The People's Perspective on Medicine

Can You Boost Your Bone Density with Exercise?

If you can't tolerate bisphosphonate medications for osteoporosis, you may be able to boost your bone density with weight-lifting and weight-bearing exercise.

Weakened bones with low bone density put a person at risk for fracture. When an older person breaks a hip, the consequences can be devastating. As a result, it makes sense to look for ways to boost your bone density. Health care professionals often prescribe medications to improve bone density, but one reader had success with an entirely different approach.

How Can You Boost Your Bone Density?

Q. I have weak bones (osteopenia). I could not tolerate Actonel, Fosamax or Forteo.
Instead, I worked with a physical therapist on exercises to strengthen bones. I did mild weight-lifting exercises and resistance work with bands for two years.

After the next test, I got a phone call: “You have increased your bone density by 15 percent and it is now within normal limits.” I was flabbergasted. More people may want to try this approach instead of taking pills.

Which Drugs Will Boost Your Bone Density?

A. The first choice of most doctors in treating osteoporosis is often a bisphosphonate such as alendronate (Fosamax), ibandronate (Boniva) or risedronate (Actonel). These drugs slow down bone breakdown so that the bone-rebuilding cells can catch up. Despite their utility, these medications have some troublesome side effects, including serious inflammation of the esophagus.

Digestive Distress from Fosamax and Calcium:

Another reader wrote:

“I have been suffering terribly from constipation and heartburn. I am convinced that the calcium and Fosamax I take to build my bones are contributing to these problems. When I complain, my doctor just tells me to eat more fiber and take Metamucil. That makes me feel bloated and gives me gas.

“My neighbor says you have information on constipation and gas. Please send it since I am desperate.”

We responded that calcium and alendronate can both contribute to constipation. Fosamax may also cause heartburn, which can be a serious complication.

Managing Alendronate-Induced Constipation:

Besides fiber and fluids, some readers have found flax seed (found in Uncle Sam’s cereal or in a health food store) helpful against constipation and gas.

UniFiber (powdered cellulose) solved one woman’s constipation problem, while sugarless gum has helped others.

Denise commented on managing this problem:

“I was able to overcome a lifelong constipation problem and dependence on stimulant laxatives (Ex-Lax), and I think I could almost teach a class on it.

“The trick to prevent bloating with Metamucil is to start with a tiny amount – 1/4 tsp in a glass of water once per day, then twice per day, then three times per day, building up over the coarse of a week. Each week, increase the amount per serving by 1/4 tsp until you reach the dosage that works for you. For me it turned out to be 2 heaping tablespoons per day (one in the morning, one whenever convenient later in the day) of the sugar-free variety (the dosage is higher for regular Metamucil).

“It is extremely important to use a full, large glass of water – at least 8 oz – because the Metamucil will absorb whatever fluid is available. If insufficient liquid is provided, it will absorb whatever it can find, resulting in the opposite effect: constipation. If you are someone who doesn’t like water or Metamucil or just doesn’t drink much, do whatever you have to to get over it. At first I had to close my eyes and hold my nose while drinking it down. (I don’t know why this helped, but it did.)

“Don’t take it within 2 hrs before or after any meds or supplements because it can decrease their absorption. If this seems like a lot of bother, compare it to being severely, chronically constipated and it won’t seem so bad.

“But, for me, even Metamucil could not overcome the constipation caused by calcium supplements – until I read that a healthy calcium to magnesium intake ratio is about 2:1. As soon as I started taking 250 mg magnesium with every 500 mg calcium, normal bowel movements resumed.

“I really hope this helps because I’ve been there and it ain’t now fun.”

