When doctors talk about FRAX, a tool that calculates your 10-year risk of breaking a bone due to osteoporosis. It's not a test you take at a lab—it's a calculation based on your age, sex, weight, medical history, and more. Also known as the Fracture Risk Assessment Tool, FRAX helps decide if you need treatment before a fracture happens, not after. Many people think osteoporosis is just about low bone density, but FRAX shows that’s only part of the story. Someone with mild bone loss but a history of falls or steroid use might have a higher fracture risk than someone with very low bone density who’s active and healthy.
FRAX doesn’t rely on a single number like a DEXA scan. Instead, it pulls together clues: whether you’ve had a previous fracture, if you smoke, if you drink alcohol regularly, if you take corticosteroids, or if you have conditions like rheumatoid arthritis. These factors matter just as much as bone density. That’s why two people with the same T-score can have very different FRAX scores. The tool was developed by the World Health Organization and is used worldwide—not just in Canada—to guide treatment decisions. For people on long-term steroids, like those with autoimmune diseases, FRAX helps determine when to start bone-strengthening drugs before muscle weakness or bone loss becomes irreversible. It’s also used to track whether treatment is working over time, especially when switching between generics of NTI drugs like alendronate or teriparatide.
FRAX is especially useful for women over 65, men over 70, or anyone who’s had a fracture after age 50. But it’s not just for seniors. People on chronic prednisone, those with early menopause, or those with a family history of hip fractures should also get assessed. The results tell your doctor whether you’re low, moderate, or high risk—and whether the benefits of a medication like bisphosphonates or denosumab outweigh the risks. It’s not about fear. It’s about prevention. A single fracture can change your life: losing independence, needing surgery, or facing long-term pain. FRAX gives you a chance to act before that happens.
Below, you’ll find real-world guides on how medications like corticosteroids, NTI drugs, and bone-targeted therapies interact with your fracture risk. You’ll learn how to spot early signs of bone loss, why switching generics can be risky for some drugs, and how to talk to your provider about monitoring your bone health—not just your blood levels.
Osteoporosis in endocrine disease often goes undetected because bone density scans can appear normal. FRAX and bisphosphonates help identify and treat high fracture risk in conditions like diabetes and thyroid disorders.