Can I Drink Alcohol If I Have Osteoporosis?

Osteoporosis is a common condition affecting the bones. It happens when the bones lose strength over time. Osteoporosis mainly affects older adults and is becoming more common as people live longer. In fact, in Americans over age 50, nearly 19% of women and about 4% of men have osteoporosis in the hip or lower spine.

Osteoporosis is a problem because it makes the bones more likely to break (or fracture). In 2006, osteoporosis was estimated to have caused about 9 million fractures around the world.

Osteoporosis treatment and prevention are complex because there are many factors that affect bone strength over time. These include nutrition, physical activity, and alcohol consumption. Keep reading to find out more about the link between alcohol and osteoporosis as well as how to prevent and treat osteoporosis if you have it.  

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Does alcohol cause osteoporosis?

Alcohol is a risk factor for osteoporosis. This means that drinking alcohol can increase your chance of developing osteoporosis over time. Alcohol is not the only risk factor, however. Other risk factors for osteoporosis include:

• Older age

• Previous fracture

• Cigarette smoking

• Menopause

• Low body weight

• A family history of osteoporosis or hip fracture

• Low testosterone

• Other illnesses (such as rheumatoid arthritis, inflammatory bowel disease)

• Long-term use of steroid medications (corticosteroids) 

We don’t know who will get osteoporosis, but we do know that bone strength develops when we’re younger. As we grow up, our bones grow and get stronger, reaching a peak bone mass in young adulthood. Peak bone mass is when our bones are at their strongest. Having stronger bones when you’re young makes you less likely to get osteoporosis when you’re older and reduces your risk of broken bones.  

How much bone mass we get depends on our activity level, nutrition, and genetics. Additionally, there is some evidence that alcohol is detrimental to growing bones. One study looking at drinking and bone strength in female college students found that heavy drinking was associated with decreased bone density in the spine. But other studies in young adults have not shown a link between alcohol and bone strength or have shown conflicting results. For this reason, experts can’t say exactly how alcohol affects growing bones. 

In older adults, the bones aren’t growing, but they do undergo remodeling — a process of breaking down and rebuilding. Osteoporosis happens when more bone is broken down than rebuilt, and the bone gets weaker.

Alcohol interferes with bone remodeling in older adults in different ways. It can:

• Decrease the amount of important vitamins and minerals in the body. These include calcium, magnesium, and vitamin D, which are important for bone strength. 

• Alter the normal function of important hormones in the body, like parathyroid hormone (PTH), growth hormone, and reproductive hormones (like estrogen), which are important in keeping bones strong. 

• Interfere with the cells that build up our bones at the molecular level.

It’s important to know that alcohol can also increase the risk of falls in older adults who have osteoporosis. This leads to fractures, which are the most serious consequence of osteoporosis.

How much alcohol is detrimental to bone health?

This is a difficult question for experts to answer. It’s partly because many of the studies looking at alcohol and osteoporosis have different ways of defining light, moderate, and heavy drinking. 

Generally, heavy drinking is defined as 15 or more drinks per week for men and 8 or more drinks per week for women. Moderate drinking is two drinks per day or fewer for men and one drink per day or less for women. Having fewer than three drinks per week over a year is considered light drinking.

Heavier drinking has been linked to decreased bone strength, increased fracture risk, and osteoporosis. For this reason, it’s recommended that, if you choose to drink, you keep your daily intake to a moderate amount.

There is some evidence that moderate amounts of alcohol may be beneficial for the bones in women who have gone through menopause. These results are mixed, however, so experts can’t say for sure that alcohol is good for bone health. If you don’t already drink, it’s probably not helpful to start now to improve your bone strength, especially considering alcohol’s other potential harmful effects.

Is there any type of alcohol that is good for bones?

No. Although there are different types of drinks that contain alcohol (beer, liquor, wine, mixed drinks), the alcohol in these drinks is the same. They can all have a negative effect on bone health. 

How can I prevent osteoporosis? 

Besides keeping your alcohol intake to a moderate amount, there are other steps you can take to improve your bone health and prevent osteoporosis:

• Get enough calcium and vitamin D. These are both important for bone health. It’s best to get calcium from your diet, but you can also take supplements to reach the daily recommended amount. Vitamin D is not found as widely in food, and we need regular sun exposure to keep the levels up. Vitamin D supplements can help you make sure you’re getting enough. 

• Stay active. Weight-bearing exercise, including walking and running, helps with bone strength. Other activities that put resistance on the bones, like weight training and using your own body weight are great, too. Regular exercise also improves balance, which helps prevent falls and broken bones.

• Quit smoking. Like alcohol, smoking is also linked to osteoporosis. For your bone health, it’s best to quit smoking, cut back, or never start. 

What are some osteoporosis treatments? 

The lifestyle changes above are an important part of osteoporosis treatment. Even after you’ve been diagnosed with osteoporosis, following a healthy lifestyle can prevent it from getting worse. However, sometimes lifestyle changes are not enough and prescription medications are also needed for treatment. 

There are several options, including: 

• Bisphosphonates: These include alendronate (Fosamax), ibandronate (Bonvia), risedronate (Actonel), which are available in pill form. Zoledronic acid (Reclast) is given intravenously (IV) once a year. Bisphosphonates are usually preferred as first-line treatment for osteoporosis. 

• Denosumab (Prolia): This is given as an injection under the skin every 6 months. It’s not usually used as initial treatment for osteoporosis unless you can’t take other medications, like bisphosphonates.

• Raloxifene (Evista): This is a pill that acts on estrogen receptors and also reduces breast cancer risk. It’s usually given to women who have both osteoporosis and an increased risk of breast cancer. 

• Teriparatide (Forteo), abaloparatide (Tymlos), romosozumab (Evenity): These medications are given as injections and work by building new bone. They’re reserved for severe osteoporosis or when other treatments fail or can’t be used due to side effects. 

Your healthcare provider can help you decide if you need medication for osteoporosis and what medication is best for you. This will depend on your personal preferences, the cost, your other health conditions, and the severity of your osteoporosis.  

Why trust our experts?

Written by:

Sarah Pozniak, MD

Sarah Pozniak, MD, has 9 years of experience since graduating medical school (6 since completing residency). She is a board-certified general internal medicine physician and has practiced as a primary care physician in both Utah and Washington, D.C. Currently, she cares for patients with chronic illnesses such as diabetes and high blood pressure using telemedicine as part of a virtual care program.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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