Team

Secondary osteoporosis is bone loss that has a driver besides aging or menopause: another health condition, a medicine, or a habit such as smoking or heavy drinking. If you have been told you have osteoporosis, or a bone broke after a minor fall, finding that driver is the step that shapes the rest of your plan.

What causes secondary osteoporosis?

A 2003 review on PubMed defines secondary osteoporosis as osteoporosis “caused or exacerbated by other disorders or medication exposures.” That sets it apart from the bone loss tied to aging and, in women, natural menopause. Here is how we group the causes, combining what NIAMS and mdsearchlight.com name. Many people with osteoporosis have more than one of these. NIAMS notes that some people with osteoporosis have no specific risk factors at all.

Conditions that can look like osteoporosis

Before a secondary cause is named, doctors also consider conditions that weaken bone in similar ways. Mdsearchlight.com lists these:

• Osteomalacia, softening of the bones
• Renal osteodystrophy, a bone disorder linked to kidney disease
• Paget’s disease, a bone disorder that usually appears in older adults
• Multiple myeloma, a cancer of plasma cells
• Lymphoma, a type of cancer
• Mastocytosis, overproduction of mast cells
• Sickle cell anemia, a blood disorder
• Osteonecrosis, loss of blood flow to the bone
• Bone infections
• Homocystinuria, an inherited disorder affecting how the body processes the amino acid methionine
• Scurvy, a disease caused by a lack of vitamin C
• Homocysteinemia, high levels of homocysteine in the blood
• Metastatic bone disease, cancer that has spread to the bones

A 2003 review from a Spanish health-system journal, indexed on PubMed, says these secondary causes are “frequent in cases initially labelled as primary osteoporosis.” That is why it is worth checking for a cause even when the picture seems simple.

How does a cause lead to bone loss?

Your bones are rebuilt all your life. NIAMS says osteoporosis develops when bone mass and bone mineral density drop, or when the structure of bone changes. Womenshealth.gov describes the usual pattern: as you age, your bones don’t make new bone fast enough to keep up with your body’s needs, and bone loss speeds up after menopause.

Secondary causes take other routes. The Frontiers research topic on secondary causes of bone fragility lists altered mineral metabolism, hormone imbalance, impaired bone remodeling (the normal cycle of breaking down and rebuilding bone) and chronic low-grade inflammation. Mdsearchlight.com gives examples: in Cushing’s syndrome, bone breakdown increases and bone formation drops, and after a stroke, bone is lost through immobilization and neurologic disability.

Your starting point matters too. Womenshealth.gov says girls develop 90% of their bone mass by age 18, so anything that blocks that build-up leaves less bone to draw on later. Mdsearchlight.com says some medicines and conditions stop full bone mass from forming in young adulthood, or cause excessive loss later.

Which factors raise the risk of osteoporosis in women?

Womenshealth.gov says your risk is higher if you:

• Are past menopause. Some women lose up to 25% of bone mass in the first 10 years after it.
• Weigh less than 127 pounds.
• Have a family history of osteoporosis.
• Are Mexican-American or white. Asian-American women also have a higher risk, because they are usually smaller and thinner.
• Do not get enough calcium and vitamin D, or enough physical activity.
• Have not had a period for three months in a row, if you are not pregnant, breastfeeding or taking a medicine that stops periods. Talk to your doctor or nurse about this.
• Have an eating disorder, especially anorexia nervosa or bulimia nervosa.
• Smoke. The risk of broken bones goes up the longer and more you smoke.
• Have a health problem such as diabetes, premature ovarian failure, celiac disease, inflammatory bowel disease or depression.
• Take certain medicines for long-term problems such as arthritis, asthma, lupus or thyroid disease.
• Drink too much alcohol. For women, one drink a day at most.

NIAMS adds that African American and Hispanic women have a lower risk but are still at significant risk. Men are at risk too, especially after age 70.

How common is secondary osteoporosis?

Mdsearchlight.com says additional factors that cause secondary osteoporosis are present in about 30% of postmenopausal women and 50% to 80% of men. For osteoporosis overall, womenshealth.gov says about 10 million Americans have it, and more than 80% of them are women. It also says one in four women 65 or older in the United States has it. Mdsearchlight.com gives a higher US estimate of 20 to 25 million people, and about two million fractures a year. Treat the numbers as estimates.

What are the symptoms, and how do I track them?

Osteoporosis is often called a “silent” disease, because you typically have no symptoms until a bone breaks. When signs do show up, they usually come from a spine fracture. NIAMS and womenshealth.gov list these five:

• Back pain
• Loss of height
• A hunched or stooped posture (kyphosis)
• A curve in the back
• Sloping shoulders

Fractures can come from a minor fall, such as a fall from standing height, or from normal stresses like bending, lifting or even coughing (NIAMS). Womenshealth.gov notes that spine fractures can happen during everyday activities such as climbing stairs, lifting objects, or bending forward.

Because the early signs are quiet, a simple log helps you see a pattern. Write down:

• When any back ache starts, with the date and the time of day.
• What you were doing: bending, lifting, coughing, climbing stairs, or a fall.
• Any change in your height or posture, measured the same way each time.
• Any bone break, and whether it followed a minor fall.
• Every medicine and supplement you took that week.

