Can I Improve My Bone Density Score? Understanding Your Options

October 1, 2025 •

5 min read

Over 53 million Americans either have osteoporosis or low bone mass, a figure that is expected to rise. The good news is that for many, strategies exist to address declining bone mass. So, can I improve my bone density score and reduce my fracture risk? The answer involves a multi-pronged approach that combines diet, exercise, and, if necessary, medication.

Quick Summary

Improving bone density requires a combination of consistent weight-bearing exercise, a diet rich in calcium and vitamin D, and sometimes, medication to slow bone loss or rebuild bone. It is possible to slow the decline and strengthen bones, though significant improvement can be a long-term process.

Key Points

Lifestyle changes can improve bone health: Consistent weight-bearing exercise, a nutritious diet, and avoiding tobacco and excessive alcohol are fundamental to slowing bone loss.
Bone density score improvement depends on severity: For osteopenia, lifestyle changes may be sufficient to improve your score, while osteoporosis often requires medication for significant change.
Medications can rebuild bone: Prescription drugs, particularly anabolic medications, can help rebuild lost bone density and are reserved for higher-risk cases.
Dietary intake is crucial: Ensure adequate intake of calcium and vitamin D through food and, if necessary, supplements to support bone remodeling.
Peak bone mass is reached in young adulthood: While building bone is most effective in youth, adults can still take significant steps to slow loss and strengthen their existing bone structure.
Consult a healthcare professional for a personalized plan: Your doctor can assess your risk factors and guide you on the best combination of lifestyle and medical treatments.

Understanding Bone Density and Your Score

Bone is living tissue that is constantly being broken down and rebuilt, a process known as remodeling. As we age, especially after our 30s, we begin to lose bone mass faster than we can replace it. Your bone density score is measured through a DEXA (dual-energy X-ray absorptiometry) scan, which compares your bone mineral density to that of a healthy young adult. A low score (osteopenia or osteoporosis) indicates a higher risk of fractures.

While your peak bone mass is largely determined by genetics, your lifestyle choices throughout life play a crucial role in maintaining and potentially improving your bone density. A lower score is not a final verdict, but a call to action. With a comprehensive approach, it is possible to stop further loss and, in some cases, increase density.

The Role of Lifestyle in Bone Health

For most people, lifestyle is the foundation of any bone health strategy. Consistent, long-term habits can make a significant difference in slowing bone loss and supporting stronger bones.

Exercise: Stressing Bones for Strength

Exercise works on bones much like it does on muscles—it makes them stronger. This is most effective with weight-bearing activities, where your feet and legs support your body's weight against gravity. High-impact activities generally offer more bone-strengthening benefits, but safety is paramount, especially for those with low bone density.

Weight-Bearing Aerobics: Examples include brisk walking, jogging, dancing, stair climbing, and hiking.
Strength Training: This involves resistance, whether from weights, bands, or your own body weight. Exercises like push-ups, squats, and lunges help strengthen major muscle groups and pull on bones, stimulating growth.
Balance Exercises: Activities like Tai Chi and yoga are excellent for improving balance and coordination, which helps prevent falls that can lead to fractures.

It's important to consult with a doctor or physical therapist to create a safe exercise plan, especially if you have significant bone loss.

Nutrition for Stronger Bones

A diet rich in key nutrients provides the building blocks your bones need for remodeling. Simply taking supplements without addressing your diet is less effective.

Calcium: The primary mineral in bone, calcium needs to be replenished daily. Good sources include low-fat dairy products, leafy green vegetables (like kale and collard greens), fortified cereals and juices, and soy products.
Vitamin D: Your body needs vitamin D to absorb calcium effectively. Sources include fortified milk and cereals, fatty fish like salmon and tuna, and moderate sun exposure. Many people require supplements to meet daily requirements.
Protein: A fundamental building block of bone, adequate protein intake is essential for overall bone health.
Other Minerals: Magnesium, zinc, and vitamin K also play important roles in bone metabolism and density.

Avoiding Harmful Habits

Certain lifestyle habits can accelerate bone loss and weaken your skeletal structure.

Tobacco Use: Smoking is strongly linked to lower bone density and interferes with calcium absorption.
Excessive Alcohol: Heavy drinking can lead to poor calcium absorption and hormonal imbalances that negatively impact bone health.

