It is usually impossible to know if you have osteoporosis, or it’s precursor osteopaenia. Most people (usually women) have a bone density test done at some point after menopause, as prior to this, the naturally higher level of oestrogen acts as strong bone protection. Reasons to suspect you are at higher risk of bone thinning include: thin build, low exercise level, smoking, early menopause, and nutrient malabsorption issues including chronic IBS, IBD or gut problems.
If you do discover on bone density testing (which involves a simple X-ray), that your bones are not what they used to be, you need to start a bone strengthening plan.
If you are at the stage of osteoporosis, your mainstream GP will usually offer you a weekly bisphosphonate tablet or 6-monthly injection (“Prolia”). These prescription medications work by slowing down the osteoclasts (which break down old bone), leaving the osteoblasts to go about their work of building bone up.
Sounds simple, right?
But think about it a bit more deeply and you would be right to have concerns about messing with this delicate balance. Evidence shows that the bone that is built up when people use bisphosphonates is less structurally strong, as the damaged bone is not being cleared away as it should. This lesser quality bone appears not to be as strong. And strong bone is what we are trying to achieve- the point of preventing and treating osteoporosis is to prevent fractures. (And fractures can include arms and legs from falls but also fractures of your vertebrae in your spine when you just bend over, if you have significant osteoporosis).
I prefer to recommend a natural approach to bone strengthening for most people. Versions of this can be used by people who have osteopaenia, not osteoporosis, or who just want to maintain their bones in an optimal state.
Here are the key nutrients that support bones-
Other trace minerals including boron, copper and manganese
Plus- exercise and healthy lifestyle measures including lowering or managing stress and getting adequate sleep have all been shown to support bone density!
It is important to firstly eat foods that are dense in the above nutrients. If you have a low or non- dairy diet, that is fine. There are plenty of other high calcium foods. Testing your levels of some of the above nutrients can be very useful also, as you may discover that supplementation is required. But two critical points:
Calcium via common supplements is not the best form to use. Osteoporosis guidelines now acknowledge that not only are high doses of calcium poorly effective in bone strengthening but they actually significantly increase your risk of a heart attack and stroke. It seems that when you take calcium (such as the popular Caltrate), it is laid down preferentially in your blood vessel walls, rather than going into your bones. The only calcium form that I recommend is calcium hydroxyapatite- not found in mainstream supplements but in products such as Bioceuticals Advacal Forte. This form acts completely differently in the body and has good evidence backing it.
The key piece of information here is that you need much more than just calcium for bones!