Osteopenia Treatment

Medically Reviewed by David Zelman, MD on November 27, 2022

When you have osteopenia, your bones are weaker than they used to be but not weak enough for you to be diagnosed with osteoporosis. That’s a condition in which bones are so thin they break easily. If your bones keep getting thinner over time, though, osteopenia can turn into osteoporosis.

But it doesn’t have to. A range of treatments and healthy habits can strengthen your bones, slow osteopenia, and prevent osteoporosis.

If you have strong bones, a healthy lifestyle can help keep them that way. If you already have osteopenia, those same lifestyle choices can lower the chances you’ll get osteoporosis. Make these practices part of your routine:

Exercise. Like muscle, bone gets stronger when you use it. The best moves for bones are weight-bearing exercises that force your body to work against gravity. That includes walking, stair climbing, dancing, and lifting weights.

Diet. For strong bones, you need a diet rich in calcium and vitamin D. High-calcium foods include:

  • Dairy products such as yogurt, low-fat milk, and cheese
  • Green vegetables such as broccoli and collard greens
  • Sardines and salmon, with bones
  • Tofu

Your body makes its own vitamin D when sunlight hits your skin. If you spend a few minutes outdoors in the sunshine each day, you get at least some of the vitamin D you need. Don’t spend too much time in the sun, though -- that raises your risk of skin cancer. A few foods naturally have vitamin D. Others, such as grains and dairy foods, are fortified with it. Good sources include:

  • Fish such as salmon, tuna, and mackerel
  • Fish liver oils
  • Beef liver
  • Cheese
  • Egg yolks
  • Fortified breakfast cereals, juices, milk products, yogurt, and margarine

Don’t smoke, and drink less. If you smoke, try to quit. Studies have shown a strong link between cigarette smoking and lower bone density.

If you drink alcohol, do it in moderation. That means no more than one drink per day for women and two daily drinks for men. Too much beer, wine, or liquor can mess with the balance of calcium in your body and change how your body makes hormones and vitamins for healthy bones. Having too much to drink can also make you more likely to fall, which means you could break a bone.

Cut back on salt and caffeine. Both may make your body lose more calcium and bone. Caffeinated coffee and sodas have been linked to osteopenia, so try to cut back or switch to the decaf kinds. Check labels of packaged foods to see how much salt (or sodium) is in a serving.

In some cases, especially if you’ve already broken a bone, your doctor may prescribe medicine to lower your chances for osteoporosis and to prevent more fractures. Medications that can treat osteopenia or prevent osteoporosis include:

Bisphosphonates. These meds slow your body’s natural process for breaking down bone. You may keep the level of bone you have or even get a small boost of bone density. Bisphosphonates are the main drugs doctors use to prevent and treat osteoporosis in postmenopausal women. They include alendronic acid (Fosamax), ibandronic acid (Boniva), risedronic acid (Actonel), and zoledronic acid (Reclast). Most bisphosphonates are pills you take usually once a week or once a month. But Reclast comes as an injection, usually once a year.

Hormone replacement therapy. Once a popular treatment to prevent bone loss, doctors rarely use it for that anymore because studies found that it made people more likely to get blood clots in their legs and lungs, along with other health problems. Sometimes, if hormone replacement helps a woman with menopause symptoms, their doctor may recommend that they keep taking it for bone loss too. Talk to your doctor to see if you should consider this therapy.

Teriparatide (Forteo) is a drug that acts like a hormone made by your parathyroid glands. It's the first medicine to help the body make new bone. You take it daily as a shot beneath your skin.

Raloxifene (Evista). This drug can prevent and treat osteoporosis. It may also lower your chances of getting breast cancer, but scientists need more research to know that for sure. It’s a pill you take once a day.

Each of these drugs has its own risks and possible side effects, so make sure you talk with your doctor about how they will affect you before you take them.

Your doctor may recommend medications if you’ve already broken a bone. But many people try a number of nutritional supplements and herbs before they have a fracture to build stronger bones. The main ones are calcium and vitamin D supplements.

Most adults should get between 1,000 and 1,200 milligrams of calcium and 600 to 800 international units (IU) of vitamin D every day. If you aren't getting enough of these nutrients in your diet and don't spend much time in the sun, ask your doctor if you should take a supplement.

Other nutritional supplements may help strengthen bones, but so far, there’s little research showing how well they work. These include:

Herbs that might be helpful include:

Before you take any herbal or nutritional supplements, talk to your doctor about them.

Show Sources


University of Michigan Health Center: "Osteoporosis in Women" and "Osteoporosis."

Columbia Medical Center: "To Treat or Not to Treat?"

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Conditions and Behaviors That Increase Osteoporosis Risk."

MedlinePlus: "Osteoporosis."

National Osteoporosis Foundation web site.

National Institutes of Health Office of Dietary Supplements: "Dietary Supplement Fact Sheet: Vitamin D."

MedlinePlus: "Calcitonin Salmon Nasal Spray."

American College of Rheumatology: "Teriparatide (Forteo) for the Treatment of Osteoporosis."

University of Maryland Medical Center: "Omega-3 fatty acids."

NIH Office of Dietary Supplements: “Vitamin D.”

Cleveland Clinic: “Soda, Tea and Coffee: Which Can Lower Your Bone Density?”

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