According to the International Osteoporosis Foundation, in the U.S. alone, osteoporosis and low bone mass affect approximately 44 million women and men over the age of 50. (1) That is a whopping 55 percent of all people aged 50 and older living in the U.S., which is why problems associated with low bone mass are now said to be a “major public health threat.”
Osteoporosis literally means “porous bones.” A scary fact about osteoporosis is that the disease is usually “silent,” developing over many years but going unnoticed. For many people, osteoporosis causes no obvious symptoms or discomfort (you can’t “feel” your bones weakening) until eventually the person affected experiences a bone fracture.
What is the best and safest osteoporosis treatment? Natural osteoporosis treatments that can be highly effective include getting enough exercise (especially doing resistance-training), treating hormonal imbalances, preventing vitamin D deficiency and eating an “osteoporosis diet.”
Your diet plays a critical role in your bone health because it determines if you’re obtaining enough protein and essential vitamins and minerals — especially calcium, magnesium, phosphorus and manganese that all play a role in bone formation.
What Is Osteoporosis?
Osteoporosis is defined as “a bone disease that occurs when the body loses too much bone, makes too little bone, or both.” (2) Osteoporosis is generally seen in women over the age of 50, although younger women and men too can develop this condition. It’s estimated that about one in two women (50 percent) and up to one in four men (25 percent) over the age of 50 will break a bone at some point due to osteoporosis.
When viewed under a microscope, osteoporotic bones visibly contain abnormal tissue structure. Osteoporosis occurs when small holes or weakened areas are formed in the bones that can lead to bone fractures (broken bones), bone pain and sometimes other complications such as a Dowager’s hump (an abnormal outward curvature of the thoracic vertebrae of the upper back, causing the appearance of a hump).
How does osteoporosis compare to osteopenia? Osteopenia is another condition that’s associated with bone loss and weakened bones, but it’s not as severe as in osteoporosis is. Here’s how Harvard Medical School explains it:
Both conditions are varying degrees of bone loss, as measured by bone mineral density, a marker for how strong a bone is and the risk that it might break. If you think of bone mineral density as a slope, normal would be at the top and osteoporosis at the bottom … Osteopenia, which affects about half of Americans over age 50, would fall somewhere in between. (3)
Signs and Symptoms
Just how “serious” is osteoporosis in terms of symptoms and long-term consequences? This condition should not be taken lightly, since weak and broken bones can be difficult to treat and cope with.
Bone breaks, or surgery required to fix fractured bones, can also sometimes cause life-threatening complications and permanent disability in older adults. Breaks, such as those due to falls or slips, can also limit mobility and independence, leading to emotional problems such as hopelessness and depression.
When they do occur, the most common symptoms of osteoporosis include: (4)
- Osteoporotic bone breaks. Fractures and breaks most commonly occur in the hip, spine or wrist bones. They also affect the feet, knees and other parts of the body. (5)
- Limited mobility, trouble getting around and difficulty completing everyday activities. Many elderly adults who break a bone will need to live long-term in nursing homes or will require assistance from an aid in their home.
- Bone pain, sometimes which is permanent and intense.
- Loss of height.
- Hunched or stooped posture. This occurs because the vertebrae, the bones of the spine, can become weaker.
- Feelings of isolation or depression.
- In the elderly, increased risk of death. About 20 percent of seniors who break a hip die within one year.
Causes and Risk Factors
Low bone mass is usually caused by a combination of factors, typically including older age, nutrient deficiencies due to eating a poor diet, existing health conditions and others. The main causes of osteoporosis include:
- Inactivity, or too little exercise which helps to maintain bone mass
- Hormonal changes and imbalances, especially low estrogen levels in women, which is the cause of many menopause symptoms. Low levels of testosterone in men can also decrease bone mass. Women suffer from osteoporosis more than men largely because of a decrease in hormones after menopause. (6)
- History of medical conditions such as autoimmune disorders, pulmonary disease, kidney or liver diseases
- Long-term use of certain medications, including proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), aromatase inhibitors, fertility drugs/hormonal medications, anti-seizure medications and steroids (glucocorticoids or corticosteroids).
