Can You Reverse Osteoporosis? Not Completely, But You Can Stop It From Getting Worse

1. Get enough calcium, vitamin D, and protein

The amount of calcium and vitamin D each person needs varies based on age and other factors. Women over age 50 years and men over age 70 years require 1,200 mg of calcium daily. And all adults over age 70 years need 800 international units (IU) of vitamin D daily.

Taking supplements is a good way to ensure you’re getting enough of these vital nutrients. But it’s always best to get as much as possible from the foods you eat. Dairy is a well-known source of calcium. Other great sources include tofu, leafy greens, and fortified plant-based milks. Vitamin D is found in some fortified foods as well as fatty fish. And a few minutes of sunlight exposure also provides vitamin D.

Protein is a nutrient you might not think is important to stop the progression of osteoporosis. But it helps to maintain bone mineral density. Both plant-based and animal-based sources of protein can help to keep your bones strong. 

2. Add strength and balance training to your routine

Moving your body helps maintain muscle and bone strength. Both are important to prevent bone fractures. Types of movement that keep osteoporosis from progressing include:

• Weight-bearing exercises like brisk walking, jogging, or elliptical training

• Resistance exercises like weight lifting, squats, lunges, or using exercise bands

• Balance exercises like tai chi or step-ups to help prevent falls 

3. Stop smoking (or cut back)

Smoking tobacco decreases bone mass in two ways: It increases bone breakdown and prevents your body from replacing bone. So if you smoke and are concerned about progression of osteoporosis, consider cutting back or quitting to maintain your bone health. Quitting smoking is challenging but possible when you’re ready to try.

4. Limit alcohol intake

Studies show that heavy alcohol use is associated with a higher risk of bone fractures in people with osteoporosis. But the evidence is less certain for low or moderate alcohol use. Most experts recommend limiting alcohol intake to 2 or less drinks per day.

5. Avoid low weight

Many people in the U.S. worry about weight gain. But in older adults, unintentional weight loss can be just as much of a problem. 

Research shows that a lower body mass index (BMI) increases fracture risk in people with osteoporosis. In fact, people with a BMI of less than 20 have almost two times the risk of hip fracture compared to people with a BMI of 25. So maintaining a BMI over 20 is recommended to prevent fractures and progression of osteoporosis.

6. Take medications if your risk of fracture is high

Medications for osteoporosis are usually recommended for people with increased bone fracture risk. There are different medication options depending on your:

• Bone fracture risk

• Medical history

• Tolerance of the medication

• Desired length of treatment

A healthcare professional can help to determine your individual risk of bone fracture. And they might recommend starting a medication in addition to lifestyle changes if your risk is high.

Low bone fracture risk

People with low fracture risk have low bone mass that hasn’t progressed to osteoporosis. But even in those with low fracture risk, lifestyle strategies — like the ones listed above — are a great way to lower their risk even more. And these strategies are recommended for everyone diagnosed with osteoporosis.

In those with low fracture risk, lifestyle strategies are the only recommended treatment. But for people who already have osteoporosis, adding medication is also recommended.

High bone fracture risk

In those with a high risk of bone fracture, most medical guidelines recommend osteoporosis medication for:

• Postmenopausal women

• Men over the age of 50 years

Combining lifestyle strategies with medication provides the optimal risk-lowering benefit.

The first-choice therapy is usually a bisphosphonate, medications that work by stopping bone loss. Examples include: 

• Alendronate

• Risedronate

• Zoledronic acid 

Bisphosphonates come in oral pills as well as an intravenous (IV) treatment. The oral version is typically taken for 5 years, while IV bisphosphonates are taken for 3 years. After treatment, the medication is stopped for 2 to 3 years if there are no new risk factors for bone fracture. 

For people who don’t tolerate bisphosphonates, denosumab is an alternative treatment. And raloxifene is another potential alternative for women who aren’t at high risk of blood clots.

Very high bone fracture risk

For people at very high fracture risk, the initial recommended treatment is a little different. Most experts suggest starting with an anabolic agent. Anabolic agents like teriparatide and romosozumab are powerful bone-building medications. These medications are usually taken for 1 to 2 years. Once this course is completed, the next step is starting a medication that prevents further bone loss — such as a bisphosphonate.  

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