Can you treat osteoporosis without medication?
Before we begin, it’s important to address this question. Multiple medications available for osteoporosis can reduce the rate of bone loss or even restore lost bone tissue and reduce the risk of bone breaks or fractures. While many people are afraid of taking medication, treatments for osteoporosis are generally very safe and effective (Mayo Clinic, 2023).
Women who have already had osteoporosis-related fractures or who have bone density much below the level diagnostic of osteoporosis require medication. However, a multi-pronged approach that also includes nonpharmacologic approaches (such as exercise and nutrition) will produce the best results. For young women with mild osteoporosis or for those at risk with low bone mass that is not yet in osteoporosis range, nonpharmacologic approaches may be all that is needed to manage the condition (LeBoff et al., 2022).
Regardless of which treatment path you and your doctor determine is best for you, it’s important to know your options. From dietary choices to weight-bearing and resistance exercises, we will explore the steps you can take to build stronger bones and enhance your overall health while enhancing the benefits of pharmaceutical interventions or allowing avoidance of medication altogether in some people.
Exercise and osteoporosis
Exercise is a crucial component of any holistic treatment plan for osteoporosis. By engaging in a well-rounded exercise regimen that focuses particularly on weight-bearing and resistance exercises, individuals with osteoporosis can promote better bone health, increase overall physical fitness, and lead more active, fulfilling lives.
Here three of the most effective types of exercise for building bone:
1. Weight-bearing exercises
Weight-bearing exercises, such as walking, running, racket sports and dancing, create the necessary stress on bones to stimulate the body's bone-building cells (Daly, 2019). These activities can increase bone density, improve bone strength, and reduce the risk of fractures. But keep in mind that running and other high-impact exercises may not be suitable for everyone (Brooke-Wavell, 2022).
2. Resistance exercises
Resistance training, including weightlifting or bodyweight exercises, is equally essential, as it not only builds muscle but also exerts mechanical stress on bone tissue, thus encouraging your bones to adapt and become stronger (Papadopoulou, 2021).
3. Balance and posture exercises
Balance exercises can enhance coordination and reduce the risk of falls. Since most fractures occur after falls, this a critical concern for individuals with osteoporosis who are at a much higher risk of fractures. Postural exercises can improve alignment, reduce back discomfort and might even decrease the likelihood of osteoporosis-related fractures of the spine. Postural training can also help improve balance and help reduce the risk of falls.
Nutrition and bone health
Nutrition also plays a vital role in the natural treatment of osteoporosis. Adequate intake of bone-supporting vitamins and nutrients is essential, and directly impacts bone health (LeBoff et al., 2022). Calcium and vitamin D are two of the fundamental nutrients for bone mineralization and maintenance. Additionally, a balanced diet that includes adequate protein, magnesium, and other essential vitamins and minerals can help support bone health. Diets rich in plant-based foods are also associated with better bone health. Conversely, excessive consumption of caffeine, alcohol, and high-sodium foods can negatively impact bone health.
By adopting bone-friendly eating habits, you can contribute significantly to the prevention and management of osteoporosis. Below, we discuss the role of two of the most important nutrients for bone health. Vitamin D and calcium work together to play a crucial and interconnected role in the treatment and prevention of osteoporosis. However, keep in mind that there are many other important nutrients that are necessary for healthy bones.
Calcium is the primary building block of bone. Maintaining an adequate calcium intake is essential for bone health. When there is a calcium deficiency in the diet, the body can compensate by taking calcium from the bones, which can lead to bone weakening and increased fracture risk.
For adults, the recommended daily calcium intake typically ranges from 1,000 to 1,300 milligrams, depending on age and gender (NIH, 2022). Good dietary sources of calcium include dairy products, leafy greens, fortified foods, and some nuts and seeds.
In cases where dietary intake is insufficient, calcium supplements may be recommended to meet daily requirements. Your doctor will be able to help you determine if supplements are appropriate for you.
2. Vitamin D
Vitamin D is critical for the absorption of calcium from the intestines and its utilization in bone formation. Without sufficient vitamin D, the body cannot effectively absorb calcium, even if dietary or supplemental sources are adequate.
Since dietary sources of Vitamin D are limited, most of our Vitamin D is actually made by the skin in response to sun exposure. In people who have insufficient sun exposure due to climate or sun avoidance, vitamin D supplements may be recommended. The recommended daily intake of vitamin D varies depending on age and specific health conditions, but is typically around 600-800 international units (IU) per day for adults (NIH, 2022).
In summary, both calcium and vitamin D are integral to the maintenance of healthy bones. An adequate intake of these nutrients, along with plant products, magnesium, protein and vitamin K, ensures that the body can build and maintain bone density, reducing the risk of fractures in individuals with or at risk of osteoporosis. However, it's essential to consult with a healthcare provider or nutritionist to determine the appropriate intake levels of these nutrients based on individual needs and health concerns.
Other lifestyle factors that impact bone health
As mentioned, certain lifestyle factors negatively impact your bone health. Smoking is associated with increased risk of osteoporosis and fractures. Excessive alcohol consumption and a sedentary lifestyle also exert adverse effects on bone. These factors impact bone health regardless of whether or not you are also taking osteoporosis medication. This is why it is so important to make healthy choices in your daily life to optimize your body’s natural ability to build and maintain healthy and strong bones.
Do I need to take medication for osteoporosis?
It’s important to emphasize that osteoporosis treatment plans need to be individualized. Managing bone health without medication is not for everyone; many individuals with severe bone loss or prior fractures require medication to substantially reduce the risk of osteoporosis consequences. According to Osteoporosis International’s updated clinician’s guide to prevention and treatment of osteoporosis, no uniform pharmacological or non-pharmacological recommendation applies to all patients (LeBoff et. al, 2022).
The best treatment for your osteoporosis will be unique to you. Make sure you discuss all the treatment options available and appropriate for you with your healthcare provider, and make informed decisions about what is best for you using concrete information about your health.
Lastly, continue to monitor your bone health so you can adjust your plan as needed.