Once bone density is lost, it cannot typically be rebuilt, but you may be able to prevent further loss. Calcium and vitamin D, along with exercise and managing medications, are important for bone strength and density.

As we age, bone density can lessen, and there are various reasons for this. Some are natural and unavoidable, but there are steps you can take to avoid some risk factors.

When bone density decreases, and bones become fragile, you may receive an osteoporosis diagnosis. This condition can cause bones to break easily.

There are no clear signs of osteoporosis. You may not be aware that you have the condition until you fracture or break a bone.

Osteoporosis does not typically show early signs or symptoms, but some signs may suggest loss of bone density.

Periodontal disease

A 2022 review of studies noted a connection between osteoporosis and periodontal disease established by older research. Both conditions are linked with bone loss and have similar risk factors, such as smoking.

Nail health

If your nails are brittle, peeling, or weak, it may suggest that your bones are affected by loss of density. However, a 2018 research review indicated that further research is needed to confirm whether nail health or other areas of the body can effectively help diagnose bone disease.

Grip strength

A small 2020 survey-based study evaluated the relationship between relative hand grip and osteoporosis in a little over 4,000 Korean women ages 60 years and older. Researchers discovered postmenopausal women with weaker grip strength had an increased risk of falls and had lower bone mineral density.

If you have concerns about your bones, always speak with a doctor or another healthcare professional.

Here are some of the ways you can consider trying to help manage bone density:

Include calcium in your diet

Of all the body’s minerals, calcium is the most plentiful. It is important for bone and tooth strength. Almost all the body’s calcium is stored in these two places. Not getting enough can lead to osteoporosis.

The recommended daily allowance (RDA) of calcium for females ages 51 to 70 is 1,200 milligrams (mg), and for males in the same age range, it is 1,000 mg.

You can try including foods in your diet that are rich in calcium. These include:

  • milk and some milk substitutes like soy and almond
  • cheese
  • yogurt
  • canned fish containing bones like sardines
  • kale
  • broccoli
  • Chinese cabbage (bok choy)

Some foods, such as cereals and on-the-go bars, may include added calcium, so it’s important to read food labels to ensure you are getting the amount your body needs.

Experts advise discussing calcium supplements with a doctor or another healthcare professional before you decide to start taking them, as they can interact with some medications, including:

  • quinolone, an antibiotic class used to treat bacterial infections
  • lithium, a mood stabilizer
  • levothyroxine, which helps manage an underactive thyroid
  • dolutegravir, an HIV medication

If you can, try to stay active

Weight-bearing activities may help make your bones stronger and help to slow bone loss.

A 2018 literature review on how exercise affects bone density in those with osteoporosis indicates that weight-bearing aerobic exercise alone may limit bone density loss. Strength and resistance exercises may also improve muscle and bone mass density.

Benefits of weight and strength training can include:

  • protection against bone loss
  • an improvement in bone mineral density
  • increased bone size
  • better balance
  • better coordination
  • increased muscle mass

You could also try going for a brisk walk, jogging, dancing, or even climbing stairs. Some sports, such as soccer, softball, ping pong, tennis, or pickleball can also help keep your bones strong.

Getting enough vitamin D

Vitamin D is important as it helps the body absorb calcium. Together, Vitamin D and calcium can help protect you against osteoporosis.

The RDA for vitamin D for adults ages 19 to 70 is 15 micrograms (mcg), which is 600 international units (IU) daily. For adults ages 71 and over, the daily amount increases to 20 mcg, which is 800 IU.

Getting sunlight directly to bare skin can help the body make vitamin D. Your body can still make vitamin D when it is cloudy or smoggy, but it may not make as much. Additionally, people with dark skin tones may not make as much vitamin D.

Remember: Sunscreen is important to protect your skin from sun damage. While sunscreen may prevent some vitamin D absorption, it does not prevent it completely.

There are not many foods that naturally contain vitamin D, but some food sources include:

  • fatty fish, such as mackerel, salmon, trout, and tuna
  • fortified foods, such as milk and milk alternatives like soy, almond, and oat
  • breakfast cereals, some fruit juices, yogurts, margarines, and other foods sometimes have added vitamin D

If you feel you do not get enough vitamin D naturally, you should consider seeking further advice from a doctor or healthcare professional.

Ask about your medications

Some medications can increase your risk of developing bone loss and osteoporosis, particularly when used long-term. These medications include:

  • glucocorticoids, such as cortisone, prednisone, and dexamethasone
  • antiepileptic medicines, such as valproic acid (Depakote) levetiracetam (Keppra), gabapentin (Neurontin), and pregabalin (Lyrica)
  • selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), citalopram (Celexa), and fluoxetine (Prozac)
  • some cancer medications that use hormones, such as tamoxifen (Nolvadex) and leuprolide (Lupron)
  • proton pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid)
  • thiazolidinediones (TZDs), such as pioglitazone (Actos), rosiglitazone (Avandia), and lobeglitazone (Duvie)
  • adrenocorticotropic hormone (ACTH), a hormone produced by the pituitary gland that regulates cortisol and androgen production

If you’re concerned about your bone health or you have osteoporosis risk factors, speak with a doctor or another healthcare professional for further advice. After reviewing your medical history and current health needs, they may prescribe medications to help slow bone loss.

When you reach age 65, you may be eligible for Medicare — the government health insurance program for people ages 65 and older and for those younger than 65 years old who have specific health conditions, such as end stage renal disease (ESRD).

Original Medicare Part B and Medicare Advantage plans cover outpatient consultations with a doctor or heathcare professional who can discuss bone density with you.

If you need take-home prescription medications, Medicare Part D stand-alone plans may cover them. Most Medicare Advantage plans also include prescription drug coverage.

It’s unlikely you can rebuild bone density, but you may be able to prevent further bone density loss by incorporating some lifestyle adaptations.

Weight-bearing aerobic exercise can help maintain bone density, and walking, jogging, dancing, or playing sports can help improve muscles and bone mass.

Speak with a medical professional about any long-term medication you are taking to check whether they could contribute to osteoporosis.