By Barbie Cervoni, RD 

 Medically reviewed by Emily Dashiell, ND

Traditional treatment options for osteoporosis include fall prevention, exercise, adequate nutrition, and medications. In addition to traditional options, natural remedies may be beneficial. The goal of treating osteoporosis is to prevent further bone damage.

Some bone loss is a natural part of aging, but hormonal changes, family history, and certain lifestyle factors, such as a poor-quality diet and smoking, can contribute to osteoporosis.1

This article investigates natural treatment options that can be utilized in the treatment and management of osteoporosis.

 skynesher / Getty Images.

Osteoporosis Diet

Bone building occurs during childhood; people experience peak bone mass sometime during their 20s.2 To prevent osteoporosis, it is important to achieve peak bone mass, which requires eating a nutritious diet that contains foods rich in calcium, magnesium, selenium, vitamin K, vitamin D, and protein. To treat osteoporosis, you still need to get enough of these nutrients.3

What to Eat

Some experts recommend considering your total dietary pattern rather than focusing on specific nutrients in isolation.4 That's because getting a variety of nutrients is important for bone health.

Foods rich in calcium and vitamin D are key for building bone and maintaining bone strength.4 Calcium-rich foods include dairy products (cheese, yogurt, milk, and fermented milk products). Dairy products also contain other nutrients important for bone health, including protein, magnesium, phosphorous, and vitamin B12.4

If you do not eat dairy, you can choose foods fortified with calcium, including yogurt alternatives, nut-based milks, orange juice, cereals, and tofu. Salmon and fish with bones, like sardines, contain calcium. Plant-based calcium sources include kale, cabbage, and other leafy green vegetables.

Vitamin D is responsible for calcium absorption. It is found naturally in only a few foods but can also be made in the body from sun exposure. People who are deficient in vitamin D may need to take a supplement.

Food sources of vitamin D include fatty fish (such as trout, salmon, tuna, and mackerel) and fish liver oils, beef liver, egg yolks, fortified milk, other fortified foods (milk alternatives, breakfast cereals, juice), and mushrooms treated with ultraviolet (UV) light.5

Certain minerals, such as magnesium and selenium, can also impact bone health.6 Natural sources include pumpkin seeds, sweet potatoes, cashews, beans, spinach, peanuts, Brazil nuts, chicken, fish, and shrimp.

These foods are also rich in protein, a macronutrient that plays a role in bone volume, mass, mineralization, and formation.4 Other protein sources include whole grains, soy, and animal products like eggs, dairy, and beef.

Soybean foods are sources of soy isoflavones, which have estrogen-like activity and are called phytoestrogens. Some studies show this may be beneficial for bone health.7 Soybean foods high in isoflavones include soybeans, edamame, miso, natto, tempeh, and tofu.8

Lastly, foods rich in vitamin C9 and vitamin K10 contribute to healthy bones. Foods rich in vitamin C include citrus fruits, berries, peppers, tomatoes, fortified juice, and cruciferous vegetables (in which vitamin K is also found).

Vitamin D Deficiency

Vitamin D deficiency can aggravate osteoporosis, especially in older people and people who are postmenopausal.4 If you are concerned with your vitamin D status, have your levels checked by a healthcare provider. Then meet with them or a registered dietitian to discuss whether supplementation is needed and in what dose.

Eating a variety of foods is important for bone health and will help you meet your nutrient requirements for each vitamin and mineral. If you are concerned that your diet is lacking, you can meet with a healthcare provider to discuss supplementation (if needed).

What to Avoid

Too much alcohol and sodium may interfere with how your body metabolizes and absorbs calcium and vitamin D, which are important for bone health.

It's uncertain the impact specific amounts of alcohol have on bone. However, experts know that alcohol can impact the way calcium and vitamin D function.6 Therefore, the National Institute on Aging recommends drinking in moderation, if at all.3

The verdict on sodium intake and bone health is controversial. Some studies suggest too much sodium can increase calcium excretion, while other studies show that ingesting more than 2,300 milligrams (mg) of sodium daily does not increase the risk of osteoporosis.6 Intake below that level is suggested for people with high blood pressure.

