Improve bone density and strength without medication?

plav, you've come to the right place. Options that's our main topic.
Medication help some patients dramatically. They have hurt some dramatically as well. For example I have had significant results with Forteo, another commentator. windyshores, had adverse events with Forteo, but success with Tymlos.
It you throw your numbers in or tell us what you are being encouraged to take, we'll tell you things even your reticent medical providers don't know.
The truth for your body will be a little different from our truths.
Welcome. it's pretty interesting.

I am 58, and had a sacral fracture last year (not from a fall); I found out after that I have osteoporosis. Most recent DEXA scan showed lumbar spine T score -4.1 and Z score -3.1. Recommendation from endocrinologist is Romosozumab(Evenity) for a year, then Reclast infusions after that. I am struggling to find any peace at all from researching these medications, and have not found a single doctor willing to discuss anything other than "standard treatment" because they say that's just what is done. I am researching like crazy to find information and options available to me. I have started physical therapy to gain strength, changed my diet, and have started taking active B12 with L-5-MTHF, D3 with K2, Berberine, Magnesium, and collagen. I have had a full-time desk job for 40 years; I am going part time so I'm not sitting so much also.

plav,
evenity is probably a sound recommendation. Evenity is a newer anabolic with a black box for cardiac risks. It will be a few years before it becomes clear whether stroke and/or MI are statistical risks. I would avoid the drug until more results are in.
My first drug of choice is Forteo. It gives you fairly rapid protection from vertebral fractures. The second drug choice would be Tymlos.
Forteo, Tymlos and Evenity have to be followed by Reclast (zolendronate) or another bisphosphonate to secure the gains you have with the first drug. Forteo and Tymlos (teriparatide) are usually given for two years. Evenity for one.
I don't think you can regain very much loss with dietary , supplement or exercise changes.
It is good to look at all the pharmaceuticals (there aren't many) because if you have adverse reactions, you want to be ready to change drugs.
If I were only 58 (and female?) I'd consider the low dose estrodial patch.
Physical therapy can be very helpful, just be certain that your PT understands vertebral fragility.
You don't mention calcium, which is maybe part of a good diet. I think recommended calcium amts are too high and contribute to athersclerosis. The medical community remains devided on that issue.
Did you have sacroplasty. Were you tested for secondary causes and were your D levels tested.
D3 and K2 work better together. But they attach to the same receptors for absorption so it is better to take them separately.
Even the endocrinologists who are talkative generally have a set way they want to prescribe. It's best to do your own research and decide for yourself. Then you have to find a willing md. They have the clinical trials and a smaller subset of their own patients. The best part of this site is the wealth of personal experience.
You'll get responses that vary from mine, I hope. And your own decision will be according to what you know about yourself. It really is so interesting. Keep asking anything and everything. Best wishes and congratulations on your semi-retirement.

My scores are like yours. But I haven’t had a fracture. I’ve had 3 doctors tell me not to take drugs, an orthopedic surgeon, a functional medicine doctor and my dentist. My planned course of action is for 2 years try to do everything possible to up my scores without meds. Then have another dexa and see. My daily supplements are recommended by my FMD. Calcium citrate or malate- 1000 mg daily( I take Osteo-K by NBI), D3 5000 IU (I was significantly low), a B complex, Magnesium 2:1 ratio to calcium (I take citrate and glycinate), Vit K2 (I’ve done a lot if research on this one. FMD said up to 45 mg. That’s MK4. There is also MK7 that I take every other day at 182 mcg.), Boron 3 mg, Copper .9mg, Zinc 15 mg , Manganese- 1.8-23 mg, selenium 55 mcg. A lot of these I get with my multi vitamin.
She also recommended yoga, fast walking, stomping and whole body vibration for exercise.
You will find TONS of info and opinions about osteoporosis when you start researching. To me, you do what s best for you based on your health and comfort. I’m not comfortable taking the drugs. I’ll reassess after my next Dexa. Also there are other tests, P1NP and CTX, you can do to determine the action of your bone building.
I would suggest reading Dr Keith McCormicks books as well as Vitamin K2 and the Calcium Paradox by Kate Rheaume-Bleue. Also I’ve just started watching Dr Doug Lucas on YouTube.
Good luck in your journey.

plav,
Dr Keith McCormick has two books that cover all of these issues- Great Bones and The Whole Body Approach to Osteoporosis.
He has a few videos on YouTube, also. One if them addresses the drug issue pretty succinctly.
He has a website that is informative and you can have a consultation with him. I have not done that.
A few years ago, I did have a consultation with Dr Lani Simpson who is in Berkeley. That was helpful. She also has two books out and a very good website.
I would start with them. I believe that would educate you as much as anything can. It is so complicated. 😳
I have had my 7th Evenity injections and no problems. Both my endocrinologist and my rheumatologist say Fosamax next, but I am going to ask for Reclast. My friend is doing very well on Reclast and after it, you have a break. Break as in vacation. 🙂

