What Are the Best and Safest Treatments for Osteoporosis?

Written by Stephanie Booth
Medically Reviewed by Jabeen Begum, MD on July 14, 2025
12 min read

The best and the safest treatments for osteoporosis help slow down bone loss and protect your bones from getting weaker. They lower your risk for fractures, especially as you get older. Your treatment may include medications, balance and strength exercises, and changes to your diet to support bone health.

Osteoporosis weakens and thins your bones, making them more likely to break. Under a microscope, your bone tissue may look like there are holes in it, like Swiss cheese.

“When bones get weaker, they can break more easily — even from small accidents like tripping or falling from standing up,” says Michael Gordon, MD, a spine surgeon at Hoag Orthopedic Institute in Southern California.

Common places for these breaks include your wrist, shoulder, hip, and spine. “The good news is that there are treatments and lifestyle changes that can help slow down bone loss and even improve bone strength,” Gordon says.

Understanding bone loss and risk factors

Your bones are living tissue. Although you can’t feel it happening, old cells in your bones are always being replaced with new ones. Until you’re in your mid-20s, your body makes new cells at a faster rate. This helps your bones get strong.

After age 50, this process naturally reverses. You start to lose more bone cells than your body can replace, which can lead to weaker bones over time. That means “even healthy, active people can still get osteoporosis as they age,” Gordon says.

In women, the most common cause of osteoporosis is menopause. “During this time, the levels of hormones like estrogen and progesterone go down,” Gordon says. “These hormones help keep bones strong.” 

Other risk factors include:

  • A family history of osteoporosis
  • Being very thin or having a small frame
  • Being White or of Asian descent
  • Not getting regular exercise
  • Not getting enough calcium or protein in your diet
  • Tobacco use
  • Drinking more than two servings of alcohol each day
  • Some medications, including prednisone, anti-seizure drugs, blood thinners, and diuretics (water pills)
  • Vitamin D deficiency
  • Eating disorders
  • Weight loss (bariatric) surgery
  • Certain health issues, such as chronic lung disease, low testosterone (for men), and endometriosis

About half of all women and 1 in 4 men over 50 may have osteoporosis. If you have it, you might notice changes in your body over time, such as:

  • Feeling like you’re “shrinking” or getting shorter 
  • Slumping or stooping
  • Low back pain

But the most common symptom is breaking a bone after a small accident that usually wouldn’t hurt your bones. Until then, you might not have any signs.

The only way to know for sure that you have osteoporosis is to get a bone density test, or what’s called a dual X-ray absorptiometry (DEXA) scan. This is an imaging test like an X-ray, which measures calcium and other minerals in your bones. If your results show that you have low bone density, your doctor will suggest osteoporosis treatment.

Bone density tests are suggested if you’re:

  • A person assigned female at birth (AFAB) and at least 65 years old
  • A person assigned male at birth (AMAB) and at least 70 years old
  • At risk for osteoporosis and at least 50 years old 

Your doctor could also order a DEXA scan for other reasons.

Simple choices that you make every day can slow down bone loss and help you stay as healthy as possible. “The best way to fight osteoporosis is to act early,” Gordon says.

These are some steps you could take:

Cut back on alcohol. It interferes with how well your body uses calcium and vitamin D. Try not to drink more than two alcoholic drinks each day. Talk to your doctor if you have trouble cutting back.

Take safety measures. For instance, you might wear shoes with better grip, remove slippery throw rugs from your home, use nightlights, or install a safety rail in your shower. The goal is to lower the chances that you’ll fall and break a bone.

Be active. Putting a little pressure on your bones, even when you’re taking a walk, helps them grow stronger. 

Work on your balance. Some types of exercise, such as yoga and tai chi, also can improve your posture and balance and can lower your risk of falling and breaking a bone.

Try not to sit too long. Stand up for at least five minutes every hour. Make stretching a habit you do at your desk, and look for tasks (such as phone calls) you can do while you get up and take a quick walk.

Getting enough calcium is crucial to help lower your risk for bone fractures.

Some good sources of calcium include:

  • Dairy products, such as milk, yogurt, and cheese (opt for low-fat or nonfat versions to make them healthier)
  • Kefir
  • Soy milk
  • Other plant-based milks or orange juices that are fortified
  • Tofu
  • Broccoli
  • Cauliflower
  • Salmon
  • Leafy green vegetables, such as collard greens, spinach, and kale 
  • Tahini

How much calcium do you need? Experts generally suggest:

  • 1,000 milligrams of calcium each day if you’re between ages 19 and 50
  • 1,200 milligrams per day if you’re a woman aged 51 or older or a man aged 71 or older

If you have dialysis for kidney issues, talk to your doctor about how much calcium you need. You’ll need to be careful not to have too much or too little.

