Osteoporosis is one of the most common and disabling diseases affecting women with many women losing between 2%-5% bone mass in the 5 years following menopause. However, it’s not the bone loss itself that puts women at risk of fracture. It’s the decrease in the quality of bone that is the issue. I have seen many women who naturally have low bone density who never break bones. That’s why I like to focus on ways every woman can build healthy bones instead of treating all women as if they are at risk for bone disease and subjecting them to drug side effects and endless testing.
That said, there are risk factors that could set you up for poor bone quality. Some of these are related to lifestyle choices and include a diet high in refined carbohydrates, lack of exercise, muscle weakness, general lack of fitness, smoking, drinking alcohol in excess, vitamin and mineral deficiencies (vitamin D, calcium, magnesium, boron, trace minerals). Other risk factors include depression (due to the associated high levels of cortisol,) ovulatory disturbances resulting in progesterone deficiency, use of corticosteroids, Rheumatoid Arthritis, a history of amenorrhea, never having borne a child, and having a mother with a diagnosis of severe osteoporosis. Of course there can be many other risk factors, so be sure to discuss with your health care provider.
7 Easy Ways to Keep Your Bones Healthy for Life
Fractures and breaks related to osteoporosis typically occur in the hip, spine or wrist. But they can occur in other parts of the body. Hip fracture rates for white women in the United States rise abruptly between the ages of 40-44. In fact, as much as 50% of bone loss in women occurs before the onset of menopause. While osteoporosis is usually not life-threatening, about 20 percent of elderly people who break a hip die within one year. That’s why it’s important to follow a healthy lifestyle as soon as possible!
Here are 7 easy ways to ensure your bones stay strong and healthy:
- Eat a low acid diet. In their book Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis—Without Dairy Foods, Calcium, Estrogen, or Drugs, Amy Joy Lanou, Ph.D. and Michael Castleman show that maintaining a slightly alkaline PH level in the blood can prevent osteoporosis. This can be achieved by eating a low acid diet. For example, eat 3 servings of fruits and vegetables (alkaline) for every serving of high-quality animal protein such as red meat, chicken or fish (acidic). 2 servings of fruits and vegetables will neutralize the slightly acidic effect of grains. Add seeds, nuts, beans and legumes for additional sources of protein. Be sure to reduce refined foods. Also many people today are adding collagen to their diet. This is widely available in supplement form and powders that can be added to smoothies, drinks and other foods. Bone broth can also be a good source.
- Take supplements. Your bones are dynamic organs that thrive in a mineral-rich environment. But most people today are deficient in one or more minerals that are vital for their health. This is primarily due to conventional farming practices that rely on pesticides, herbicides, and chemical fertilizers that deplete the soil of nutrients. Take a high-quality vitamin and mineral supplement to restore these trace minerals. Make sure it includes adequate levels of boron (12 mgs per day), calcium (500-1,500 mgs per day), magnesium (400-800 mgs per day), vitamin D (2,000 IUs per day), vitamin C (2,000 mgs per day), beta carotene (25,000 IUs per day), and trace minerals.
- Get enough exercise. Two 40-minute sessions of weight training per weeks have been shown to increase bone density as much as estrogen according to research by Miriam Nelson, Ph.D. Author of Strong Women, Strong Bones. In addition, higher impact activities such as vertical jumping and stair climbing can also build bone. A comprehensive exercise program that includes weight-bearing aerobic exercise, strength training, and balance and stretching exercises is ideal. Walking, biking, and climbing are exercises that are proven to keep bones well mineralized.
- Practice proper alignment. Proper skeletal alignment is crucial for maintaining healthy bones and hips throughout life. Pilates and yoga are good types of exercises for developing awareness of your alignment. Ester Gokhale’s Primal Posture training is also a good option.
- Balance your hormones. Progesterone plays an important role in bone metabolism. I recommend ¼-1/2 teaspoon of 2 percent natural progesterone cream daily on the skin. Pueraria mirifica can also help balance hormones and support your bone health. High cortisol levels can increase your risk for osteoporosis. If you are depressed or chronically stressed, you need to get help.
