In the United States, about 10 million people are living with osteoporosis. Another 44 million are at risk due to having low bone density. Osteoporosis is characterized by low bone density, which increases the risk of bone fractures, even with minor falls and injuries.
For women, osteoporosis is more common than stroke, heart attack and breast cancer combined. Because of this, it is imperative to know the best preventative strategies and the treatment options available to protect your bone density. Let’s break down the top preventative strategies, which include various medications and lifestyle changes.
11. Bisphosphonates
This class of medications is commonly prescribed to treat osteoporosis, particularly for post-menopausal women. There are four primary options that your doctor may discuss with you, including:
• Alendronate: a medication taken weekly or daily by mouth
• Risedronate: an oral tablet prescribed monthly, weekly or daily
• Ibandronate: an oral tablet taken monthly or as an intravenous injection that you will be given four times yearly
• Zoledonic Acid: a type of intravenous infusion given once a year or once every two years
How do these medicines work?
These medications work by slowing down osteoclasts, which are a type of cell responsible for breaking down bone mass. They work to allow bone cells to function more effectively by slowing down bone loss. Doctors prescribe these medicines to prevent further bone weakening and promote improve bone strength.
Are there side effects?
Side effects are possible with this class of medicine. The most common effects include abdominal pain, nausea and heartburn-like symptoms. Another drug commonly prescribed for osteoporosis can held reduce fracturing, which we’ll cover in the next slide.
10. Monoclonal Antibody Drugs
One of the most common effects of having osteoporosis is experiencing bone fractures. Monoclonal antibody drugs help to reduce your risk of fractures. There are two primary drugs in this class that can be prescribed for osteoporosis:
- Romosozumab
- Denosumab
How do these medicines work?
Romosozumab works to increase the formation of bone. It was just approved by the FDA to treat osteoporosis in April of 2019. Doctors may prescribe this drug to women who have a high fracture risk and are postmenopausal. Those who have not responded well to other medicines for this condition might also be a good candidate.
This drug is administered as two injections. They are administered once a month for a period of up to 12 months. Women with a history of stroke or heart attack in the last 12 months may not be ideal candidates for this medicine.
Denosumab slows down the bone breakdown process by linking to a protein involved in this process. It also helps your bones to maintain their density. It is administered every six months as an injection.
What precautions should I take?
Prior to taking any of these medicines, your doctor may recommend a dental examination. This is because these drugs might have an impact on your dental health, especially among those with poor oral hygiene.
Some medications are prescribed for patients with a specific demographic, which we’ll talk about in the next slide.
9. Hormone Medications
Some medications affect your hormones. These medications are typically prescribed to women who are either in menopause or have completed this stage of their life.
What are the common types of hormone medications?
Your doctor will discuss with you the various types of hormone medications, which include:
•Selective estrogen receptor modulators, which help the parts of estrogen that are related to preserving bone. One common example is raloxifene, an oral tablet that you take daily.
•Parathyroid hormones help control phosphate and calcium levels, which can promote new bone growth. Both of the primary drugs in this class are daily self-injections and include abaloparatide and teriparatide.
•Calcitonin helps the body’s ability to regulate calcium levels and may be prescribed to women who are unable to use bisphosphonate medicines.
Are there any other hormone medications?
For post-menopausal women, hormone replacement therapy may be beneficial in reducing their risk of osteoporosis and helping them with any pre-existing bone density issues. It may include only taking estrogen or taking this hormone along with progesterone.
There are tablets that women can take daily to balance their hormone levels. Common options include:
- Menest
- Premarin
- Estrace
There are also patches that only need to be applied once or twice weekly:
- Climara
- Minivelle
- Vivelle-Dot
If you have questions about which hormone treatment would work best for you, your doctor will be able to discuss your options. There are also other ways to prevent and treat osteoporosis, which include diet changes that we’ll mention in the next few slides.
8. Vitamin D and Calcium
To ensure that your body is able to absorb calcium effectively, you need to make sure that you have enough vitamin D, which plays a critical role in overall bone health.
How can I get enough vitamin D?
