Mar 28;11(4):718. doi: 10.3390/nu11040718. PMID: 30925689; PMCID: PMC6521087.

Reference 2: This review explores whether drinking milk can help support bone health in Asian populations, particularly those at higher risk of osteoporosis. The authors highlight that many people in Asia consume less milk than recommended, which may contribute to lower calcium intake and poorer bone health. The paper explains that milk provides important nutrients for strong bones and discusses practical options for people who cannot tolerate regular milk, such as lactose free milk and yoghurt. Overall, the review suggests that finding suitable ways to include dairy or alternative calcium rich foods in the diet may help support lifelong bone health.

Citation: Jiao H, Xu Y, Zhang Y, et al. “Is it advisable for Asians to drink milk, especially those at risk of osteoporosis?” Front Nutr. 2025 Jun 25;12:1586623. doi: 10.3389/fnut.2025.1586623. PMID: 40635901; PMCID: PMC12239142.

Reference 3: This review explores ways to protect bone health in populations where calcium and vitamin D intake is often too low. The authors explain that getting enough of these nutrients is essential for building and maintaining strong bones, yet deficiencies remain common in many parts of the world. The paper highlights that healthy eating, safe sun exposure, regular physical activity, and, where needed, fortified foods or supplements can all help support bone health. It also emphasises the importance of public health efforts to improve awareness and make nutritious foods more accessible, particularly for people at greater risk of osteoporosis.

Citation: Yeum KJ, Ju S, Choe U. “Strategies for preventing bone loss in populations with inadequate calcium and vitamin D intake.” Nutr Res Pract. 2025 Apr;19(2):155-169. doi: 10.4162/nrp.2025.19.2.155. Epub 2025 Mar 13. PMID: 40226767; PMCID: PMC11982687.

Vitamin D Deficiency Despite Sunshine

Reference 1: This review examined how common vitamin D deficiency is around the world and found that it remains a widespread public health concern. The authors explain that many people do not get enough vitamin D because of factors such as limited sun exposure, diet, and lifestyle. As vitamin D plays an important role in maintaining strong bones and muscles, low levels may increase the risk of poor bone health. The study highlights the importance of improving awareness and ensuring people have adequate vitamin D through safe sun exposure, diet, fortified foods, or supplements when needed.

Citation: Cui A, Zhang T, Xiao P, Fan Z, Wang H, Zhuang Y. “Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants.” Front Nutr. 2023 Mar 17;10:1070808. doi: 10.3389/fnut.2023.1070808. PMID: 37006940; PMCID: PMC10064807.

Reference 2: This review examined vitamin D levels among adults living in South Asia and found that vitamin D deficiency is very common across the region. The authors explain that factors such as limited sun exposure, lifestyle, skin pigmentation, and diet may all contribute to low vitamin D levels. Because vitamin D is essential for maintaining healthy bones and muscles, addressing this deficiency is an important part of supporting lifelong bone health. The study highlights the need for greater awareness and practical strategies to help people achieve adequate vitamin D levels.

Citation: Siddiqee MH, Bhattacharjee B, Siddiqi UR, MeshbahurRahman M. “High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis.” BMC Public Health. 2021 Oct 9;21(1):1823. doi: 10.1186/s12889-021-11888-1. PMID: 34627207; PMCID: PMC8501935.

Vegetarian and Plant-Based Diets

Reference 1: This review explores how vegetarian diets may affect bone health. The authors explain that while well planned vegetarian diets can provide many health benefits, they may also be lower in important nutrients such as calcium, vitamin D, protein, and vitamin B12 if not carefully balanced. The paper highlights that these nutrients play an important role in maintaining strong bones and reducing the risk of fractures. It also emphasises that people following vegetarian diets can support their bone health by choosing a varied, nutrient-rich diet and including fortified foods or supplements when needed.

Citation: Falchetti A, Cavati G, Valenti R, et al. “The effects of vegetarian diets on bone health: A literature review.” Front Endocrinol (Lausanne). 2022 Aug 5;13:899375. doi: 10.3389/fendo.2022.899375. PMID: 35992115; PMCID: PMC9388819.

Reference 2: This review examines how vegetarian diets may influence bone mineral density, a measure of bone strength. The authors explain that people following vegetarian diets may have lower bone mineral density if they do not consume enough nutrients that are important for healthy bones, such as calcium, vitamin D, and protein. However, the paper also highlights that a well planned vegetarian diet can support good bone health when these nutritional needs are met. The review emphasises the importance of choosing a balanced diet to help maintain strong bones throughout life.

Citation: Chuang TL, Lin CH, Wang YF. “Effects of vegetarian diet on bone mineral density.” Tzu Chi Med J. 2020 Sep 16;33(2):128-134. doi: 10.4103/tcmj.tcmj_84_20. PMID: 33912409; PMCID: PMC8059457.

Reference 3: This review examined how vegan and vegetarian diets may affect bone mineral density and fracture risk. The authors found that people following plant based diets, particularly vegan diets, may have lower bone mineral density and a higher risk of fractures if they do not get enough nutrients that support bone health. The paper highlights the importance of consuming adequate calcium, vitamin D, protein, and other key nutrients when following a plant based diet. It also emphasises that well planned vegetarian and vegan diets can support healthy bones when nutritional needs are carefully met.