We have three guides that might be very helpful for these health concerns:

Graedons’ Guide to Constipation

Graedons’ Guide to Digestive Disorders

Graedons’ Guide to Osteoporosis

In addition, you may want to listen to our recent interview with Dr. Robynne Chutkan:

Other Side Effects of Alendronate and Other Bisphosphonates:

  • • Stomach pain
    • Swallowing difficulties
    • Hoarseness
    • Tarry stools
    • Nausea
    • Diarrhea
    • Gas
    • Bloating
    • Headache
    • Dizziness
    • Rash
    • Swelling of joints or extremities
    • Bone pain or pain in hips or legs

Destruction of bone in the jaw (osteonecrosis) or in the hip are rare but very serious complications of these medications (Journal of Oral Maxillofacial Surgery, Aug. 2012). In addition, recent research suggests that bisphosphonates can impair macrophages, white blood cells that are important actors in the immune response (Oral Diseases, online June 5, 2018).

Boost Your Bone Density with Weight-Lifting:

People who cannot tolerate a bisphosphonate may need an alternate approach to deal with your bone problem.We are delighted to learn how well you have done with your exercise program. Others may benefit from your approach.

The time to put an exercise program lie yours into place is now. On the other hand, it may never be too late to start. One clinical trial that confirms the benefits you found offered people progressive weight lifting exercises following a hip fracture (Journal of the American Medical Directors Association, Jan. 2012). Those who participated in the exercises were less likely to die or be admitted to a nursing home during the two years of the study than those who received usual care.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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CONSTIPATION REMEDY: I learned this remedy from another’s comment on this site. Has worked for me over 2yrs! Simmer 1 tablespoon whole flax seed for 3mins in small amount of water; let stand 7 mins more. Pour into 1qt container & add water to equal one full quart of amber liquid. Drink 4oz morning & evening. Adjust strength or dose accordingly

I was on Alendronate (Fosamax generic) for 5 years and was taken off early May – apparently it doesn’t work after 5 years and one can have a fracture .

I noticed since then worsening of muscle and joint pain – has anyone experienced this? I am unable to find much on the internet about side effects of stopping this drug?

Studies have also shown regular practicing of specific yoga poses are very helpful in slowing down bone loss and even building bone density. A good resource is research by Loren Fishman, MD and Ellen Saltenstall. They have also published a well documented helpful book called, “Yoga for Osteoporosis” which I would strongly recommend for people with this disease.

On the issue of constipation, limiting processed foods and animal products including eggs, dairy and cheese combined with eating a whole foods, plant based diet including at least 1-2 TBL of ground flax meal daily is a game changer for most people with constipation.

Adding flax is easy in my morning oatmeal or green smoothie. My brother-in-law had life threatening colon blockage and finally experienced relief after changing his diet. To me, it is amazing that after multiple hospitalizations and surgeries, no doctor had seriously discussed the drastic negative impact his traditional western diet was having on his health.

I live in Raleigh, NC, area and have done OsteoStrong sessions in Durham and Raleigh. It’s 4 osteogenic loading machines based on your age, weight, height. Most I see in center have osteopenia or osteoporosis and we trade stories about meds we don’t want to take.

These ctrs are new but the ones with the testimonials are out west since they have been in business longer. There is published research on the OsteoStrong website showing how their system builds bones, increases strength and even lowers A1C.

I would love to know what exercises/weights the writer used to increase her bone density. I asked for PT sessions to do just that and it was mostly me trying to steer the Physical Therapist in the right direction. Insurance didn’t want to cover the cost of this proactive treatment.

I stopped going after a few sessions and do my own workout three times a week, along with Dr. Fishman’s yoga regimen, bone broth and daily walking. I pray that this will be enough to improve my bd scores next year.

More information needs to be given to patients who cannot or will not take medications that could be damaging. There has to be an answer for those of us trying to avoid long-term problems.

I have osteoporosis of spine and take Evista. No side effects. Also I use total-body vibration equipment and do mild weight lifting.

I have had my gallbladder taken out, and since then I have had to change my eating habits to gluten-free. Regular foods seem to put a blockage in my bowel system which really hurts. So I really have to watch the medications that I take, as well.