- Low vitamin D levels
- High amounts of emotional stress and depression
- Nutritional deficiencies, especially in vitamins and minerals that help to build bone such as calcium, phosphorus and vitamin K
- Weight loss, dieting that results in severe calorie restriction and malnutrition
Being a woman and over the age of 70 are the two biggest risk factors for osteoporosis. (7) It’s also possible to develop osteoporosis or suffer from low bone density due to a number of different health problems that can deplete the body of minerals and weaken bones over time.
Examples of health conditions that are risk factors for osteoporosis include:
- Breast or prostate cancer
- Hyperparathyroidism or hyperthyroidism
- Cushing’s syndrome
- Inflammatory bowel disease
- Autoimmune diseases including rheumatoid arthritis (RA), lupus, multiple sclerosis, or ankylosing spondylitis
- Parkinson’s disease
- Hematologic blood disorders
- Female athletic triad, irregular/absent periods, or premature menopause
- Chronic obstructive pulmonary disease (COPD), including emphysema
- Chronic kidney disease
- Liver disease, including biliary cirrhosis
- Organ transplants
- Polio and post-polio syndrome
- Spinal cord injuries
Doctors typically diagnose patients with osteoporosis using a a bone mineral density (BMD) test. To perform a BMD test, a special machine measures the amount of bone mineral that is present in certain areas of bone, usually those located in the hips, spine, forearms, wrists, fingers or heels. A dual-energy X-ray absorptiometry (DEXA scan) is a common way to perform a BMD test.
Other tests that can help to confirm a diagnosis include taking a patient’s medical history, performing a physical exam, urine and blood tests to diagnose underlying conditions, biochemical marker tests, x-rays, and vertebral fracture assessments (VFAs). One reason that your doctor might suspect you have lost bone mass is if your height as decreased, since this typically happens due to tiny fractures developing in the spine.
What is the prognosis for someone with osteoporosis? For example, how long can you live with osteoporosis? Osteoporosis itself is usually not life-threatening, so it’s definitely possible to live many years with the condition if you take steps to slow its progression. For example, performing daily weight-bearing exercise can help build bone mass gradually and decrease your risk for complications as you age.
Conventional Osteoporosis Treatment
Conventional osteoporosis treatment usually involves the use of medications, exercise and dietary changes. There are a number of different medications available that can help stop bone loss, however, not all types of suitable for all people. The type of medication that your doctor will recommend depends on factors like: your age, gender, medical history (for example, if you have had cancer or an autoimmune disease) and underlying causes of bone loss (such as your diet and lifestyle).
Some medications that are used to manage osteoporosis include: (9)
- Bisphosphonates (most are suitable for both men and women).
- Rank Ligand inhibitors (suitable for both men and women).
- Bisphosphonates intended for women only, such as Boniva.
- Parathyroid hormone-related protein agonists.
- Hormone replacement therapy (most are for women only). These can include estrogen agonist/antagonist (also called selective estrogen receptor modulator (SERM)), or tissue specific estrogen complex.
Natural Osteoporosis Treatment
Even though it’s best if osteoporosis is diagnosed and treated in its early stages, you can still take steps to manage symptoms and help stop the disease from progressing. Below are ways to support bone health and reduce symptoms like pain and loss of mobility.
1. Healthy Diet
What are the best foods to eat when you have osteoporosis? Make it a priority to eat enough protein and foods that provide essential nutrients, especially calcium, magnesium, phosphorus, manganese and vitamin K (more on specific recommendations can be found below).
About half of your bones’ structure is made of protein, so a low-protein diet does not support healing as well as a high-protein diet. However, it’s important to balance protein intake with mineral intake.
How much protein should you eat daily? The recommended daily allowance for adults is between 0.8 grams per kg of body weight per day, up to about 1.0 grams/kg/day. Good protein foods include grass-fed meat, wild-caught fish, pastured eggs and poultry, fermented cheese and yogurt, nuts, seeds, beans and legumes. (10)
2. Physical Activity
Exercise is beneficial for people with osteoporosis for many reasons: it can help to build bone mass, improve balance and flexibility, relieve stress, reduce inflammation and more. (11) What exercises should you avoid if you have osteoporosis? To be safe, avoid all activities that require lots of jumping, bending forward from the waist or too much twisting of the spine.
