I am a newbie here.
Had an Osteoporosis diagnosis in Nov from a DEXA scan. First available routine GP appointment at the end of Jan.
I am taking vit D3 and Calcium as he prescribed in the interim. I think GP will talk to me about treatment with bisphosphonates. I would like to know if I can get sorted naturally beforehand, and if anybody has managed this.
Thank you.
It's certainly possible to stabilise bones without using osteoporosis medication, but it requires commitment, and you won't be able to see evidence of it within a few weeks or even months. If you're going on DEXA scan results, you need to wait at least 2 years for a follow-up scan in order for the results to stand any chance of being significant. You also need to be aware that it's normal to lose bone density as we age, so even maintaining scores is an achievement. You'll need a combination of regular exercise (as high impact as is safe for you), both weight bearing and resistance, a healthy diet, and a number of supplements. You need to know your blood vitamin D level in order to know how much supplement to take - many rheumatologists recommend a blood level of at least 75nmol/litre (30ng/ml if you're in the US), some experts say 100nmol/litre or even higher. Calcium in most cases should be from diet, unless you can't get enough that way. You need vitamin K2 (not the same as K/K1) to help direct calcium to the bones, magnesium if you can tolerate it (otherwise a diet rich in it) and a high protein intake.
Were you sent for a DEXA scan following a fragility (low or no impact) fracture? Do you have your scan results, not just one t-score, but t-scores and z-scores for total hip, neck of femur and spine, plus a FRAX fracture risk score? Has you GP run blood tests to check for underlying causes? These all have a bearing on the way forward. I was diagnosed 10 years ago and have managed to maintain my bone density for 5 or 6 years without meds, meaning that my scores are now normal for my age, although I am still into the osteoporosis range. The fracture risk score, combined with age, indicates whether medication should be recommended or not - see the chart here: nogg.org.uk/full-guideline/...
My first DEXA scan in 2017 showed osteopaenia, the second one, which I prompted as a follow up, was in Oct 2024. Result was osteopeania in hip and osteoporosis in spine. I have all the te t and z scores. I don't have a FRAX score and haven't had blood tests for causes.Maybe the GP will clarify things in Jan. I have not seen him yet.
Thank you for all the information Met00.
Greenllama everything Met00 has said above is brilliant information. They really helped me too when I came to the forum to ask for help. A couple of points I can add are consider looking at tocotrienols (not to be confused with tocopherols) which is a particular type of vitamin E. There is some research that says it is helpful in maintaining bone. It is an expensive supplement though.
Also, depending on your age and health, body identical HRT can also have it's role in helping to maintain/slow down the progression of bone loss around the time of menopause. The ROS has some interesting videos on this on their website. Whether you regard HRT as natural or not or whether you consider it a medication I will leave up to you. I decided to start HRT during perimenopause due to menopause symptoms primarily but I was also happy to learn there are bone benefits too. I'm in the osteopenia range and hope to maintain as far as is possible.
Equally important is to build muscle/maintain muscle through exercise - muscle wastage as we get older is also a problem alongside bone loss. Strong muscles help support the bone and if you loose your balance you are less likely to fall if you have muscle strength to right yourself.
Thank you Bertiepuss. Just had a look at tocotrienols, not very clear info on the web, but I eat porridge for breakfast and can eat more olives. Probably to old for HRT at 66. I do need to do more excercise though. 🙂
I wouldn't hold your breath on any further tests or much follow up. I was diagnosed in October, saw the doctor who told me osteoporosis (no score explanation), put me on adcal and alendronic acid, then said we'll review in 5 years....the end! I initially had to request a Dexa scan after 2 spinal compression fractures in August whilst on holiday.
Hello Nadjio. Sorry you were not given the information you needed from the doctor.
The Royal Osteoporosis Society have nurses you can phone for advice. One reassuringly helped explain my score. They might let you know what you need to ask the doctor to help you make an informed decision on your treatment. Hope things get sorted for you soon.
Thank you, I will probably contact them in the new year. As a relative newbie, I'm still getting my head around the diagnosis and coming to the realisation that my doctor isn't very good. I was diagnosed with two fractured vertebrae in Bulgaria, skeleton doctor at the hospital there said I should have further scan in three months to ensure it healed and incase of further fractures. Just a couple of weeks ago, went to my local a&e because it felt like I had another fracture at the base of my spine, saw a physio there who said she thought it was muscular and sent me on my way. I honestly feel like there's nothing to be done, so crack on (literally) with painkillers. So yes you're right ROS nurses will be more helpful.
Hope the pain is better soon and you get the answers you need.
Hi Nadjio, I have two fractures L1 and L5 .. the first one was told by 2 doctors and 1 physio it was muscular …. The 2nd fracture a year later I went to a&e and told by doctor it was muscular … after the first time I insisted on an X-ray and it was a compression fracture!
Now on medication …..hope your back is feeling better by now and hopefully it is muscular.
If your root cause is insufficient vitamin D or Calcium then, sure. If not (and most of the time it isn't) then your actual root cause will continue to eat away at your bones. You might slow it down if you are also deficient in Vitamin D or calcium but supercharging above that required isn't going to do much.
Good point uncountable3. I will try and find to the root cause if possible. Maybe Sodium Valproate and Citalopram (an SSRI) have affected bone density after many years.
Very interesting. But what are the root causes of osteoporosis? Am I correct in thinking science doesn't know? Could it be low calcium, D, other nutrients in childhood? Or in our mothers when we were in the womb? Is it, like Paget's Disease, which my mother had, associated with poverty?