It is recommended that you get your vitamin D from the sunlight when possible. However, many people live in areas where this is not a possibility, especially during the fall and winter months. In these cases, taking a supplement can help to ensure that your body has enough of this critical nutrient.
When you take a vitamin D supplement, you must be using the right dose. Your doctor can test your blood levels of this vitamin to make an accurate recommendation. However, for most adults, 400IU daily is a general recommendation. If you are over age 51, it may be recommended that you get 600IU daily.
Vitamin D in your diet is crucial.
Calcium is critical for bone health. Most people are able to get enough of this nutrient from their diet in foods like:
- Dairy
- Fish
- Calcium-fortified items
- Soy products
- Green leafy vegetables
Along with sufficient vitamin D comes implementing healthy lifestyle habits that promote physical well being for your body, including exercise.
7. Physical Activity
Regular physical activity is essential for slowing down bone loss and building stronger bones. The earlier a person starts to exercise regularly, the better the benefits for their bone health.
What types of exercise can I do?
There are two main types of exercise that will truly benefit your bone health. You should aim to do a combination of both:
- Weight-bearing
- Strength-training
When you are strength training, you are working to build your muscles, especially in your upper spine and arms. With stronger muscles, your bones have better support, which can positively impact their health and reduce your risk of fracture.
Weight-bearing exercises are ideal for your hips, legs and lower spine. Since hip fractures are common among those with osteoporosis and can be devastating, it is imperative to ensure that your lower body is as strong as possible. You can try:
- Walking
- Climbing
- Using an elliptical machine
Tai chi is great for all ages.
It is also important to work your balance so that you can reduce your risk of falls. Exercises like tai chi are a good choice. It is ideal for people of all ages, but it is especially beneficial for older adults, who should also ensure their habits iare healthy, which we’ll talk about in the next slide.
6. Avoiding Smoking and Excessive Alcohol Intake
Smoking and drinking in excess can be detrimental to your overall health and mental well being. These habits can have negative effects on all parts of your body, including your bones.
Smoking harms bone density.
Smoking has an impact on bone density and makes it harder for your body to absorb calcium and other nutrients that are critical for bone health. Smoking in excess may also reduce estrogen levels.
Heavy drinking can hurt your bones.
Heavy drinking can also negatively impact your bone health, especially when you drink heavily as a young adult or an adolescent. Alcohol can affect calcium in several ways, including not allowing enough to reach your bones.
The stomach is also not able to adequately absorb calcium when you are drinking two to three ounces of alcohol daily. It can also interfere with the ability of your pancreas to absorb vitamin D and calcium which can further reduce how much calcium is available in your body for optimal bone health. That’s why it’s critical to live a healthy life and also eat the right foods.
5. Eating More Protein
Several studies have looked at the impact protein has on your bone health. It has been determined that it may help to reduce your risk of osteoporosis, especially if you are a woman experiencing or past menopausal stage of your life.
About one-third of bone mass and 50 percent of bone volume is made up of protein. It is constantly going through remodeling and turnover. How much protein you consume can either benefit your bones or be detrimental.
For seniors, eating slightly more protein than the recommended intake may reduce their fracture risk and bone loss, according to some studies. For this to be true, they must also be getting enough calcium too. However, consuming excessive amounts of protein from plant and animal sources can damage bone health, so it is all about the right balance.
How much protein do I need?
For the average male:
- 56 to 91 grams daily
For women:
- 46 to 75 grams daily
Increase your protein intake through specific foods.
There are several ways to get more protein in your diet. Look for protein sources that contain all of the essential amino acids, such as:
- Eggs
- Fish
- Meat
- Dairy products
- Vegetables
- Quinoa
- Nuts
4. Monitoring Your Weight
Whether you are underweight or overweight, this can have a negative impact on your bone health. If your body mass index is below 21, you are at risk for osteoporosis. Another reason being underweight may contribute to osteoporosis is because it may be associated with not getting enough nutrients.
Eat healthy foods to keep a healthy weight.