Walking and other weight-bearing activities are best for supporting bone strength. Types of exercises that are recommended most for people with low bone density include:
- brisk walking (a treadmill may be best to prevent falls)
- using an elliptical
- bodyweight exercises like squats and assisted push-ups
- tai chi
You can use a chair, wall, bands, light weights and tubes to assist you. Even gentler forms of exercise are helpful; some studies have shown that adults who practice tai chi have a 47 percent decrease in falls and 25 percent the hip fracture rate of those who do not. (12)
If you experience pain and soreness for more than one or two days after exercising, this is probably not the right type of exercise for you. Always speak with your doctor or physical therapist if you’re unsure of what type is best.
To improve bone density, weight training exercises are essential. I recommend strength training ideally three times a week for at least 30 minutes at a time. It’s best to do “compound movements” that strengthen multiple parts of the body at once. Examples of compounds exercises include: squats, barbell and dumbbell presses, dips, all types of push-ups, deadlifts, jumping rope and pull-ups. If you’re new to strength-training and this sounds intimidating, consider working with a personal trainer or attending group exercise classes for help. (14)
I also recommend trying vibration platforms. You stand on one of these platforms for about 5–20 minutes daily to help naturally improve bone density.
3. Help Prevent Falls
The National Osteoporosis Foundation estimates that each year about one-third of all people over age 65 will fall, and many times this will result in a fracture/broken bone. Here are steps you can take to reduce your risk of falling and injuring yourself when at home or out and about:
- Use a walker or cane if needed.
- Get up slowly from sitting or lying down.
- Keep your home well lit, and use a flashlight when walking outside in the dark.
- Wear sturdy, comfortable shoes that help you balance (sneakers, low-heeled shoes with rubber soles, boots, flats instead of heels, etc.)
- Use hand rails when available to support you as climb stairs.
- Be careful about walking on slippery roads or sidewalks after it’s rained or snowed.
- Avoid walking on wet, slippery, highly polished marble or tile.
- Clean walking paths around your home, such as by clearing your porch, deck, walkways and driveway.
- Keep a light outside your front door on.
- Inside your home, place items you use most often within easy reach. Use assistive devices to help avoid straining, stooping or injury. Use a sturdy stepstool is needed.
- Consider wearing a personal emergency response system (PERS) if you live alone.
- Remove all loose wires, cords and throw rugs. Keep floors and carpets free of clutter that might make you trip.
- Install grab bars in your shower/tub or bathroom walls.
- In your kitchen lay down non-skid mats or rugs.
- Keep stairwells well lit.
- Try not to rush around in a hurry, since this makes falling more likely.
4. Essential Oils
Putting essential oils topically on affected areas, as well as through consumption, may increase bone density and aid bone repair or help with osteoporosis-related pain. (15, 16) I recommend using essential oils such as ginger, orange, sage, rosemary and thyme oils topically about three times per day. Mix several drops with a carrier oil such as coconut oil and apply to any painful areas.
Other essential oils sometimes suggested for osteoporosis include wintergreen, cypress, fir, helichrysum, peppermint, eucalyptus and lemongrass oil. Also consider healing therapies such as aroma-touch, acupuncture and massage to help reduce stress.
5. Sunshine to Boost Vitamin D Levels
Aim to get about 20 minutes of sunlight exposure on your bare skin daily, which is the best way to prevent a vitamin D deficiency. To make enough vitamin D, you need to expose large areas of your skin to the sun without sunscreen, but only for short periods of time. The darker your skin tone, the more sunlight you will need to make enough vitamin D.
Studies also suggest that older adults have a harder time making vitamin D than younger people, even with the same amount of sun exposure. (17) If you live in a cold climate and don’t get outside much (such as during the winter), or if you’re older than 60, it’s recommended that you supplement with vitamin D3 cover your bases.
- Magnesium (500 mg daily) — Magnesium is required for proper calcium metabolism. (18)
- Calcium (1000 mg daily) — Choose calcium citrate which is best absorbed. (19)
- Vitamin D3 (5,000 IU daily) — Vitamin D helps improve calcium absorption. (20)
- Vitamin K2 (100 mcg daily) — Needed to form a protein critical for bone formation. (21) Take a high quality vitamin K2 supplant or eat more vitamin K rich foods.
- Strontium (680 mg daily) — A metallic element that can help improve bone density. It’s found naturally in seawater, nutrient-rich soil and certain foods, but most people need to supplement to get enough. (22)
7. Discussing Medication Use With Your Doctor
If you take steroids to treat an existing health condition such as rheumatoid arthritis, asthma, Crohn’s disease, cancer or lupus then you should take extra precaution to exercise, eat a mineral-rich diet and quit smoking in order to protect your bones. Common steroid medicines can include cortisone, dexamethasone (Decadron®), methylprednisolone (Medrol®) and prednisone.