- Limit caffeine. Caffeine increases the rate at which calcium is excreted in urine. Limit your caffeine intake to the equivalent of no more than 2 cups of coffee. Be sure to cut out soft drinks as well. In addition to containing caffeine, they also are high in phosphorus, which directly interferes with calcium absorption.
- Quit smoking and limit alcohol. Smokers and women who consume more than 2 alcoholic drinks per day are at the highest risk for osteoporosis.
Should You Get Bone Density Screening?
Bone density screening to determine your current bone density is done through a dual-energy X-ray absorptiometry (DEXA). These machines measure density of bones in specific areas of your body including hips, forearms, spine, or sometimes your entire body. It takes about 10 minutes and is painless. The issue I have with these tests is that they can be misleading, especially if you have small bones. Women with smaller bones often register in the lower bone density range compared with the general population. This suggests that you are at high risk for osteoporosis even if your bone quality is good and you have been in that range your entire life.
A more useful test for many women is a urine test to determine your rate of bone loss. The NTx test and Pyrilinks test measure collagen breakdown products. Testing for bone breakdown product s is a useful way to monitor any bone building program because it will show you improvement long before a DEXA scan will.
Sometimes women lose bone too quickly. This can sometimes be caused by parathyroid abnormalities. If you are at high risk for osteoporosis and have had a low DEXA test reading, you may want to pursue parathyroid testing with your health care provider.
Why You Should Avoid Bisphosphonates
Bisphosphonates are drugs commonly used to treat low bone density. They work by prevent bone breakdown. While this sounds like a good idea, these drugs—which include alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel)—can be downright dangerous. That’s why they are on my list of drugs I won’t take!
Bisphosphonates work by inhibiting bone resorption by cells called osteoclasts, which are necessary for the continual remodeling of bone that occurs throughout life. Studies of women taking alendronate show nontraumatic spinal fractures and atypical femur fractures that don’t heal. Here’s why: Suppressing bone turnover creates excessive mineralization of bone, which makes it more brittle. Plus when bone gets too thick, blood vessels can’t nourish it.
These drugs also seem to inhibit normal repair of microdamage to bone. Finally, bisphosphonates bind so tightly to bone they can stay in the circulation for decades—even after a woman has stopped taking them! That means, even after you stop taking them you can still suffer the consequences of these drugs.
What do you do to build strong, healthy bones? Please share your comments below.
I was diagnosed with osteoporosis and prescribed Prolia. I recently had some dental work & because of this postponed the Prolia injection from 6 to 9 months. During that 3 mos.time my thoracic spine starting hurting real bad & an x-ray showed 2 compression fractures & then that night I tripped over my vacuum & I got 2 more compression fractures in my lumbar spine. If I knew then what I know now about Dexa Scans, Prolia & all the other osteo drugs I would have not taken any meds. I am doing dance class & more weight bearing exercise. BUT, what do I do now about the Prolia? I would really appreciate some help. Thank you.
I get Zometa infusions monthly and take Vitamin D for cancer in my spine (metastatic breast), is there anything else I can do?
I agree with you. I’d never take a pharmaceutical like Fosamax. Natural processes which allow our body to work are more balanced & overall provide a better outcome. There are no magic pills & rebalancing can take some time.
I am active. I take Bone Restore Elite with Super Potent K2 from life extension. I am researching food etc and your info to make best choices. I had a fx spine in 2020 DHMC told me nothing was wrong a yr later my PT made them do a ct scan that showed the fx. dr wanted me to take an acid type fast iv to treat my Osteoporosis- i declined. I have followed you for yrs and am relieved to find this info etc from you Dr Northrup Thankyou
Again, thank you SO much for this article. I ordered the book you recommended Building Bone Vitality and I’m reading it now. I’m so glad I refused my pushy doctor advice to take bisphosphonate. I miss your FB videos. I am so grateful for your teachings and knowledge. Thank you!
I’m Dr. Northrup’s editor. Dr. Northrup is still posting videos on FB. They are not getting the reach they once did due to censorship. You can always go directly to her page to see the posts.
