From the Research
Ozempic (semaglutide) may have negative effects on bone health, particularly in adults with increased fracture risk, as evidenced by a recent study showing lower lumbar spine and total hip areal bone mineral densities after 52 weeks of treatment 1. The effects of Ozempic on bone health are still being researched, but current evidence suggests that GLP-1 receptor agonists like semaglutide could increase the risk of bone fragility and fractures in some patients, particularly with long-term use. Some key points to consider include:
- Weight loss associated with Ozempic can reduce bone mineral density
- The medication may alter calcium metabolism
- It might affect bone remodeling processes
- Patients taking Ozempic, especially those already at risk for osteoporosis (postmenopausal women, older adults, those with prior fractures), should consider calcium supplementation (1000-1200mg daily) and vitamin D (800-1000 IU daily) 1
- Regular bone density scans may be appropriate for high-risk individuals The bone health effects appear dose-dependent, with higher doses potentially causing more significant impacts, as seen in a study where semaglutide once weekly did not increase bone formation based on the bone formation marker Procollagen type I N-terminal propeptide (PINP), but was associated with an increase in bone resorption and lower areal bone mineral densities 1. These concerns should be balanced against the medication's benefits for diabetes management and weight loss, and patients should discuss their individual risk factors with healthcare providers rather than discontinuing the medication without consultation. It is essential to prioritize the most recent and highest quality study, which in this case is the 2024 study published in EClinicalMedicine 1, to guide clinical decision-making and ensure the best possible outcomes for patients.