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Coronavirus and osteoporosis

Last updated: 16:30 Tuesday 3 November 2020

Having osteoporosis does not increase your risk of catching coronavirus (COVID-19).

Our free Helpline is still here for you, with our team of specialist nurses now working remotely to take your call.

If you have breathing issues

If multiple spinal fractures and a significant change in body shape mean you have serious breathing issues, we recommend you follow the guidance from the Government for people most vulnerable from the virus.

This is because you might be more at risk of complications if you do get the coronavirus.

Not everyone with breathing problems because of spinal fractures is at risk of complications from the virus. If you have minor breathing problems, your risk of complications is lower.

Denosumab and immunity

If you take denosumab, you don’t need to take special measures to protect yourself from infection. You can and should continue to take your medication.

Denosumab is an antibody-based medication, but it doesn't suppress your immune system. This means it doesn't increase your risk of complications from the coronavirus.

This is unlike other antibody-based medications used to treat diseases like rheumatoid arthritis.

Taking your treatment

It’s important that your next injection isn’t delayed for more than four weeks, as the benefits wear off quickly. This causes a sudden drop in bone density and increases your risk of spinal fractures.

You can have repeat injections up to four weeks early, so you have some flexibility.

The NHS is recommending to hospitals and GPs that they make sure you still get your treatment on time.

If you're reluctant to go into hospital for your injection, Amgen, the manufacturer of Prolia® (denosumab), has made resources available to help with self-administration.

A decision on whether you're able to self-administer should be made by your healthcare professional, together with you.

Your healthcare professional then enrols you in the Prolong patient support programme.

If you're accepted, you can collect your injection from a pharmacy. You can self-administer the injection or, if you have a carer, they can do it for you.

To help you do the injection, you can watch a video tutorial on

Healthcare professionals are being contacted and asked to enrol people who they feel would benefit from the scheme.

Pre-injection blood tests

We're advising healthcare professionals that not everybody needs to have their pre-injection blood test during the coronavirus pandemic. This is to reduce the risk of exposure to the virus.

If you:

  • Have had two pre-injection blood tests that have come back normal
  • Are taking regular calcium or vitamin D supplements
  • Haven't had any kidney problems since your last injection

Speak to your doctor about whether you can skip your blood test on this occasion. You can refer your doctor to our free Helpline if they're unsure.

A delay of a few months does not increase your risk of breaking a bone, and doesn't cause your bone density to significantly drop.

Zoledronic acid is a long-lasting drug. It stays in your body for longer than 12 months, and probably more than 24 months.

If you're prescribed calcium and vitamin D, keep taking them, even if your medication is delayed.

A delay of a few months does not increase your risk of breaking a bone, and doesn't cause your bone density to significantly drop.

Ibandronic acid is a long-lasting drug.

If you're prescribed calcium and vitamin D, keep taking them, even if your medication is delayed.

You should continue your teriparatide injections as normal during the coronavirus pandemic.

If you can't get your prescription, contact your clinical team. Many routine face-to-face appointments are being cancelled, but a telephone appointment may be available instead.

If you miss a few doses, don't worry. This is unlikely to affect your overall bone health. Restart your treatment as soon as you are able.

If you're completing your two-year course, it is important to discuss your treatment plan with your clinical team. Find out more about ending your teriparatide treatment.

If you have any questions, our specialist nurses are here for you. Contact our free Helpline by calling 0808 800 0035, or email

If you miss a number of doses over a few weeks, your overall bone health is unlikely to be affected.

If you need to collect your prescription, and are unwell, self-isolating or social shielding, ask family, friends or a neighbour to help you.

Most areas now have networks and voluntary groups that help people in this situation, so check social media to see if you have any locally that can help you.

If you're prescribed calcium and vitamin D, keep taking them, even if your medication is delayed.


If your hospital appointment is still going ahead, it means your doctor or specialist is confident the benefits of attending your appointment are greater than your risk of coronavirus.

Be reassured hospitals have special measures in place to keep you safe from coronavirus. You can help by washing your hands, using hand sanitiser at the hospital, and wearing a mask. 

If you're feeling unwell on the day of the appointment, it's best not to attend your appointment. 

Cancelled appointments

If you routine appointment has been cancelled, try not to worry about your bone health.

Your healthcare professional has decided a delay is unlikely to affect your risk of breaking bones in the long term.

The delay also reduces pressure on the NHS, and keeps you safe from unnecessary exposure to the coronavirus.

It's still important that you get a new appointment when the current situation improves. 

Therapies for pain and wellbeing

Personal therapy clinics and practices, like physiotherapy and occupational therapy, are beginning to start back up. If they do, they'll have strict social distancing measures in place to keep you safe. 

If you usually have therapy to help with pain and wellbeing, try getting in touch with your practice to find out if and when they can start treating you again.

To help you manage your pain at home, we have lots of information about self-help strategies for pain, and exercise for back pain.

For more support with managing pain, speak with a specialist nurse on our free Helpline.

Coughing with spinal fractures

If you’ve had spinal fractures, we know how painful coughing can be sometimes. But there are some simple things you can do to brace your upper body when you cough, to help make it more comfortable and effective.

In this video, Specialist Helpline Nurse Niki demonstrates some of these techniques, and shares some methods for easing any pain you might have after coughing.

Read more on managing pain after spinal fractures.

Vitamin D

Public health advice is that you consider taking a daily supplement of 10 micrograms (sometimes called 400 units) of vitamin D.

This is to help keep your bones and muscles healthy while you stay at home during the pandemic. If you're spending more time indoors, you're getting less vitamin D from the sun.

It is not because vitamin D reduces your risk of coronavirus.

You don't need blood tests to monitor your vitamin D levels before you start a supplement, or while you're taking one.

Do not take a higher dose than recommended, unless your healthcare professional tells you to. Too much vitamin D can be dangerous. Be reassured there is no risk of having too much vitamin D if you follow the advice of your healthcare professional.

If you're already taking vitamin D on the advice of your healthcare professional, you should continue with your normal dose. You don't need to take a bigger dose.

If you're unsure, speak to your healthcare professional, or contact our free Helpline.

Exercise and physical activity

Being less active during lockdown could affect your bone health, because your bones are living tissues that get stronger when you use them. Your muscle strength, coordination and balance can also be affected if you're less mobile and not able to keep up with activities - which could increase your chances of falling and breaking a bone.

So, it’s important you continue to exercise and stay physically active wherever possible.

See our exercise resources for more information about what you can do to promote better bone health and muscle strength, as well as improve your balance.

You're not alone

It’s understandable if you feel anxious. But you're not alone.

We remain fully committed to offering you the support you need in these challenging times.

Our free Helpline is still here for you, with our team of specialist nurses now working remotely to take your call. And we're looking at new ways that we can give you support while society is social distancing.

If you do get very low and unhappy there are people and organisation that can help you look after your mental wellbeing:

Get support from a Specialist Nurse

Contact our free Helpline for tailored information:

0808 800 0035

Or online, through live chat

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