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The Complete Guide to Osteoporosis

 Understanding osteoporosis, its impact on health, remedies, and lifestyle adjustments for stronger bones and better well-being.

What your bones look like with Osteoporosis and Osteopenia
Image of what Osteopenia looks like in bones
Image of what Osteoporosis looks like in bones

What is Osteoporosis?

Osteoporosis, often referred to as the “silent disease,” is a condition that weakens bones, making them fragile and susceptible to fractures. It occurs when the body loses bone mass or fails to produce enough new bone, leading to reduced bone density and increased risk of fractures, even from minor falls or stresses.

Osteopenia is a condition of lower-than-normal bone density and is a precursor to the development of osteoporosis. While it isn’t as severe, detecting osteopenia in its early stage is vital as it serves as an essential “warning sign”,” urging proactive measures to prevent the progression to osteoporosis.

Managing osteopenia and osteoporosis includes a number of options, each contributing to a holistic approach for prevention and treatment:

  • Calcium and Vitamin D 
  • Physical Activity 
  • Medications 
  • Nutrition and Diet
  • Hormone Replacement Therapy (HRT
  • DEXA Scans

Continue reading for more detailed information on these solutions and how to implement them in your lifestyle.

Who is at Risk and How Osteoporosis Impacts Lives

Osteoporosis predominantly affects postmenopausal women, but it can also impact men and individuals of all ages and genders. 

People with small or thin frames, a family history of osteoporosis, and certain medical conditions such as hyperthyroidism and chronic kidney disease (CKD) are at higher risk. 

As bones become more fragile, the risk of fractures in the hip become more prevalent. This is important to note because a potential hip fracture could lead to early death. About a quarter of those about 65 years old die within a year following a hip fracture.

Risk of fractures in the spin and wrist also increase, impacting daily activities, independence, and overall quality of life. 

How Osteoporosis Impacts Health

Osteoporosis first received clinical recognition in the 19th century when researchers began to describe and categorize cases of spontaneous bone fractures, recognizing that these incidents were not merely a result of aging but indicative of a distinct condition. French physician Jean Lobstein, in the early 1800s, is credited with coining the term “osteoporosis” to describe this phenomenon.

The 20th century brought significant advancements in understanding osteoporosis and its effect on the bones. The invention of X-ray technology enabled researchers to “peer” inside bones, revealing their internal architecture and density. In the 1940s, Fuller Albright and colleagues made groundbreaking observations about postmenopausal women’s bone loss and its link to hormonal changes, particularly estrogen deficiency.

The 1970s brought the development of dual-energy X-ray absorptiometry (DEXA), a critical tool used today for measuring bone density accurately. This innovation allowed for the diagnosis and monitoring of osteoporosis with precision, guiding healthcare interventions.

Advancements in pharmaceuticals brought medications like bisphosphonates and SERMs, targeting bone remodeling to slow bone loss. Hormone Replacement Therapy (HRT) also became a common solution to address estrogen decline in postmenopausal women.

Today, osteoporosis treatment combines lifestyle changes, exercise, medications, and sometimes HRT for a comprehensive approach.

A doctor diagnosis a woman with osteoporosis

Diagnosing Osteoporosis

What’s Normal & What Isn’t?

The standard for diagnosing osteopenia and osteoporosis is typically based on bone density levels, measured through a test called dual-energy X-ray absorptiometry (DXA or DEXA). This test calculates your bone mineral density (BMD) and compares it to the average BMD of a young, healthy adult of your sex. The result is presented as a T-score, which indicates how much your bone density deviates from the average.

How T-scores are categorized:

  • Normal: A T-score of -1.0 and above is considered normal.
  • Osteopenia: A T-score between -1.0 and -2.5 indicates osteopenia
  • Osteoporosis: A T-score of -2.5 and below indicates osteoporosis.

It’s important to note that T-scores are just one part of the diagnosis. Clinical judgment, risk factors, and other considerations also play a role in determining whether treatment or preventive measures are needed. 