Nevertheless, the Bone Health and Osteoporosis Foundation recommends limiting processed foods high in sodium, like snack foods.11

Some studies have found a link between a high intake of soft drinks, especially cola, and an increased risk of fractures.12 Colas contain phosphoric acid, which may reduce calcium in the body. But this area of research is not yet conclusive.13

Exercise

Weight-bearing exercise helps improve bone strength in youth and adolescence. Weight-bearing exercise in adulthood aims to build strength and muscle mass, improve coordination and balance, improve daily function, and delay loss of independence associated with osteoporosis.14

Specific weight-bearing exercises and activities include squats, step-ups, lunges, jumping rope, jogging, hiking, and stair-climbing. It is recommended to start under the guidance of a healthcare provider (if you are not already used to exercising) to avoid injury or pain.

Lifestyle Changes

Smoking, being inactive, and drinking too much alcohol can increase the risk of bone loss.11 If you smoke, consider getting help in quitting. Reduce your alcohol consumption if you drink more than moderately.

Aim to move daily; walking is a great exercise to start with. Regular checkups with your healthcare provider are also important for assessment and treatment.

Acupuncture

Acupuncture is considered a complementary and alternative therapy in treating osteoporosis. That means some people use it along with mainstream treatment options, while others use it as an alternative. Acupuncture may help treat osteoporosis by improving bone mineral density.

In a meta-analysis published in the American Journal of Chinese Medicine, researchers found that warm-needle acupuncture—in which burning moxa cones, a compacted form of mugwort herb, are placed on the handle of the needle after insertion—could increase the bone mineral density of specific bones such as the femur.15

The type of acupuncture delivered may matter, and more long-term research is needed to determine the exact effects. But this may be a worthwhile therapy to explore with your medical team if you are interested.

Medicinal Herbs

Some research suggests that certain herbs, such as red clover,16 horsetail,17 turmeric,18 and red sage19 may have beneficial effects in treating osteoporosis. Notably, most studies examining the benefits are small and short in duration. Some are animal or test tube studies rather than being human studies including people with osteoporosis. Therefore, more research is needed.

In addition, herbs are not regulated by the Food and Drug Administration (FDA). Long-term use of some of these herbs is not advised. Before beginning any new regimen, you should discuss it with your medical team.

Melatonin

Melatonin is a hormone that helps regulate circadian rhythm and is known for its role in sleep. But melatonin may also play a role in bone health.

There is an association between age-related reductions in melatonin with bone loss and osteoporosis.20 Melatonin may prevent bone degradation, reduce oxidative stress associated with bone loss, and promote bone formation.

Yet, most studies that have been done are in animals or in test tubes. More studies conducted in humans are needed to better understand melatonin's role in treating osteoporosis. The dosage and timing of supplementation also need to be investigated.

Tai Chi

Tai chi is a form of exercise with slow, rhythmic movements. In a 2017 meta-analysis of randomized control trials, researchers found that various forms of long-term tai chi (at least 24 weeks) were effective at reducing bone mineral density loss in certain areas of the body.21

Their data included older adults, perimenopausal and postmenopausal people, people with osteoarthritis, and cancer survivors.

The authors note that the type of tai chi, which may differ in impact and use of weight-bearing exercises, as well as the duration of sessions and length of programs, are important factors to consider in examining the data. In addition, the qualifications of the instructor can impact results.

These results are promising and encouraging, however, more research examining these parameters is needed.

Summary

Natural remedies for osteoporosis are plentiful and could be a starting point or an addition to conventional treatment options for osteoporosis. The same concepts used to prevent osteoporosis may help treat it.

