Osteoporosis and Bone Health in London 2026. Who Should Be Scanned, What a DEXA Shows and What Actually Prevents Fractures

An estimated 3.5 million people in the UK have osteoporosis and around 500,000 fragility fractures follow from it each year, yet nothing hurts until the fracture arrives, which is what makes it the largest preventable condition most people never test for. Around 1 in 2 women and 1 in 5 men over 50 will sustain a fragility fracture in the years they have left. Hip fracture is the outcome that counts most, with roughly 70,000 to 80,000 a year in the UK, mortality in the following 12 months commonly reported at 20% to 30%, and a substantial loss of independence among those who survive. The steepest bone loss of a woman's life comes with the menopausal transition, where as much as 20% of bone density can go in the 5 to 7 years around it, making the early 50s the decade in which measurement would be most valuable and is least often done. Diagnosis rests on the DEXA scan, which measures bone mineral density at hip and spine and returns a T-score. Between minus 1 and minus 2.5 is osteopenia. Minus 2.5 or lower is osteoporosis. That figure is then fed into a FRAX fracture risk assessment, because treatment decisions turn on 10-year fracture probability rather than on the scan by itself. At The Wellness you are assessed, DEXA is arranged at a specialist centre with consultant reporting, and bloods are arranged at an accredited partner laboratory. Bone health assessment from £995. Fees appear further down this page.

Reviewed by the medical team at The Wellness. Last updated 1 September 2026.

Arrange a bone health assessment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

Who should have a DEXA scan

Women from the menopause onwards, and sooner where it arrived early. Bone loss picks up sharply as oestrogen falls, and premature ovarian insufficiency or menopause before 45 places a woman in a higher risk category for decades rather than years.

Anyone who has already had a fragility fracture, meaning a break sustained in a fall from standing height or less. That one event is the strongest predictor of the next, and a considerable number of people who break a wrist in their 60s are never assessed, then turn up with a hip fracture in their 70s.

Anyone on oral corticosteroids for 3 months or longer, where bone loss is fast and starts early in treatment. Also relevant are aromatase inhibitors after breast cancer, androgen deprivation therapy in prostate cancer, long-term proton pump inhibitors, some anticonvulsants and long-term heparin.

Anyone with a parent who fractured a hip, which is a FRAX variable in its own right. Anyone with a low body mass index, particularly under 19. Smokers, and anyone drinking more than 3 units a day. People with rheumatoid arthritis, coeliac disease, inflammatory bowel disease, chronic kidney or liver disease, hyperthyroidism, hyperparathyroidism, type 1 diabetes or a history of eating disorder.

Men over 50 with any of the above, given that men account for a fifth of fragility fractures, are assessed far less often, and do worse than women after a hip fracture.

And anyone who has lost height, developed a stoop through the upper back, or has unexplained back pain, since vertebral fractures are frequently silent and are the commonest osteoporotic fracture there is.

What does a DEXA scan actually show

Dual-energy X-ray absorptiometry measures bone mineral density at the lumbar spine and the hip. It takes 10 to 20 minutes, needs no preparation beyond leaving calcium supplements alone on the day, and delivers a very low radiation dose, well under that of a chest X-ray.

The result comes back as a T-score, setting your density against that of a healthy young adult. Above minus 1 is normal. Between minus 1 and minus 2.5 is osteopenia, meaning density is reduced without yet being osteoporosis. Minus 2.5 or lower is osteoporosis. A Z-score, comparing you against others your own age, is used in younger adults and children.

The scan on its own does not settle treatment, and this is exactly where most private scanning stops. FRAX takes your density together with age, sex, weight, height, previous fracture, parental hip fracture, smoking, steroid use, rheumatoid arthritis, secondary osteoporosis and alcohol intake, and returns a 10-year probability of major osteoporotic and hip fracture. UK treatment thresholds follow National Osteoporosis Guideline Group guidance and rest on that probability rather than the T-score alone, which is why a scan without a risk assessment leaves the decision hanging.

Vertebral fracture assessment can be carried out during the same appointment as the DEXA and picks up the silent spinal fractures that shift the risk category entirely.

Ask whether you need a scan on WhatsApp or email team@thewellnesslondon.com.

What blood tests belong in a bone assessment

Secondary causes lie behind a meaningful share of osteoporosis, particularly in men and in younger women, and finding one changes the treatment completely.

Calcium, phosphate, alkaline phosphatase and albumin, which between them screen for hyperparathyroidism, osteomalacia and Paget's disease. Parathyroid hormone where calcium is abnormal, since primary hyperparathyroidism is a treatable cause identified on a blood test and cured by surgery.