I’m supplementing with boron which has not only kept my arthritis pain at bay but has calcium absorption properties. Supposedly, our soil has become deficient of this important mineral. I was never a big fan of carbonated beverages, but much research indicates that they leach calcium from bones so I avoid them.
I have had 3 dexas wirh each one having slightly worse numbers despite my healrhy lifestyle. How do I get the urine and trsts. I am post menopause by 15 years and slender. Quite small bones. I asked for dexa and also vit d measured because my conventional medicine doctor didn’t do it. Help!
Dear Dr. Northrup,
Can you please also share with us your opinion regarding Anabolic prescriptions like Evenity, Forteo etc.
I have been reading that Vitamin K2 is very important in the building of healthy bones. Some studies even recommend not taking Calcium, just Vitamin K2, Vitamin D3 and a healthy diet. I have stopped taking Calcium because my serum Ca is above normal range. What is your opinion?
K2 and magnesium help Vit D to be absorbed and kept in the bone
All of the 7 items discussed by Dr. Northrup are absolutely true. I am 72, weight 119 lbs, 5’5 tall, and have small bones. (I wear a size 0) I started working out with heavy weights 15 years ago so I do NOT take the drugs mentioned above. I do unassisted pullups (45 in three sets) back squat 200lb and deadlifts 175lb. I work out three times a week for one hour, mow my own grass (for cardio) and play golf. have a bone density test every two years and I have increased by bone density 3% to 6% every two years. I take supplements and eat a healthy diet. All of this not only makes me feel great, but I look like I am in my 50’s, have a great posture and balance and do not worry about taking care of myself! I recommend everything Dr. Northrup has shared!
Thank you for sharing! This is very inspiring.
I’m a vegan, but I think my bones are strong (even though I broke a hip 7 months ago — I fell very hard on a place I had fallen hard twice before) but I don’t eat meat or wheat (I do eat lots of veggies and some seeds, nuts and peanuts). Any advice?
Thank you dr. Northrup for sharing this vital knowledge with us and encouraging us to take action to stay healthy.
Thank you Dr. Northrup – you have been my go to for 20+ years, most especially the last 3 years. I deeply appreciate all the wisdom & experience you share. Our Creator has got you in the Palm of His/Her Hand …
What about Evenity and Prolia?
Good article. Thank you Dr. Northrup!
What about strontium citrate for bones?
Thank you for encouraging women in their journey in life and for outlining a protocol to follow to save bones. I have a question regarding beta carotene 25,000 IU/day. If turmeric is included in the diet that contains enough vit A, could one just take vitamin E instead? Please advise.
A little discouraging to read about bisphosphonates since I recently was on Fosamax for an autoimmune condition, polymyalgia rheumatica PMR. My rheumatologist prescribed prednisone and stated that prednisone causes bone weakness. After a year I am off both drugs and still have PMR but am trying to treat it on my own.
Though I probably still imbibe in too many alcoholic beverages, I have been taking high-quality minerals and vitamins, eating good foods (usually, anyway!), and working out like a beast for years and years. I also use progesterone cream, as well as low dose DHEA to help balance my morning cortisol. At 48, aside from still needing to balance my stress better, I am doing amazing compared to what I witness with my same-aged peers. I have a long ‘wellness’ story, but I’m so glad it’s always been a topic of interest to me and I’ve chosen the routes to health that I have, because, at least at this point, it shows. I’m trying to feel at ease about menopause when it hits but I believe that if I continue doing what I’m doing, it will be just fine. I do struggle with hot flashes atm, but am working on getting them under control with diet choices and supplementation (magnesium and theanine). Wishing lots of luck to all you other ladies out there but if I had one statement of advice that has always been my biggest game changer, it would be to “move your body”! As often as possible and be hard core. Push yourself a bit!
Im new to your website, I find your information so very helpful… Thank You..
TY for these excellent suggestions!
Is it safe to take calcium supplements?
What do you think of Prolia?
I imagine you won’t like it, but why?