Citation: Iguacel I, Miguel-Berges ML, Gomez-Bruton A, Moreno LA, Julian C. “Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis.” Nutr Rev. 2019 Jan 1;77(1):1-18. doi: 10.1093/nutrit/nuy045. PMID: 30376075.

I Think I Might Be at Risk of Osteoporosis

Why should I ask?

Osteoporosis is often called the “silent disease” because there are usually no symptoms until a fracture occurs. If you have risk factors, it is important to discuss your bone health before a fracture happens. Some common risk factors include but not limited to: Family history, Smoking, Alcohol, Low Body Weight, Age and Previous Falls.

Questions to ask your Doctor

1Am I at risk of osteoporosis?
2Should I have a bone health assessment?
3Should I have a DXA scan?
4What are my personal risk factors for osteoporosis and fractures?
5Are any of my medications affecting my bone health?
6What lifestyle changes can help protect my bones?

I am experiencing Height Loss, Stooped Posture, or Bone Pain

Why should I ask?

Losing height, developing a stooped posture or experiencing persistent back pain may not simply be part of ageing. These symptoms can sometimes be caused by vertebral fractures that happen without a major injury.

Questions to ask your Doctor

1Could my symptoms be caused by osteoporosis?
2Should I have spinal imaging or a VFA?
3Could I have had a spinal fracture without realising it?
4What treatments are available if I have vertebral fractures?
5How can I reduce my risk of future fractures?

I have Risk Factors but my DXA Scan was Normal

Why should I ask?

A normal bone density result does not always mean your bones are healthy. Some people may still be at increased fracture risk because of other risk factors or underlying conditions that affect bone quality.

Questions to ask your Doctor

1Does a normal DXA scan mean I cannot have osteoporosis?
2Why am I still at risk of fractures?
3Should my fracture risk be assessed using other tools?
4Are there additional tests I should have?
5How often should my bone health be reviewed?

I am worried about being on an Osteoporosis Medication

Why should I ask?

Many people are concerned about possible side effects of osteoporosis medicines. Understanding both the benefits and risks can help you make an informed decision with your doctor.

Questions to ask your Doctor

1Why are you recommending this medication?
2What are the common side effects?
3How common are the serious side effects?
4What happens if I decide not to take treatment?
5Are there other treatment options that may be suitable for me?

I am going through Menopause

Why should I ask?

Bone loss accelerates during and after menopause because of declining oestrogen levels. Acting early can help maintain bone strength and reduce future fracture risk.

Questions to ask your Doctor

1Does menopause increase my risk of osteoporosis?
2Should I have a DXA scan?
3Am I getting enough calcium and vitamin D?
4Would hormone therapy or another treatment benefit me?
5What lifestyle changes can help protect my bones?

I Have Another Medical Condition That May Affect My Bones

Why should I ask?

Some medical conditions can weaken bones, affect bone quality or interfere with the body’s ability to absorb important nutrients. Others may increase your risk of falls and thus fractures. These include diabetes, rheumatoid arthritis, thyroid disease, kidney disease, celiac disease among others.

Questions to ask your Doctor

1Does my medical condition increase my risk of osteoporosis or fractures?
2Should I have a DXA scan or other bone health tests?
3Are there treatments that can help protect my bones?
4Do I need to see a bone specialist?
5How often should my bone health be monitored?

I take Long-Term Medicines

Why should I ask?

Some medicines can reduce bone strength or increase fracture risk, particularly if they are taken over a long period. Your doctor can help determine whether you need additional monitoring or treatment.

Questions to ask your Doctor

1Could this medication affect my bones?
2Should I have a DXA scan?
3Do I need calcium or vitamin D supplements?
4Should I take medication to help protect my bones?
5How often should my bone health be reviewed while taking this medication?

I am Falling More Often and am Worried about my Balance

Why should I ask?

Most fragility fractures occur after a fall. Identifying the causes of falls and improving balance and strength can significantly reduce your fracture risk.

Questions to ask your Doctor

1Why might I be falling more often?
2Could my medications be contributing?
3Should my vision or hearing be checked?
4Would physiotherapy or balance training help?
5Can I be referred to a falls prevention programme?

I am an Older Man

Why should I ask?

Although osteoporosis is often thought of as a women’s disease, men can also develop osteoporosis and experience serious fractures. Unfortunately, osteoporosis in men is frequently under-recognised and underdiagnosed.

Questions to ask your Doctor

1Can men develop osteoporosis?
2Should I have a bone density test?
3What are my personal risk factors?
4Do I need treatment to reduce my fracture risk?
5Are there lifestyle changes I should make?

My Blood Tests show Low Vitamin D and/or Low Calcium

Why should I ask?

Vitamin D and calcium play essential roles in maintaining healthy bones. Low levels may contribute to bone loss and increase the risk of fractures if left untreated.

Questions to ask your Doctor

1What may have caused my low vitamin D and/or calcium levels?
2Do I need supplements?
3How much calcium and vitamin D should I be taking?
4Should my levels be checked again?
5Are there other tests needed to identify the underlying cause of my my low vitamin D and/or calcium levels?