Taking these medications for three or more months has been shown to increase your risk for losing bone mass and developing osteoporosis. While these drugs might be necessary to manage serious health conditions, you should still talk to your doctor about the dose that’s right for you or possible alternatives based on your risk for bone loss.
- Raw cultured dairy — Kefir, amasai, yogurt, and raw cheese contain calcium, magnesium, vitamin K, phosphorus, and vitamin D rich foods all of which are vital for building strong bones.
- Foods high in calcium — Calcium is an essential structural component of the skeleton, so calcium deficiency can contribute to broken bones. Some of the best source of calcium include all dairy products, green vegetables (like broccoli, okra, kale and watercress), almonds and sardines.
- Foods high in manganese — Manganese is involved in the formation of bone mass and helps balance hormones naturally. Some of the best sources include whole grains like teff, brown rice, buckwheat, rye, oats and amaranth, beans and legumes, macadamia nuts and hazelnuts.
- Wild-caught fish – Osteoporosis may be related to chronic inflammation. Omega-3 fatty acids found in certain fish help reduce inflammation. The best sources include wild salmon, sardines, anchovies, mackerel, and halibut.
- Sea vegetables – These vegetables are high in critical minerals for bone formation, plus they provide antioxidants that are supportive of overall health. Try to include algae, nori, wakame, agar or kombu in your diet.
- Green leafy vegetables – Bones need vitamin K and calcium to stay strong, which green leafy vegetables are full of. Some of the best sources include kale, spinach, Swiss chard, watercress, collard greens, mustard greens, dandelion greens and escarole.
- Alkaline foods – Osteoporosis may be related to an acidic environment, so eating plenty of fruits and vegetables can help promote a more alkaline environment that prevents bone loss. The most alkaline foods are: green vegetables, fresh herbs and spices, grapefruit, tomatoes, avocado, black radish, alfalfa grass, barley grass, cucumber, kale, jicama, wheat grass, broccoli, cabbage, celery, beets, watermelon and ripe bananas. One of the best things to have is green juices made from green vegetables and grasses in powder form, which are loaded with alkaline-forming foods and chlorophyll.
- Other quality proteins — Remember that in the elderly, diets too low in protein can impair bone health. (23) However, very high-protein diets are not the healthiest either because they tend to be overly acidic, so striking a balance is important. Aim to eat a moderate amount of clean, high-quality proteins with every meal, such as grass-fed meat, wild-caught fish, pastured eggs and poultry, fermented cheese and yogurt, nuts, seeds, beans and legumes.
What foods should you not eat if you have osteoporosis? The foods below can worsen bone loss and may contribute to low bone mass or osteoporosis:
- Too much alcohol – Increases inflammation that can lead to more calcium being leached from bones.
- Sweetened beverages – The high phosphorus content found in soda can remove calcium from bones. Sugar also increases inflammation.
- Added sugar – Increases inflammation which can make osteoporosis worse.
- Processed, red meat – A high intake of sodium and red meat may result in bone loss.
- Caffeine – Excessive caffeine intake can result in bone loss.
- You should also avoiding smoking, which worsens many chronic health conditions.
Talk to your doctor right away if you experience a bone fracture, persistent bone pain, a worsening hunch in your back, or repeat injuries. It’s important to address bone loss as soon as you can, since it usually only worsens with age.
Make sure to let your doctor know about any conditions you may have dealt with in the past (an eating disorder, autoimmune condition, etc.), your exercise routine, diet and other risk factors.
- Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. This causes weak bones and increases the risk for bone breaks/fractures and injuries.
- Causes of osteoporosis include: aging, poor diet, lack of exercise, hormonal changes, calorie restriction, certain medications, and a number of health conditions including cancer, diabetes, and autoimmune diseases.
- Osteoporosis treatment usually involves exercise, a healthy diet, supplements and sometimes medications.
- To help manage osteoporosis symptoms, be sure to eat a mineral and protein rich diet, prevent falls and slips, do weight bearing exercises daily, get enough sunlight to make vitamin D, use essential oils and manage stress.
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