My friend, who is a neurologist, was diagnosed with osteoporosis and hesitant to start medication. So when I received my own diagnosis about a year ago, and was told medications are the way to go, I also looked into alternative ways to manage my osteoporosis. I was already exercising with weights. I started the 12 minute yoga for osteoporosis by Fishman, added a third day of weights to my weekly exercises, started regular calcium and vitamin D, joined the Bone Coach program. The bone coach program requires a lot of time, and I don’t have that now since I’m working full-time. I also started Fortibone about a month ago. I’ll have another bone scan in about eight months. I’ll also do the bone coach program after I retire in the middle of 2024. Takes a lot of time to hunt down and understand the pros and cons of the methods of recourse. That’s one reason why I joined this support group.

Plav, I was diagnosed with osteoporosis at around the same age. My T-score was -2.8. I was determined not to take any drug since I've always lead a natural lifestyle and thought that if I just worked a little harder, I could regain what was lost. I decided to give it a full two years to see results. My endocrinologist was not happy about this but I was adamant and so she accepted my plan. I increased my already active exercise regimen to daily hiking, dancing or pilates, strength training 3x a week, I stood all day at my computer instead of sitting, did 400 core reps a day and calculated my nutrition using food first to get all my nutrients, supplementing anything that was short. I took control and did everything I possibly could do. In two years, I went from -2.8 to -3.2. Gaining bone in menopause is rarely physiologically possible but my stubborn nature and my interest in natural healing refused to accept that initially. After my valiant attempt and epic fail, I knew I had to accept that a pharmaceutical was necessary. My doctor insisted on Fosomax but I didn't think that was my best option. I fought for Forteo as all of my loss was in my spine and that is where it builds bone. I had no side effects (and the mental relief it provided was immeasurable). The first year I went from -3.2 to -2.8. The second year, I went from -2.8 to -2.9 so my recommendation is that if you decide to go on Forteo, test your bone markers throughout your course as gains slow the second year and in my case, slightly reversed. After my two years of Forteo, I had to make the next drug decision to maintain the gains. After weighing all options, I decided to go on HRT. At that time, it was not considered an acceptable choice but I was still within the 10 years of menopause and felt like it was the most natural choice I could make. I've now been on HRT for 5 years and I have pretty much maintained. Since you are 58, this might be a reasonable course of action for you, a bone builder first followed by HRT. It's really hard to accept the fact that medication is needed but it seems your osteoporosis is pretty serious as your scores are quite low and you've already had a fracture. I only wish I had gone on Forteo and HRT sooner. Losing bone in menopause is easy, gaining it back is so much harder and really, only accomplished through medication. Had I gone on medication rather than waiting two years, my gains would have put me out of osteoporosis completely. Now that is not possible and I really regret that decision. Wishing you the best of luck in your journey.

After reading all of you I am more determinded to skip the drugs which I think have so many negative side effects. I dont want to be a suffering guina pig (again). Not that I did not try in my fifties, Fosamax was the one, and the result was years of Gerd suffering which made me decide against any other proposed drugs. Now at 83 I had a compression fracture after moving an enormous garden pot (probably my weight, and a stupid endeavor after considering!). It is healing naturally with care and a belt! I hope to resume a less brutal gardening in the spring!
I wish you all the best in your decisions which I am sure will help because we are all differents.

With scores like that I sincerely and respectfully hope you will consider meds. Both Keith McCormick and Lani Simpson have done meds, by the way. I am quite sure if you did a consultation with McCormick, author of "The Whole Body Approach to Osteoporosis" and the recent "Great Bones", he would tell you to go on a bone builder.

I chose Tymlos because the dose is adjustable and I could ramp up. I had excellent gains even though I never reached a full dose. Now I am doing Evenity (nxt week).

Many docs are recommending Evenity these days because it is so potent for bone growth. I am not worried about the black box warning even though I have heart issues. The study comparing cardiovascular risk between Evenity and placebo showed no difference. There was a slight difference versus those on alendronate (Fosamax) but it is possible that is because Fosamax is slightly protective.

I have several fracures because of cancer treatment affecting bones and COVID delaying Tymlos. I would endure quite a few side effects to avoid any more pain and disability, but I found a way to make Tymlos tolerable.

I have never heard about the bone coach program nor the yoga for osteoporosis by Fishman. Could you please tell me where I could get more information about both. Thanks!