Eating a variety of nutrient-dense foods that contain ample amounts of calcium, vitamin D, and other vitamins and minerals is an important first step. In addition, exercise, lifestyle changes such as stopping smoking if you smoke, adding various herbs to your diet, and practicing tai chi may be beneficial. Before starting anything new, discuss it with your medical team.

Sources

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International Osteoporosis Foundation. What is osteoporosis?

National Institute of Aging. Osteoporosis.

Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and dietary patterns related to osteoporosis. Nutrients. 2020;12(7):1986. doi:10.3390/nu12071986

National Institute of Health. Office of Dietary Supplements. Vitamin D.

Webb D. Update on osteoporosis-what you should know about dietary recommendations and the latest therapeutics. Today's Dietitian. 2021; 23(2):4.

Barańska A, Kanadys W, Bogdan M, et ak. The role of soy isoflavones in the prevention of bone loss in postmenopausal women: a systematic review with meta-analysis of randomized controlled trials. Journal of Clinical Medicine. 2022; 11(16):4676. doi:10.3390/jcm11164676

Harvard T.H. Chan School of Public Health. Straight talk about soy.

Chin KY, Ima-Nirwana S. Vitamin C and bone health: evidence from cell, animal and human studies. Curr Drug Targets. 2018;19(5):439-450. doi:10.2174/1389450116666150907100838

Tsugawa N, Shiraki M. Vitamin K nutrition and bone health. Nutrients. 2020;12(7):1909. doi:10.3390/nu12071909

Bone Health and Osteoporosis Foundation. Nutrition-food and your bones-osteoporosis nutrition guidelines.

Chen L, Liu R, Zhao Y, Shi Z. High consumption of soft drinks is associated with an increased risk of fracture: a 7-year follow-up study. Nutrients. 2020;12(2):530. doi:10.3390/nu12020530

Harvard Health Publishing. By the way, doctor: does carbonated water harm bones?

National Institute of Arthritis and Musculoskeletal and Skin Disease. Osteoporosis overview.

Pan H, Jin R, Li M, Liu Z, Xie Q, Wang P. The effectiveness of acupuncture for osteoporosis: a systematic review and meta-analysis. Am J Chin Med. 2018;46(03):489-513. doi:10.1142/s0192415x18500258

Thorup AC, Lambert MN, Kahr HS, Bjerre M, Jeppesen PB. Intake of novel red clover supplementation for 12 weeks improves bone status in healthy menopausal women. Evid Based Complement Alternat Med. 2015;2015:689138. doi:10.1155/2015/689138

Arbabzadegan N, Moghadamnia AA, Kazemi S, Nozari F, Moudi E, Haghanifar S. Effect of Equisetum arvense extract on bone mineral density in Wistar rats via digital radiography. Caspian J Intern Med. 2019;10(2):176-182. doi:10.22088/cjim.10.2.176

Riva A, Togni S, Giacomelli L, et al. Effects of a curcumin-based supplementation in asymptomatic subjects with low bone density: a preliminary 24-week supplement study. Eur Rev Med Pharmacol Sci. 2017;21(7):1684-1689.

Guo Y, Li Y, Xue L, et al. Salvia miltiorrhiza: an ancient Chinese herbal medicine as a source for anti-osteoporotic drugs. J Ethnopharmacol. 2014;155(3):1401-1416. doi:10.1016/j.jep.2014.07.058

Li, T, Jiang, S, Lu, C, et al. Melatonin: another avenue for treating osteoporosis? J Pineal Res. 2019;66:e12548. doi:10.1111/jpi.12548

Zou L, Wang C, Chen K, Shu Y, Chen X, Luo L, Zhao X. The effect of taichi practice on attenuating bone mineral density loss: A systematic review and meta-analysis of randomized controlled trials. Int J Environ Res Public Health. 2017;14(9):1000. doi:10.3390/ijerph14091000

By Barbie Cervoni, RD
Cervoni is a New York-based registered dietitian and certified diabetes care and education specialist.