One very serious side effect that you neglected to mention is locking of the jaw, which can become permanent if it continues for too long. On Fosamax for a year, my jaw began to lock for several seconds. I mentioned it to my doctor and he said it happened in less than 1% of those on Fosamax, so it couldn’t be the cause in my case. Even so, I stopped taking Fosamax, and over the next 6 months the jaw problem lessened and stopped. A year later the doctor again talked me into taking Fosamax, and sure enough my jaw began locking again. I stopped and swore I’d never touch Fosamax again. That was about 7 years ago, and I’ve had no jaw problems since. Even though the doctor thought 1% chance meant the same as zero %, I obviously WAS in the 1%. It is essential to pay attention to your own health and symptoms, because YOU are the one who pays the price when a doctor makes an incorrect assumption. Do your own research if you have a problem or question what your doctor says, and at least get a second opinion when something seems “off”.

My DR. wants me to take PROLIVA for bone density. What is your thought on this medicine?

I turned it down. I researched Prolia and other drugs for osteoporosis and chose to work with a nutritionist, continue doing my gym routine, and add specialized exercises at an OsteoStrong studio. I posted more specific information about my journey below.

The black box warning on Prolia scared me. And the fact is that after I finished two years of Prolia, I would have had to take other drugs to hold onto the bone I may have developed. Those other drugs do not develop new bone, but hold onto old bone, causing bones to become brittle.

In six months, I will get to see if my very bad bone density numbers have improved. I believe the research about OsteoStrong that says my bones will stabilize and my body will start making new bone.

Another good exercise program for building bone density is Yoga for Osteoporosis! It’s a series of 12 yoga poses put together by Loren Fishman, MD that helps with using body weight and muscles pulling on bone to strengthen bones. I am just beginning to really focus on this, so I will see how it goes. I have osteoporosis due to hyperparathyroidism. My density has increased since my surgery 3 years ago and I think the yoga will increase density even more.

I swear, if it’s possible, pharmaceutical companies will come up with a pill for everything. Why don’t doctors encourage people to be more active, and provide alternatives for medication? I know they’ll say it’s because patients don’t listen or won’t follow a program, but that’s just not true.

I have had doctors trying to get me to do regular bone density tests (the hospitals need to pay for those machines somehow) for years. I’m a small person, and I’ve always had “low” results, so the next step is to get me onto a prescription! Not one of them has ever talked to me about weight lifting; I’ve always been the one to bring it up.

Maybe it’s a bit outdated now, but years ago I read “The Myth of Osteoporosis.” At that time, apparently the machines that do the tests did not have any standards for calibration, so one machine might test differently than another. And just to scare us, I remember those ads of the profile of a woman aging and gradually becoming humped over like one of those old crones you see in children’s fairy tales. I’m not saying that doesn’t happen, but it’s far from inevitable. And after pushing these various drugs for years, they discovered some horrible side effects. No thanks.

And apparently (unless something has changed) bone density machines can only determine the thickness of bone walls, not the actual interior structure which plays a big part in how well bones hold up.

I finally told my clinic to stop sending me automated calls reminding me I was due for a test because I wasn’t doing it, and I definitely wasn’t going to take a prescription. Interestingly, the young woman who is my PA told me her mother stopped taking medication for low bone density, and she was fine with my reasoning as well.

I just wish we would put more emphasis on wellness and taking care of ourselves instead of finding more ways to medicate.

I just listened to your podcast about strengthening bones and noticed that you didn’t mention stomach upset from bisphosphonates. I was diagnosed with osteopenia and put on Fosamax. At first it didn’t bother me, but gradually I had increasing nausea until the last time I took it, it made me throw up immediately. Since I couldn’t keep it down, I figured there was no point in taking it any more. I would really like more details on the exercises that can strengthen bones because that’s the only thing that will help me now.

Have you heard if this new thing “Osteostrong” ? Some kind of robotic weight equipment that is supposed to keep your bones string in just 10 minutes a week? They have opened a facility in Durham and Raleigh I believe and one will eventually open in Cary. I was not able to get a clear description of how this works,

Why don’t people proofread their comments before posting. I think she/he meant “strong”, not string. SMH.

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