There are many causes of osteoporosis, so the challenge is finding which one(s) is/are responsible for bone loss in each of us. We naturally lose bone density as we age, so if our peak bone density is below average at age 30, we'll almost certainly have below average bone density later in life. Or we may have good bone density when we're younger, but lose at a faster rate than others. Among the causes are poor diet, a sedentary lifestyle, smoking, excess alcohol, diseases such as coeliac disease and hyperparathyroidism, certain medications (including PPIs and steroids), low blood Vitamin D. Genetics seems to play a role too, although I'm not convinced that it's osteoporosis itself that's inherited, or rather, whether it's a disease or condition (like coeliac or low Vitamin D) that's inherited and/or family approach to lifestyle. It also needs to be remembered that the modern definition of osteoporosis, which is having a t-score (as measured by DEXA scan) of -2.5 or worse, brings far more people into osteoporosis than in the past, when it was diagnosed following a fragility fracture. I personally believe that fragility fractures are still a far more accurate way of making the diagnosis, although I do understand that once you've fractured it's too late to prevent the fracture from happening! Bone density alone is a very poor predictor of fracture risk (and it's fracturing that's the cause for concern), which is why it's common to have fragility fractures with osteopenia and sometimes even normal bone density, yet some people with very poor bone density never fracture.
my specialist said that in 30 years he’d never seen anyone do it. I’m super fit and for decades I did hours of weight bearing exercise per week plus running marathons and took Vit D supplements, no calcium deficiency. I still got osteoporosis! There is no research showing definitively that exercise can reverse or prevent osteoporosis. I wish there was. However, I have had a significant improvement by taking Evenity, with no side effects. I still do all the exercise as well.
NHS Specialists prescribe medication and don't see those who don't take it, so I wouldn't expect a specialist to see anyone who maintains bone density without it. My bone density has hardly changed in 10 years, and has been stable for the past 5, with an improvement in my spine. I don't take medication.
It’s a personal decision for everyone. Obviously I’m not keen on meds unless they are absolutely necessary but having suffered awful fractures I felt for me they are. I want to throw everything at it - pharma treatments plus diet and exercise. I thought long and hard about it considered how I’d feel if I went against medical advice, rejected drug treatments then had more dreadful fractures. I weighed up the probabilities of serious side effects with the drugs (low to very low) against my probability of more fractures (high to very high). But as I say, it’s a personal decision for everyone.
Yes, I might feel differently if I'd fractured.
I think people tend to underestimate the impact of fractures. Most of us have had one as a kid, or our friends did, and it healed quickly and was fun signing the cast. As an adult it is very different - fractures can ruin your life. Agony for months followed by permanent impairment and disability. You risk mobility, loss of independence, permanent constant pain - I couldn’t get dressed without crying in agony. I couldn’t get dressed by myself at all for ages, couldn’t drive etc etc, A high proportion of hip fractures are associated with premature death. In my case, I recovered very well because I’m relatively young and was extremely fit prior to the first fracture. But I believe this was largely due to a year of intensive physiotherapy which not everyone can afford. Exercise is great, but very few people really will commit to the level needed to make a difference, especially if they are in their fifties or older and not done much for years! Also - it gets harder when you get older. Exercise is brilliant, I love it, I believe it is part of the answer but for me, why turn my back on modern medicine when I’m lucky enough to live in a time and place where it’s available and is free at point of need? I would do anything to reduce my chance of more fractures.
I too, turned down drugs, and did exercise and changed diet. Massive improvement over 2 years, then stable over the next 5. Don’t take drugs unless essential. I’ve also had 2 cancers. Strangely, travel insurance companies always ask (re cancer), ‘were you offered and did you refuse chemo or radiotherapy?’. With osteoporosis, there is no question about turning down drugs. Only follow up question is about number of fractures over the preceding 5 years. So, their medical advisers don’t think the drugs are relevant? Hope this doesn’t change.
Good news that you are stable Justme16. If you are happy to say, what are your T scores please?
My spine has a T score of -2.7.
Hello Rhubarbtr. I am glad you have no side effects and significant improvements.
Thank you - me too! Have a good Christmas
I was keen to go in a diet/exercise route and so, the day before I was to have a phone conversation with the Rheumatology consultant, I phoned the ROS nurses.. She was adamant that medication was the way forward. She mentioned the ROS work 'Strong, steady, straight' which I brought to the attention of a physio I go to who subsequently advised me on an exercise regime.. Best of luck.
Hello Maker-of-soup.Maybe silly question but are the excercises helping?
I feel better in myself but really it's impossible to know. My balance could be improved so that is what I am concentrating on. I will keep cycling even though it's not doing anything to my bones.. it's what my husband and I enjoy.
Hi Greenllama ,
Just dropping by to wish you a warm welcome to our community! Thank you for joining us here 
Just in case you haven't seen our website already, we have lots of information about living with osteoporosis, receiving a diagnosis, understanding scan results and much more: theros.org.uk/
We also have information about nutrition for bones which might feel particularly relevant at this time: theros.org.uk/information-a...
Hope you can continue to connect and share with our community
Wishing you all the best on your health journey,
Lulu
ROS Moderator
I was diagnosed with osteopaenia over 20 years ago , prescribed Calcium and D3. I was rescanned and told my bones were fine but stayed on the Calcium. I am fit and active but fell and had a fractured neck of femur 3 months ago. I had an IV dose of Zoledronate a month ago with no immediate problems. Not to scare you but consider all sides of the issue. Good luck
Thanks, will do 🙂. Hope your femur has healed well.
Thank you all for your replies and good wishes 🙂.
Alendronic acid and mental health
Just beeen diagnosed with osteoporosis but concerned about side effects of Alendronic Acid- blurred and loss of vision 
Alendronic acid - to take or not to take?
Codeine with paracetamol 