Medications for Improving Bone Density Scores

While lifestyle changes are critical, they may not be enough for those with diagnosed osteoporosis. Medications can play a powerful role in stabilizing or rebuilding bone mass. These are often used in conjunction with a healthy diet and exercise regimen.

Antiresorptive Medications: This class of drugs works by slowing down the rate at which bone is broken down, allowing the body to maintain density. Bisphosphonates, such as alendronate (Fosamax) and zoledronic acid (Reclast), are common examples. Denosumab (Prolia) is another option, delivered via injection.
Anabolic Medications: These drugs actively stimulate bone formation and are typically reserved for individuals with very low bone density or multiple fractures. Teriparatide (Forteo) and romosozumab (Evenity) are examples that help rebuild lost bone.

Comparison of Lifestyle vs. Medical Bone Health Strategies


Feature	Lifestyle Modifications	Medical Treatments
Mechanism	Stimulates bone formation naturally through exercise; provides building blocks through diet.	Slows bone breakdown (antiresorptive) or promotes new bone growth (anabolic).
Typical Effect	Primarily slows bone loss; can result in modest bone density increase.	Can stop bone loss and, in some cases, increase bone density more significantly.
Speed	Slow, long-term process, requiring consistency over years.	Generally faster, with effects noticeable on subsequent DEXA scans.
Side Effects	Minimal; typically involves improved overall health and balance.	Potential side effects vary by medication; requires medical supervision.
Suitability	Recommended for everyone; foundational strategy for all bone health goals.	Often reserved for individuals with osteoporosis or high fracture risk; prescription-only.

Creating Your Personalized Bone Health Plan

The best approach for improving your bone density is a plan that is tailored to your individual needs. Your healthcare provider can assess your fracture risk, review your lifestyle, and help you determine the right course of action.

Get a DEXA Scan: If your doctor recommends it, a bone density scan provides a baseline measure of your bone health and informs treatment decisions.
Evaluate Your Diet: A dietitian can help you assess your current intake of bone-supporting nutrients like calcium and vitamin D. You can then prioritize dietary sources and determine if supplementation is needed.
Start a Safe Exercise Program: With your doctor's guidance, incorporate a combination of weight-bearing aerobic activity, strength training, and balance exercises into your weekly routine.
Discuss Medication Options: If your bone loss is significant, discuss the benefits and risks of different medications with your doctor. They can determine if medication is the most appropriate next step for you.

Conclusion: Small Steps for a Stronger Future

While we can't completely reverse severe bone loss, it is absolutely possible to slow its progression and strengthen your skeletal structure over time. For those with osteopenia, lifestyle changes alone may be enough to stop the loss and improve your score. For individuals with osteoporosis, a combined approach of lifestyle and medication is often the most effective strategy. The journey to better bone health is a long-term commitment, but by taking proactive steps and working with your healthcare team, you can build a stronger, more resilient future for your body. For more information, visit the National Institutes of Health page on bone health: https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health.

Frequently Asked Questions

A bone density score, or T-score, between -1 and -2.5 is considered low bone mass (osteopenia). A T-score of -2.5 or lower is indicative of osteoporosis.

While natural methods like diet and exercise can significantly slow bone loss and modestly increase density, medication is often required for substantial score improvement, especially in diagnosed osteoporosis cases.

A combination of weight-bearing exercises (like walking or jogging) and strength training (using weights or resistance bands) is most effective. These activities put stress on your bones, which stimulates bone growth and strength.

Improving bone density is a slow, long-term process. Results, which are monitored with follow-up DEXA scans, may not be seen for a year or more and depend on the treatment regimen.

It is generally recommended to get calcium from food sources first, as absorption is better and safer. Supplements may be necessary if your dietary intake is insufficient, but should be used under a doctor's guidance.

Higher doses of vitamin D supplementation do not necessarily improve bone density in healthy adults and may be harmful. Your healthcare provider can test your vitamin D levels and recommend an appropriate, safe dosage.

Antiresorptive medications, like bisphosphonates, slow the rate of bone breakdown, while anabolic medications, like teriparatide, promote the formation of new bone. Anabolics are typically reserved for more severe cases.