The Better Bones Blog

by Dr. Susan Brown, PhD.

osteopenia treatments

Osteopenia Treatments — What Works?

Women often come to me looking for help with osteopenia treatments, and I’m happy to oblige — but usually I have to clear up a few misconceptions first. The biggest one is that there’s automatically something “wrong” just because they were told they had osteopenia after a routine bone scan. “If it ain’t broke, don’t fix it,” goes the old saying, and in many cases, osteopenia is mostly a reflection of a woman’s slender body type.

But for those situations where there is cause for genuine concern — women with a family history of osteoporosis, documented menopausal bone loss that exceeds the usual amount of around 2% per year, or a low-impact fracture — there are many ways to reduce bone loss and support bone health.

Looking for natural osteopenia treatments? Here are seven specific actions you can take — without resorting to bone drugs — that have been shown to help increase bone strength and density:

7 ways to naturally increase bone density

#1 Engage in regular weight-bearing exercise. Bone and muscle are a team, and they’re a use-or-lose proposition. We’ve seen dozens of studies that show the bone-building benefits of resistance and weight-bearing exercise, and we recently highlighted one study of high-intensity resistance exercise that got amazing results in postmenopausal women with osteopenia and osteoporosis.

#2 Engage in low-intensity exercise too. Even low-intensity activities like walking a dog for 20 minutes daily have a positive effect on bone health. Add a weighted vest to make your walk a weight-bearing exercise, and you’ll have an easy additional way to help your bones stay strong.

#3 Ensure you have adequate amounts of key bone-building nutrients — especially vitamin D. Calcium (though it’s an important bone mineral) isn’t the ultimate nutrient for bone health, and indeed if it isn’t balanced with other key nutrients, it can be harmful. Multiple studies have identified vitamin D as an essential piece of the puzzle — and they’ve also indicated that many of us don’t have adequate vitamin D stores. I recommend baseline vitamin D testing to determine whether you’re deficient in this all-important nutrient, because true deficiency is a serious health concern (and not just for bones) that needs to be addressed.

#4 Make vitamin K your new best friend. There’s a great deal of new research that shows vitamin K is vital for bone health, and for cardiovascular health as well. Some recent studies have even shown that one form of vitamin K, MK-7, is more effective at building bone than using bone drugs.

#5 And get to know all of the 20 key bone building nutrients. We have mountains of new information on vitamins D and K and their benefits for bone health (and whole body health), but I can also list at least 20 key nutrients that we need to stay healthy. Get to know them — and make sure you are getting enough of them.

#6 Develop an alkaline diet. An alkaline diet helps reduce the chronic, low-grade acidosis that eats away at your bones — something most people on a standard American diet aren’t even aware is affecting them. There’s recent research that shows just how important an alkaline diet is for those at risk for osteoporosis.

#7 Stress less. Amazingly, stress is highly correlated with fracture risk and bone loss (and that’s above and beyond all the other health issues it causes). Taking concrete steps to lower your stress levels is an easy way to address your bone health.

Empower yourself about osteopenia — register today!

If you’ve been told you have osteopenia, I encourage you to join me in my upcoming on-line course, Moving Beyond Osteopenia. I have developed this course to empower each of you with a deeper understanding of osteopenia and osteopenia treatments, what it might mean for you and how to make truly informed decisions about osteopenia treatment and your overall bone health.

This dynamic, information-packed course  comes with a live Q&A session with me where I answer your questions and comment on your concerns.

Register today and join us as we dive deeper and find out exactly what it takes to build stronger bones for life!


grandmother protecting children's bone health

Are we setting kids up for osteoporosis?

Recent studies point to a worrisome trend: children and young adults, especially girls, have become a great deal more sedentary in recent years, and it’s affecting their health. And while most of these studies talk about the short-term impacts this has — rising obesity and increased depression and anxiety being among them — I wonder about the impact of this lifestyle on children’s bone health and risk for osteoporosis as they grow older.

Sedentary lifestyles among kids and teens becoming the norm, especially for girls

Researchers from the U.S. National Institute on Aging in collaboration with Johns Hopkins’ Bloomberg School of Public Health and North Carolina State University, looked at activity levels in 12,589 participants grouped by age: children (6–11 years); adolescents (12–19 years); young adults (20–29 years); adults at midlife (ages 31–59); and older adults (60–84 years). Slightly more than half (51%) of the participants were female.

The findings that were most startling—and concerning—were that among children, more than 25% of boys and 50% of girls age 6–11 had not met the World Health Organization (WHO) recommendation that children age 5–17 get at least 60 minutes of moderate-to-vigorous physical activity every day. This is a much higher level of sedentary behavior than was previously thought to exist in children. And it’s even worse among adolescents: more than 50% of male and 75% of female adolescents age 12–19 did not meet WHO activity level recommendations.

What will happen to children’s bone health when they become adults?

Well, we know that the peak time for building bone happens in adolescence and young adulthood. And we also know that bone (and muscle) are a “use it or lose it” system — no exercise means muscle doesn’t move, and non-moving muscle means bone isn’t stimulated to turn over and strengthen. So if children, and especially adolescents, are sedentary, it means they are not maximizing their bone building during the crucial peak bone-building period of their lives. And that means that later in life, when losing bone is common, they won’t have as much to spare, putting them at risk of osteoporosis.

It’s especially problematic for the girls and young women in the study, because as we know, when women reach midlife, it is often the case that they lose bone during menopause. This menopausal bone loss isn’t necessarily a major problem — unless the woman did not build adequate bone reserves during adolescence and young adulthood. And this study suggests that the majority of girls in the study were particularly prone to being sedentary — which can have devastating long-term consequences.