The World Health Organization (WHO) has established a similar classification system based on a different measurement, the Z-score, which compares your BMD to the average BMD of people your age, sex, and ethnicity.

Dexa can results for osteoporosis

Holistic Approaches to Osteoporosis Prevention and Treatment

Whether you’re taking a medically guided approach via diagnostics and medication or tackling your osteo-path on your own, there are are various interventions available to support your bone health journey:

Calcium and Vitamin D

Calcium and Vitamin D play pivotal roles in maintaining strong bones. Calcium is a fundamental component of hydroxyapatite, a mineral complex that provides bone with its strength. When dietary calcium intake is insufficient, the body withdraws calcium from bones, weakening their structure. 

Vitamin D, often referred to as the “sunshine vitamin,” aids calcium absorption and utilization in bones. Vitamin D is essential for the absorption of dietary calcium in the intestines and its incorporation into bone tissue. Without adequate Vitamin D, the body cannot utilize the ingested calcium effectively, leading to compromised bone health.

Physical Activity

Weight-bearing exercises, such as walking, jogging, and strength training, stimulate bone growth by subjecting bones to mechanical stress. 

Specifically speaking, running and running based sports (soccer and tennis) can improve lower body bone density. While walking can slow bone density loss, strength training can improve upper and lower body bone density. 

This controlled stress prompts bone-forming cells (osteoblasts) to deposit new bone tissue and reinforces bone architecture, making bones more resilient and less prone to fractures.

Additionally, physical activity enhances muscle strength, which indirectly benefits bone health by reducing the risk of falls and fractures.


Certain medications, such as bisphosphonates and selective estrogen receptor modulators (SERMs), are designed to slow bone loss and decrease fracture risk. These medications regulate bone remodeling by targeting the activity of bone-resorbing cells (osteoclasts), preventing excessive bone breakdown.

Bisphosphonates inhibit osteoclast activity, reducing bone resorption and preserving bone mass. SERMs mimic the effects of estrogen in specific tissues, including bones, helping to maintain bone density. These medications work by modulating the delicate balance between bone formation and resorption, ultimately promoting stronger bones and reducing fracture susceptibility.

Commonly Prescribed Bisphosphonates:

  • Alendronate (Fosamax)
  • Risedronate (Actonel)
  • Ibandronate (Boniva)
  • Zoledronic acid (Reclast)

Commonly Prescribed SERMs:

  • Raloxifene (Evista)
  • Bazedoxifene (Duavee, a combination of bazedoxifene and conjugated estrogens)

Nutrition and Diet

Magnesium, phosphorus, and potassium are minerals that contribute to bone mineralization and overall bone health. Adequate intake of these minerals through whole foods and supplements ensures a supportive environment for bone cells and the mineralization process. 

Caffeine, soda, and excessive alcohol consumption can interfere with calcium absorption and disrupt hormonal balance, potentially leading to compromised bone health over time.

Hormone Replacement Therapy (HRT)

For postmenopausal women, hormone replacement therapy (HRT) involves supplementing declining estrogen levels. Estrogen supports bone health by regulating bone remodeling, promoting calcium absorption, and inhibiting excessive bone breakdown. 

During menopause, estrogen levels decline, leading to increased bone resorption and decreased bone formation. HRT provides exogenous estrogen, helping to maintain bone density and reduce the risk of fractures. However, the decision to pursue HRT should be made in consultation with a healthcare provider, considering individual health factors and potential risks.

DEXA Scans

Dual-energy X-ray absorptiometry (DEXA) scans are a gold standard for assessing bone density. This painless and non-invasive test provides valuable information about bone health, helping your healthcare provider monitor changes and determine the effectiveness of treatments.

Exercise for Optimal Bone Health

Slow Motion Strength Training

Slow motion strength training (SMST) is a scientifically-proven exercise method that can effectively prevent and treat osteoporosis. In fact, SMST was originally created at the University of Florida as a solution to treat women with Osteoporosis because it was proven to help build bone density in addition to muscle and other incredible benefits. 