Vitamin D, which has to be corrected before most treatments will work properly and is low across a large share of the UK population by late winter. Thyroid function, because an overactive thyroid and over-replacement with levothyroxine both speed bone loss.

Coeliac serology, since coeliac disease frequently announces itself as osteoporosis or iron deficiency rather than as gut symptoms. Full blood count, kidney and liver function, and inflammatory markers. Serum protein electrophoresis where myeloma is in the frame, particularly alongside unexplained vertebral fracture or bone pain.

Testosterone in men, since hypogonadism is an important and treatable cause. Oestradiol, FSH and LH in younger women where early menopause or amenorrhoea is suspected.

What actually prevents fractures

Weight-bearing and resistance exercise, which is better evidenced than most people expect and works on 2 fronts, holding bone and cutting falls. Progressive resistance training 2 or 3 times a week, impact exercise where the skeleton can take it, and balance work such as tai chi, which has trial evidence for reducing falls in older adults.

Calcium from the diet in the region of 700 to 1,000mg a day, supplemented only where intake falls short, and vitamin D at 10 micrograms daily with correction where a measured deficiency exists. Supplements alone in people whose levels are already adequate have not been shown to reduce fractures, which is worth knowing before buying either.

Falls prevention, the half of fracture prevention nobody advertises. Most fragility fractures happen because somebody fell, so a medication review covering anything that causes dizziness or sedation, vision and hearing checks, a look at hazards in the home, and strength and balance training all cut fractures independently of bone density.

Medication where the level of fracture risk justifies it. Oral bisphosphonates are first-line for most people, cutting vertebral fractures by roughly 40% to 70% and hip fractures by around 40% in trials, and they come with specific instructions that matter for absorption and for oesophageal safety alike. Intravenous zoledronate suits those who cannot tolerate oral treatment. Denosumab is a 6-monthly injection that must never be stopped abruptly, because rebound vertebral fractures can follow, so it needs a continuation plan from the start. Romosozumab and teriparatide are anabolic options used in high-risk disease under specialist supervision. Hormone replacement therapy protects bone and is a reasonable option to weigh in women who have menopausal symptoms and bone concerns at the same time.

Stopping smoking and bringing alcohol below 3 units a day both make a measurable difference.

What does bone assessment cost in London

Private DEXA scanning in London typically costs £150 to £350 for the scan by itself, with no consultation, no FRAX assessment and nobody to act on the result. Consultant rheumatology and endocrinology first appointments cost £250 to £500, with scans, bloods and follow-ups billed separately, so a full private pathway assembled piece by piece commonly lands at £900 to £1,500. Intravenous zoledronate infusion costs £600 to £1,200. Comprehensive imaging programmes at the top of the London market exceed £32,000, and multi-day executive programmes at the Harley Street executive health centres reach £14,000.

At The Wellness the assessment, the coordination, the scan reporting and the review come as one fee. All figures are from prices.

  • Executive Health Programme, our most comprehensive assessment with full biomarker profiling and coordinated imaging, from £11,995.

  • Executive Body Scan, consultant-reported organ imaging with full bloods and consolidated review, from £5,995.

  • Women's and men's body scan programmes with full bloods and review, from £3,495.

  • Complete Biomarker Assessment, over 100 markers with extended review, from £1,400.

  • Bone health assessment, including consultation and examination, DEXA of hip and spine arranged at a specialist centre with consultant reporting, vertebral fracture assessment where indicated, a full bone and secondary cause blood panel, FRAX risk calculation and a review appointment with a written treatment plan, from £995.

  • Comprehensive Blood Panel including calcium, phosphate, alkaline phosphatase, parathyroid hormone where indicated, vitamin D, thyroid and coeliac serology, with consultation and interpretation, from £495.

  • Extended 45-minute consultation for complex bone disease or treatment review, from £395.

  • In-person consultation from £220. Same-day video consultation from £150. Mini consultation from £59.

  • Zoledronate infusion, denosumab, anabolic treatment and rheumatology, endocrinology or metabolic bone clinic referral arranged with named consultants and the appointment booked.

Appointments within the week at 10 Portman Square, Marylebone, 3 minutes from Baker Street.

Why The Wellness is the best place in London for bone health

Because a scan by itself answers nothing. A T-score of minus 2.1 is osteopenia, and whether it warrants treatment depends wholly on your age, your fracture history, your parental history, your steroid use and the remaining FRAX inputs. We work that risk out and hand you a decision instead of a number and a leaflet.