It’s best to get your calcium from foods. That can be hard if you are:

  • Vegan
  • Lactose intolerant
  • Eat a lot of protein or sodium
  • Are taking long-term corticosteroids
  • Have a gastrointestinal condition such as inflammatory bowel disease (IBD)

If so, you may benefit from calcium supplements, but talk to your doctor first. They can check if it would worsen any health issues you have or interfere with medicines you take. Your doctor can also tell you if it’s important to take calcium supplements at a different time than your other medications.

There are some concerns that high doses of calcium supplements could raise your risk for heart disease, but more studies are needed.

To help your body absorb calcium from either food or supplements, you also need vitamin D. Experts advise getting 600 international units (IU) per day up to age 71, then bumping it up to 800 IU daily.

You can get vitamin D from fortified foods and also from sunshine. But it gets harder to make vitamin D as you get older and during winter. 

If you’re very low on vitamin D, your doctor may also suggest a supplement. Just don’t take too much more than advised. Too much vitamin D can cause symptoms such as throwing up, confusion, and weakness. It could also cause serious health issues, such as kidney failure and an irregular heartbeat. In some cases, it can be fatal.

Not all foods are good for your bones. Try to limit:

Sodium. Foods high in salt, such as chips, fast food, and canned foods, make it harder for your body to retain calcium.

Sugar. High amounts aren’t good for your bone health. That’s especially true for sweetened drinks. Researchers have found a link between soda intake and bone fractures. 

Caffeine. A lot of caffeine in your system forces your body to remove calcium at a faster rate. Try to limit yourself to 400 milligrams each day. That’s about four 8-ounce cups of coffee. But remember, many sodas, energy drinks, and even some foods also contain caffeine.

Alcohol. Heavy drinking can lower your bone density over time.

All exercises are great for your physical and mental health. But some workouts are especially good for your bones. These include:

Weight-bearing activities. Any activity that makes your body hold you up against gravity can help strengthen your bones. Most forms of exercise fall into this group, including walking, running, climbing stairs, dancing, or playing golf or tennis. Try to do this type of exercise at least four times per week for 30 minutes. 

Resistance exercises. When your muscles work hard against something, they get your bones involved. This is another way they can grow stronger. Using weights, resistance bands, and even your own body weight, such as when you’re doing a push-up, are all resistance exercises.

Check with your doctor before you take up a new type of activity, especially if you’ve been diagnosed with osteoporosis or have other health issues. If you’re new to these types of activities, a physical therapist or personal trainer can help you create a safe workout.

Not only does smoking lower how much blood circulates to your bones, but it also slows down the number of bone-forming cells that your body makes. Smoking also makes it harder for you to absorb all the calcium from the food you eat.

People who use tobacco have worse bone mineral density than nonsmokers. Nicotine can also cause your bones to heal more slowly after a break and raise your risk of complications.

While more research needs to be done, early studies show that vaping harms bone health, too. For instance, one study showed that people who vaped had 46% more fractures than people who didn’t.

Avoid falls and injury

Once you’re diagnosed with osteoporosis, you’ll have it for the rest of your life. That means trying to prevent falls and not break any bones will be important. Some things you can do include:

Stay safe. Always buckle your seatbelt in a car. Wear proper sports gear, such as a helmet when you ride a bike.

Get guidance. When you’re trying a new workout, take an in-person class, or ask someone with experience for help. They can correct your form so you don’t get hurt.

Don’t overextend yourself. For instance, if you have to get something from a high shelf, use a step stool or ladder instead of a chair. 

Clean up clutter. Too much stuff in your house can become a tripping hazard, which may lead to more falls.

Stay on sure footing. Use a nonslip mat in your shower, and make sure any rugs are firmly fixed to the floor. Clean up spills right away.

Which natural remedies help improve bone health in osteoporosis?

You may see products for sale online that promise to reverse bone loss. Before you buy, ask your doctor and do some research to see if they actually work.

So far, research into supplements such as fish oil, isoflavones, and black cohosh have been mixed. If you feel like you want to try a supplement as part of your osteoporosis treatment, talk to your doctor first. You’ll need to make sure that it won’t interfere with other medications you take or worsen your bone loss.

Daily lifestyle changes, such as trying to eat more calcium-rich foods, doing regular weight-bearing exercises, and quitting tobacco, are still the best natural remedies for osteoporosis.

