Nurse measured me an inch shorter than last year and just wrote it down. Should height loss be taken more seriously than that?

Annual physical last Thursday. The nurse measures me, writes the number, moves straight on to blood pressure. I look at the screen and I'm an inch shorter than the same appointment last year. An INCH. I said something about it and got a friendly "well, we all shrink a bit."

Now, you all know my history from my scan thread, spine T-score -2.6, mother broke her hip. So an inch off my height in a year is not a thing I can shrug at the way the nurse did. I have no back pain to speak of. Nothing has happened to me, no falls, no lifting anything stupid. Just shorter.

What I want to know from women who've been here: is an inch in a year normal ageing or is that the sort of number that should have made somebody stop and look? And do I go back and make a fuss, or wait until my bone clinic follow-up in November?

Make the fuss. I say that as somebody who didn't.

I lost height over about three years and put it down to getting older, and it was only when my daughter took a photo of me at a family thing and I saw the shape of my upper back that I got it looked at. Turned out I had two old spinal fractures I had never once known about. No dramatic moment, no fall, nothing I could point to. My doctor said that's more common than people think.

November is a while away for a number that changed that much in a year.

Practical point before you panic: get measured properly, twice, on a decent stadiometer, shoes off, standing tall against the board. I had a "half inch loss" one year that turned out to be a nurse who let me keep my shoes on the year before. My height has been stable ever since it was measured the same way each time.

I'm not saying that's what happened to you, and joanb is right that it needs looking at either way. But go in with an accurate number rather than a comparison between two different methods.

Linda K. said:

is an inch in a year normal ageing or is that the sort of number that should have made somebody stop and look?

Height loss of that size, in that timeframe, in a woman with your bone density result, is a finding worth investigating rather than filing under ageing. Some gradual loss with age is expected, mostly from the discs between the vertebrae and from posture, but it is slow. A rapid or larger loss raises the question of a vertebral compression fracture, and the important point for anyone reading this is that these fractures are frequently silent: they can occur without a fall and without memorable pain, which is why they are the most commonly missed osteoporotic fracture. That is not a reason to assume you have one. It is the reason the measurement is taken seriously.

Two practical thresholds are widely used to trigger a look at the spine: a documented loss of roughly 4 cm or more from your peak adult height, or a measured loss of about 2 cm or more between two properly taken measurements. Sue's caution matters here, because measurement technique accounts for a lot of apparent change, so the first step is a careful remeasure rather than an assumption. Where a fracture is suspected, the usual next step is spine imaging, either a lateral spine X-ray or a vertebral fracture assessment, which some DXA machines can perform at the same visit as a density scan.

The reason this matters practically is that a vertebral fracture is not just a historical curiosity. A previous fragility fracture is one of the strongest predictors of the next one, and it feeds directly into fracture risk calculators and into whether treatment is recommended, which is exactly the conversation set out in osteoporosis and bone health after 50. Reducing the chance of the next fall belongs in the same plan, and that side is covered in preventing falls and fractures after 50.

Whether you wait for November is a decision for you and your own clinician, not for me, but I would say this: the specific things worth reporting when you contact them are the size of the loss, the timeframe, your spine T-score, your mother's hip, and any change in the shape of your upper back or in how your clothes sit. Those five details tend to move an appointment faster than "I think I've shrunk."

The clothes thing in Dr. Ellsworth's list is worth underlining. For me the tell was blouses that suddenly sat wrong at the front and a waistband that had stopped being where waistbands go. I thought I'd put weight on. I hadn't.

Update. I called the office on Monday rather than waiting, and used almost exactly the five details in that list, which I wrote on a card first because I knew I'd waffle. Got in on Friday.

Remeasured properly, shoes off, against the wall board. The loss is real but it's smaller than the screen said, because last year's number was taken in shoes, exactly as Sue guessed. Still enough of a change that my doctor has ordered spine imaging rather than waiting for November, and she pulled the bone clinic appointment forward as well.

So I don't have an answer yet, which is not how I wanted to end this post. But I'm not sitting on it until November either, and the nurse's "we all shrink a bit" is now a sentence I intend to argue with for the rest of my life.