Because secondary causes are searched for rather than presumed absent. Primary hyperparathyroidism, coeliac disease, thyroid over-replacement, hypogonadism in men and myeloma are all picked up on blood tests, all alter the treatment, and are all routinely missed when a scan is bought on its own.

Because falls prevention is treated as half the work. Most fragility fractures occur because somebody fell, so medication review, balance and strength work and a look at hazards in the home sit alongside anything prescribed for bone density.

Because we own no scanner. The DEXA is arranged wherever it is best done, with consultant reporting, which also means our telling you that you do not need one carries weight, and a considerable number of people who ask for a scan do not need one yet.

And because treatment is followed through rather than merely started. Bisphosphonate instructions explained properly so the drug is absorbed and the oesophagus protected, a continuation plan for anyone on denosumab because stopping abruptly can bring rebound vertebral fractures, and interval retesting to confirm the treatment is doing its job.

Related reading

Private menopause care covers the hormonal transition when bone loss accelerates, biomarker screening covers the wider panel, back pain and joint pain covers vertebral fracture as a cause of back pain, executive health screening covers the full assessment, and private specialist referral explains how consultant appointments are arranged.

Book a bone health assessment on WhatsApp or call 020 3951 3429.

Frequently asked questions

Who should have a bone density scan

Women from the menopause and earlier where it came before 45, anyone who has had a fragility fracture, anyone on oral steroids for 3 months or longer, and anyone with a parental history of hip fracture, low body mass index, rheumatoid arthritis, coeliac disease, early menopause or long-term use of aromatase inhibitors or androgen deprivation therapy. Men over 50 with any of those should be assessed too.

What is a normal DEXA T-score

Above minus 1 is normal. Between minus 1 and minus 2.5 is osteopenia. Minus 2.5 or lower is osteoporosis. The score alone does not settle treatment, which follows a FRAX 10-year fracture probability combining density with age, previous fracture, parental hip fracture, steroid use, smoking and other risk factors.

How much does a private DEXA scan cost in London

Scan-only DEXA typically costs £150 to £350 with no consultation or risk assessment attached. At The Wellness a bone health assessment including consultation, DEXA at a specialist centre with consultant reporting, a full bone and secondary cause blood panel, FRAX calculation and a review appointment with a written plan is from £995.

What blood tests are needed for osteoporosis

Calcium, phosphate, alkaline phosphatase and albumin, parathyroid hormone where calcium is abnormal, vitamin D, thyroid function, coeliac serology, full blood count, kidney and liver function, with serum protein electrophoresis where myeloma is in the frame and testosterone in men. Secondary causes account for a meaningful share and change the treatment.

Do calcium and vitamin D supplements prevent fractures

They help where intake or levels fall short, with around 700 to 1,000mg of calcium daily from diet and 10 micrograms of vitamin D. Supplements alone in people whose levels are already adequate have not been shown to reduce fractures, so measuring first beats supplementing on principle.

What exercise is best for bone density

Progressive resistance training 2 or 3 times a week, impact exercise where the skeleton can take it, and balance work such as tai chi. It works on 2 fronts, holding bone and cutting falls, and falls prevention matters because most fragility fractures happen because somebody fell.

The Wellness is a doctor-led private healthcare group providing medical care from 10 Portman Square, Marylebone, adjacent to Harley Street. All doctors are GMC-registered. DEXA and imaging are arranged at specialist centres and reported by consultants, and blood analysis is performed by accredited laboratories. Sudden severe back pain, loss of height with pain, or a fracture after a minor fall needs prompt assessment, and in an emergency call 999. This article is general information and not a substitute for medical advice about your own health.

Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

References. National Osteoporosis Guideline Group, UK clinical guideline for the prevention and treatment of osteoporosis, including FRAX-based intervention thresholds. NICE guideline NG226 on osteoporosis assessment and management, and clinical guideline CG146 on osteoporosis fragility fracture risk assessment. NICE technology appraisal guidance on bisphosphonates, denosumab, romosozumab and teriparatide. Royal Osteoporosis Society published prevalence data on osteoporosis and fragility fractures in the UK. Published data on hip fracture incidence and one-year mortality in the UK. Published evidence on bone loss across the menopausal transition. Published trial evidence on bisphosphonate fracture risk reduction and on rebound vertebral fracture following denosumab discontinuation. Published evidence on exercise and falls prevention in older adults. Published 2026 London private DEXA and rheumatology market pricing.
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