Treatment for osteoporosis can be lifestyle improvements in the form of an exercise and vitamin regimen, or a GP may prescribe medication, or a combination of both.
See which areas you can take steps in to improve your bone health – Test Yourself
All medications can have possible side effects. Always speak to your GP about any drug treatments you plan to take.
Bisphosphonates are inhibitors of bone resorption that are given as tablets and sometimes injections. They inhibit cells (osteoclasts) that break down bone, helping to maintain bone density.
This medication includes:
Bisphosphonates are the most common treatment for osteoporosis and their main side effects are stomach upset and heartburn. However, this can be mitigated by avoiding lying down or bending over for 30 to 60 minutes after taking the medication. This helps to avoid it travelling back up into the oesophagus where it can cause irritation. Another possible side effect of bisphosphonates is bone, joint or muscle pain.
See NICE guidelines to bisphosphonates
The most recently developed injection treatment is Denosumab. It is in a class of medications known as RANK ligand inhibitors and works by inhibiting the cells (osteoclasts) that break down bone. It is an anti-body-based (monoclonal) medication but doesn’t suppress the immune system.
Raloxifene is a drug that delivers a similar effect on bone as the hormone oestrogen. This treatment is mainly given to postmenopausal women and those on glucocorticoids. Bisphosphonates are usually preferred over SERMs for treating osteoporosis.
Postmenopausal women are at a higher risk for developing osteoporosis because female hormones, especially oestrogen, play a large role in maintaining a woman’s bone health and levels drop dramatically at menopause. So, women who take HRT reduce their risk of osteoporosis; however, HRT is usually not specifically recommended as a treatment for osteoporosis.
Where osteoporosis in men is caused by low levels of male sex hormones, testosterone can be used to remediate the problem.
Salmon calcitonin is a naturally occurring peptide that is an analog of human calcitonin, a hormone responsible for normal calcium homeostasis. First administered as a parenteral injection, it is now most widely administered intranasally and is particularly indicated for postmenopausal osteoporosis.
Severe osteoporosis can be treated with a form of parathyroid hormone called teriparatide (brand name Forteo), which is administered by injection. Naturally occurring in the body, this hormone helps regulate calcium metabolisation. Whilst other treatments can slow down the breakdown of bone, parathyroid hormone stimulates osteoblasts to create new bone. This is not a first-line treatment, however.
See also Exercises for Bone Health
Weight bearing is important for both preventing and treating osteoporosis.
Any exercise where muscle overcomes a resistant force - including gravity - staves off age-related declining muscle mass and grows new muscle. This is good for bones because denser muscle means a person weighs more as they go about their day-to-day activities, which helps build bones, and the more muscle around joints and bones, the more protected they are from injury.
Rebounding means jumping up and down on a mini trampoline and is a great low-impact exercise that, amongst other benefits, is good for bone health. Because it is low impact it can be enjoyed by people who suffer from osteoporosis, as well as those seeking to prevent it. Some trampettes come with a handle for those who would like extra support.
You can go to rebounding aerobics classes or you can purchase your own rebounder and exercise at home. Start off gently and be mindful of the impact that rebounding can have on knees – even low impact exercises can cause injury if proper technique is not observed.
The benefits of vibration therapy are yet to be firmly established.
Vibration therapy, standing on a vibrating platform, was developed to treat astronauts who lost bone and muscle mass due to spending extended periods of time in zero gravity. The effectiveness of vibration therapy is, as of yet, unclear – some studies found an increase in bone density and others didn’t. Until more conclusive results are achieved, vibration therapy should be viewed as a complementary, but not the go-to, treatment for osteoporosis.
See also Adults and Bone Health
Vitamin D and magnesium help the body absorb calcium.
How much should you be getting:
There is also research being conducted into the usefulness of vitamin K2 for bone health.
Consult your GP for guidance on supplements if you are unsure of your needs.
Studies suggest that smoking decreases bone mass and increases the risk of fracture in both women and men. See the NHS’s Stop Smoking page if you need help stopping smoking.
Studies have shown that heavy alcohol consumption compromises bone health. The NHS recommends no more than 14 units a week. Also, alcohol increases your chances of falling and breaking bones. See the NHS’s Alcohol Support page.
For your bespoke bone health advice Take Our Test