“Taking only calcium and vitamin D is not enough to treat osteoporosis,” Gordon says. “Studies from the last 20 years show that using medicine is the best way to stop bones from breaking.”

As part of your osteoporosis treatment, your doctor could prescribe:

Bisphosphonates. These drugs slow down how quickly your body breaks down bone cells. Some are taken by mouth, while others are given by IV (through a vein in your arm) in a doctor’s office or hospital.

Bisphosphonates come with guidelines you’ll need to follow. For instance:

  • If you have a daily dose, take it right after you wake up, at the same time every day.
  • If you take a monthly pill, take it on the same day each month.
  • After taking a pill or tablet, wait at least 30 minutes before you eat, take any other medicines, or lie down.
  • If the drug is injected into your vein, your doctor will probably do regular blood tests to check your health.

Different bisphosphonates include:

Many doctors prescribe a bisphosphonate for osteoporosis treatment for five to eight years. Then, you’ll stop taking it for a year or two. If your risk for fractures is still high, you may need another course.

Selective estrogen receptor modules (SERMs). Raloxifene (Evista), another osteoporosis drug, is only to be used by women in postmenopause, after your periods have stopped for good. It works like estrogen to stop your bone loss. Studies show that Evista doesn’t raise your risk for breast or uterine cancers, but it can cause blood clots and increase hot flashes.

Parathyroid hormone (PTH). The medications abaloparatide (Tymlos) or teriparatide (Forteo) are a lab-made form of parathyroid hormone, which controls your calcium levels. They can help increase your bone mass. You get them as a daily shot, for up to two years. There’s some concern that in high doses, this type of osteoporosis treatment can raise your risk for bone cancer, but more studies need to be done.

Monoclonal antibodies. Romosozumab-aqqg (Evenity) is another option for postmenopausal women. It’s made from lab-made proteins that mimic antibodies in your immune system. Evenity boosts how quickly new bone cells form and slows down the breakdown of old bone cells in your body. You’ll get a monthly shot for a year. Romosozumab may increase the risk of myocardial infarction, stroke, and cardiovascular death.Romosozumab should not be initiated in patients who have had a myocardial infarction or stroke within the preceding year.

Biologics. Denosumab (Jubbonti, Prolia) is made from living organisms. It turns off the process that makes your body break down bones. It can be prescribed whether you’re a man or a woman. You get it as a shot at a hospital or clinic, once every six months. Denosumab is usually only prescribed if other osteoporosis medicines don’t help.

Medicines that you get as shots “are more expensive but work very well,” says Gordon. “Like all medicines, they may have side effects, but most people do fine with them.”

Menopausal hormone replacement therapy (HRT) — either estrogen alone or a combination of estrogen and progestin — is known to help preserve bone and keep fractures from happening. 

The drug Duavee (estrogen and bazedoxifene) is a type of HRT approved to treat menopause-related hot flashes. It may also prevent osteoporosis in women who’ve gone through menopause.

Duavee may raise your risk for many health issues, including gallbladder disease, some types of cancer, and dementia. It can also increase your risk for blood clots, stroke, and heart attack, even after you stop taking it. 

Your doctor will have to make sure the benefits of you taking Duavee outweigh its risks to your health.

The most common osteoporosis treatments include getting enough calcium through foods or supplements, doing regular weight-bearing and strength exercises, and taking medications. Regular checkups with your doctor and getting bone density scans are important to make sure your condition isn’t getting worse. Always go to the ER if you think you broke a bone or can’t move a part of your body.

Can osteoporosis be cured completely?

There’s no cure for osteoporosis. Instead, the goal of treatment is to keep more bone loss and fractures from happening. Lifestyle changes, such as quitting smoking, eating calcium-rich foods, and getting regular exercise are key. Medication also plays a big role.

What foods help improve bone density?

Foods that can help improve bone density include:

  • Calcium-rich foods, such as low-fat dairy products
  • Leafy greens, such as kale
  • Tofu
  • Beans
  • Fortified products, such as some types of cereal and orange juice

Don’t forget about foods that contain vitamin D, such as eggs and fatty fish like salmon. Vitamin D helps your body better absorb calcium.

Is walking good for osteoporosis?

Walking can be a part of osteoporosis treatment. It’s a weight-bearing activity, which means it can make your bones stronger. It can also help improve your balance. Aim for at least 30 minutes of exercise, four times a week, and don’t forget to do cardio and strength-building activities, too.