 It is estimated that a 10% increase in children’s peak bone mass would delay the development of osteoporosis by 13 years. 

children's bone health chart

So what can we do to protect children’s bone health?

I have some thoughts:

  • Let’s all be aware that our daughters and granddaughters need to be more active. Start the habit of exercise early. We have this picture of little girls in our society as delicate flowers — but girls can be just as rough-and-tumble as boys if allowed to be! But whether it’s ballet classes or the soccer field, getting them involved in physical activities can only benefit them, short term AND long term.
  • And let’s also remember that when it comes to activity, it doesn’t necessarily have to be vigorous. Whether it’s a child or an adult, even low to moderate levels of physical activity can be beneficial (and they’re certainly more beneficial than sitting!)
  • If the children and adolescents in your life have sedentary habits, model a different lifestyle for them. I guarantee that no adolescent wants their mother or grandmother outdoing them on the hiking trail — so if you set the pace, they’ll keep up!

You can also help them by ensuring they get adequate nutrients for bone building in the teen years — via a healthful diet if you can manage it, but picky eaters may need nutritional supplements.


Verma VR, Dey D, Leroux A, et al. Re-evaluating the effect of age on physical activity over the lifespan. Prev Med 2017;101:102–108.

What is the difference between osteopenia and osteoporosis?

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Some clients come to me wondering about the difference between osteopenia and osteoporosis. Often, they have just been told that their “diagnosis” of osteopenia means they need bone drugs to prevent a life-altering fracture.

I’m not surprised by their confusion, because most physicians are just as confused when it comes to fracture risk. But the evidence is clear: osteoporosis and osteopenia are not the same thing, and their risk of fractures is not the same either.

Here is the difference osteopenia and osteoporosis, in a nutshell:

Osteoporosis suggests a disease process; osteopenia is a description of lowered bone density. 

When you have a diagnosis of osteoporosis, it means you have an actual disorder that can be seen under a microscope. The word “osteoporosis” means “porous bone,” and a close look at the bones of someone with osteoporosis shows the bones are more like Swiss cheese than the spongy appearance of healthy bone.

Osteoporosis is not a normal response to aging, but is indicative of  long-term imbalances which culminate in a bone weakening disease process.

Osteopenia, on the other hand, is not a diagnosis. It’s a description. This is a key difference between osteopenia and osteoporosis. The word “osteopenia” means “low bone mass”—and all it’s really doing is stating an observation that your bone mass is lower than that of a woman in her late 20s—someone at the peak of their bone-building and strength.

I’m always tempted to roll my eyes and say “Well, of course!” — because just as you might expect a 55-year-old woman’s hair to be a little grayer than a 25-year-old’s, it’s realistic to expect her bones wouldn’t be as dense as those of a woman 30 years younger.

Osteoporosis warrants an extensive work-up looking for causes of excessive bone loss. Osteopenia  may or may not be an early warning sign of bone weakening and generally does not trigger the need for a work-up or conventional medical treatment — with some exceptions.

Since osteoporosis is a disease process with a lot of potential factors, a diagnosis of osteoporosis should initiate a full work-up.

Osteopenia, however, is not a diagnosis nor a disease and often, in fact, is the result of statistics.  Because bone density testing “T scores” represent a statistical calculation — by statistical definition, 15% of healthy young people will be told they have osteopenia. Most often these are small boned, light weight individuals. In these cases having “osteopenia” is simply a product of an individual’s general body type and more a statistical artifact testing bias than anything to do with their actual bone health. 

When is osteopenia something to take seriously?

Since women’s peak bone mass occurs in their late 20s, it stands to reason that some amount of bone loss takes place throughout the subsequent decades. Whether or not slipping into “osteopenic” bone density range is a serious concern depends on the individual case. This is where we find the proverbial devil hiding in the details. Here’s how this goes… 

At the Center for Better Bones, our developing clinical findings have discovered different “types” of osteopenia — some being more troublesome than others. I will be detailing these clinical findings in our upcoming online course, Moving Beyond Osteopenia. For now let me mention a few key factors that distinguish a harmless finding of osteopenia from one that may well signal serious bone weakening:  

  • Finding “osteopenia” in a bone scan becomes concerning if subsequent scans reveal rapid and excessive bone loss, such as more than 2% a year loss during the menopause transition, and more than .05 to 1 % a year loss from 5 years after menopause and onwards.  On-going excessive bone loss signals that one is on the road to osteoporosis.
  • Osteopenia found in those whose parent(s) have fractured a hip fracture could be an early red flag of future bone fragility. It warrants follow-up to find out whether this individual herself is losing bone, and if so, how rapid is the loss. 
  • Entering menopause with osteopenia is a concern as the average woman loses 10% of her bone mass between the first few years before and the first five years after her last period. Some women lose up to 20% in this transition. Starting the menopause transition with lower than normal bone mass signals the need for a life-supporting, bone-preseving program.
  • Anyone with osteopenia who has experienced a low-trauma fracture has documented bone weakness and would do well to take their “osteopenia” seriously by implementing a bone building lifestyle and nutrition program.

To conclude, let me say that the limitations of bone density testing are now clear. Amongst other things, it is now obvious you cannot foretell fracture by bone density alone. Many women with normal or near normal bone mass experience fracture. If you’re concerned about osteopenia and interested in taking charge of your bone health, I invite you to join me in my upcoming online course, Moving Beyond Osteopenia: An Empowered Woman’s Course on Demystifying Her Diagnosis.



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