By engaging in controlled, deliberate movements, this technique targets bone and muscle with minimal joint impact, promoting bone density improvement and reducing the risk of fractures. 

Studies have also shown that SMST stimulates bone growth and triggers bone remodeling, making it an ideal exercise regimen to fortify bones and enhance overall bone health.

Increased Bone Density: 

  • Build stronger bones through targeted resistance exercises that stimulate bone growth and improve bone density.

Enhanced Muscle Strength: 

  • Strengthen muscles surrounding your bones and joints, providing added support and protection against fractures.

Improved Balance and Stability: 

  • Develop better balance and stability to reduce the risk of falls and related fractures.
A trainer helping a woman do bicep curls
A person using the lat pulldown machine to strength train
A woman strength training on the leg press

Nutrition & Supplementation for Osteoporosis

Proper nutrition and supplementation can help in building and maintaining strong bones. Below are essential nutrients and supplements that promote bone density and overall bone health.

Calcium-Rich Foods

Dairy, fortified plant-based milk, leafy greens, and seafood are calcium powerhouses.

Vitamin D Sources

Sunlight exposure, fatty fish, egg yolks, and fortified foods are excellent sources of Vitamin D.

Protein Intake

Protein aids in bone repair and maintenance. Incorporate lean meats, legumes, nuts, and seeds.

Minerals and Vitamins

Magnesium, phosphorus, Vitamin K, and Vitamin C all contribute to bone health.

A healthy woman enjoys a walk through the park
A person enjoying their time traveling
A woman riding a horse

Lifestyle Tips for Better Bones

Slow Motion Strength Training

Adopting a bone-conscious lifestyle can significantly contribute to preventing and treating osteoporosis. With a few simple adjustments, you can begin creating stronger, healthier bones.

Osteoporosis demands attention, but understanding its nuances can help you to take charge of your bone health. By taking informed action with the right combination of remedies and lifestyle choices, you can pave the way for stronger bones!

Key Takeaways

Osteoporosis, aka the “silent disease,” weakens bones and increases the risk of fractures. Early detection is crucial, so keep an eye out for the warning sign, osteopenia. If you’re looking to manage or prevent osteoporosis, here are key takeaways to consider:

Nutrition and Supplements:

Ensure your diet includes calcium-rich foods like dairy, fortified plant-based milk, leafy greens, and seafood. Don’t forget vitamin D sources such as sunlight exposure, fatty fish, egg yolks, and fortified foods. Protein is essential for bone maintenance, so include lean meats, legumes, nuts, and seeds. Prioritize minerals like magnesium and phosphorus, as well as vitamins K and C, to support bone health.

Physical Activity:

Engage in weight-bearing exercises, yoga, and balance training to enhance bone and muscle health. Activities like walking, jogging, and strength training stimulate bone growth and reduce fracture risk.

Medications (if prescribed):

Depending on your situation, your healthcare provider might suggest medications such as bisphosphonates or SERMs to slow bone loss and decrease fracture risk. These medicines target bone-resorbing cells, helping maintain bone density.

Hormone Replacement Therapy (if applicable):

If you’re a postmenopausal woman, consider hormone replacement therapy (HRT) to supplement declining estrogen levels. Estrogen regulates bone remodeling and calcium absorption, vital for bone health.

Slow Motion Strength Training (SMST):

Explore SMST, a scientifically-proven exercise method that can effectively build bone density and muscle strength. SMST involves controlled, deliberate movements that target bones and muscles with minimal joint impact.

Lifestyle Choices:

Quit smoking to prevent bone weakening and limit alcohol and caffeine consumption, which can hinder calcium absorption. Make your living space safer to prevent falls and injuries. Don’t forget to schedule regular check-ups, including bone density tests, with healthcare providers for proactive management

Combine these informed actions with suitable remedies and lifestyle choices to build stronger bones effectively!

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