If someone is underweight due to their diet, they may be lacking the following, all of which play a critical role in bone health:
- Calcium
- Vitamin D
- Protein
Menopause & diet
It is especially important to work on your diet and caloric intake prior to menopause. When you are in the menopausal transition, bone loss will automatically accelerate, making your risk of osteoporosis even higher. If you are underweight and in menopause, it is a good idea to have your bone density checked to know where you stand.
Excess weight puts stress on bones.
If you are overweight, the excess weight can put more stress on your bones, especially those that are prone to fracture among people with osteoporosis. People who are overweight are particularly vulnerable to fractures in their wrist or arm.
There are plenty of other diet changes that can promote healthy bones, including soy, which we will cover in the next slide.
3. Soy Intake
Soy contains a substance called isoflavones, which are compounds similar to estrogen. Isoflavones may help stop bone loss and protect your bones against fracture and other issues.
Who does soy benefit?
Soy appears to be the most beneficial for women who are in and past menopause. This is because estrogen levels of drop during this time and the isoflavones may help to balance this hormone for women.
What foods and drinks include soy?
Soy comes in many forms, including:
- Supplements with isoflavones
- Soy milk
- Tofu
How much soy do you need per day?
The general recommended dose is 50 milligrams a day. However, it is best to talk to a healthcare professional about what is right for your specific needs.
Make sure to also talk to a doctor before taking soy since it may interact with certain medications, especially those that are hormonal. It may also increase the risk of breast cancers that are dependent on estrogen for some women. If you don’t want to implement more soy into your diet, there are other things, like herbs, that will improve your bone health.
2. Various Herbs
There are certain herbs that may be beneficial for bone density. Red clover is one herb that may be beneficial. It is sometimes recommended by alternative healthcare practitioners due to it having natural estrogen compounds. These compounds may help to reduce the rate of bone loss among women.
It is important to note that the estrogen-like compounds in this herb could potentially interfere with medications used to treat this condition, especially the hormonal ones. Because of this, if you want to take red clover, make sure to talk to your doctor first.
Black cohosh contains phytoestrogens.
Black cohosh is another herb that may benefit osteoporosis. Native Americans use this herb regularly for bone health and certain other conditions due to it containing phytoestrogens. These are compounds that are similar to estrogen.
One study explored the benefits of black cohosh on bone health. In mice, it helps to promote bone formation. The researchers state that further studies are needed to determine the potential for humans.
Horsetail reduces bone loss.
Horsetail is another plant-based option for osteoporosis. It contains silicon which is thought to aid with the stimulation of bone regeneration to reduce bone loss. This herb is typically used as a tincture, tea or herbal compress.
Still looking for another way to prevent or treat osteoporosis? The answer might be in vitamin K2, which we’ll discuss in the next slide.
1. Vitamin K2
Vitamin K2 can be used for osteoporosis prevention as well as part of a treatment regimen. Low vitamin K2 levels in the body have been shown to relate to reduced bone density.
What does vitamin K2 help with?
Research shows that while vitamin K2 does not reverse osteoporosis, it may help promote bone health by:
- Stimulating the formation of bone
- Suppressing the resorption of bone to further limit bone loss
- Impacting bone metabolism regulation, which decreases the risk of fractures associated with osteoporosis. The metabolic impact appears to affect women far more than men.
Vitamin K2 can lower your risk of fractures.
One study looked at women getting a minimum of 100 micrograms of vitamin K daily. The researchers concluded that these women were at a 30 percent lower risk of breaking a hip compared to those who were consuming less vitamin K daily.
What foods contain vitamin K2?
You can choose to get vitamin K2 from foods or supplements. Foods are preferable since they also provide other bone-healthy nutrients. They include:
- Leafy green vegetables
- Kiwi
- Cabbage
- Avocado
- Fish
- Eggs
- Prunes
Incorporating these foods into your daily diet can help you to get sufficient amounts of vitamin K2 for better bone health.
Prevention is key
With a high prevalence of osteoporosis, everyone needs to work toward prevention. Maintaining a good bone density can reduce your risk of fractures to help you to maintain your mobility and overall well-being.
Utilizing prevention is your best tool against osteoporosis. Should your bone density be lower than average, working with a healthcare practitioner can help you to keep your bones healthy.