Bring the log to your appointment. It gives your clinician the details that a cause search depends on.

How do doctors check for a secondary cause?

The first test is usually a DXA scan. DXA (dual-energy X-ray absorptiometry) is an X-ray of your bones that measures density, using a very low amount of radiation (womenshealth.gov). Mdsearchlight.com says a T-score of -2.5 or less can diagnose osteoporosis. A T-score compares your bone density with that of a healthy 30-year-old adult. A fracture after a minor injury can also lead to a diagnosis. Spine X-rays may be taken if a fracture is suspected.

Womenshealth.gov says your doctor may suggest a bone density test if you are 65 or older, or younger than 65 with risk factors.

The next step is looking for a secondary cause. Mdsearchlight.com says doctors may look for one in a premenopausal woman with osteoporosis, or in a man under 50 with weak bones or fractures. The Frontiers topic lists the signs that should raise suspicion:

• A clinical sign of a specific disease
• A Z-score (a bone density score compared with people your age and sex) of more than -2 SD
• A very low T-score compared with your fracture risk factors
• A fragility fracture (a break from a minor fall) with normal or osteopenic bone density
• Osteoporosis or a fracture in people with normal sex hormone levels (eugonadal)
• Treatment that is not working despite taking it as prescribed

Other tools add detail. Mdsearchlight.com describes FRAX, which estimates your risk of a major fracture in the next 10 years, but notes it may be less useful under 40 or with worse spinal bone density. The trabecular bone score looks at bone structure, HRpQCT looks at the small-scale structure of bone, and a bone biopsy (a small sample of bone tissue) is sometimes used in severe cases. Mdsearchlight.com notes that some people break bones despite normal bone mass, which can happen with diabetes.

Depending on your symptoms and history, the tests that follow can include blood counts, checks for inflammatory conditions, bone, kidney and liver function, a diabetes evaluation, hormone levels and thyroid checks. Mdsearchlight.com says the full list depends on your case. It names a primary care physician, or a bone specialist such as an endocrinologist or rheumatologist, as the right doctor to start with.

What is osteopenia, and what exercise helps?

Osteopenia means your bone density is lower than normal. If you have been told you have it, the activity guidance from womenshealth.gov is the most useful place to start. Regular physical activity of any type helps slow bone loss, improve muscle strength and help your balance. Weight-bearing activity matters most, because your body works against gravity during it. The examples the page lists are:

• Dancing
• Gardening
• Lifting weights
• Tennis
• Tai chi
• Yoga
• Running
• Walking

Balance matters too, because many fractures come from falls. Womenshealth.gov says fractures can follow a minor stumble or a bump into furniture. The NIA room-by-room fall prevention guide lists the home changes that lower the risk: handrails on both sides of stairs, good lighting with switches at the top and bottom, grab bars by the toilet and in the tub or shower, nonskid mats on wet surfaces, no throw rugs, and a night light in the bathroom.

For joint, muscle and bone care more broadly, see Joint, Muscle and Bone Care.

What are the guidelines for preventing osteoporosis?

NIAMS says you can take steps to help prevent the disease and fractures. Its guidance and the womenshealth.gov guidance agree on these core steps:

• Get enough calcium and vitamin D every day, mainly from food.
• Stay physically active, choosing weight-bearing activity such as walking, running or dancing.
• Do not smoke, or do not start.
• Drink alcohol in moderation. For women, that is one drink a day at most. Too much at one time, or mixed with certain medicines, can affect your balance and lead to falls.
• Take prescribed medicines. NIAMS says they can help prevent fractures in people who have osteoporosis.
• Build strong bones early. Womenshealth.gov says building them in childhood and the teen years helps prevent osteoporosis later.

What should I eat and drink for stronger bones?

Womenshealth.gov gives these daily amounts for women:

• Calcium: 1,300 mg at ages 9 to 18; 1,000 mg at 19 to 50; 1,200 mg at 51 and older.
• Vitamin D: 600 IU up to age 70; 800 IU at 71 and older.
• Pregnant or nursing women need the same amounts as other women of the same age.

Calcium occurs naturally in milk, cheese, yogurt and leafy greens such as broccoli, kale and mustard greens. Some breakfast cereals, orange juice, tofu, soymilk, breads and pastas have calcium added. If dairy upsets you, womenshealth.gov suggests lactose-reduced milk or yogurt, a lactose supplement taken before dairy, or other calcium sources.

Vitamin D is found in salmon, tuna and egg yolks, and it is added to some cereals, milk and orange juice. Your skin also makes vitamin D in sunlight. Womenshealth.gov says about 10 to 15 minutes of sun on your hands, arms and face, two to three times a week, is generally enough, though it depends on your skin, sunscreen use, season, location and air pollution.

Is there one vitamin that rebuilds bone density?

Womenshealth.gov says calcium and vitamin D work together to build and maintain strong bones, and that vitamin D helps your body absorb the calcium you eat. Mdsearchlight.com says getting enough calcium and vitamin D can help strengthen bones. Womenshealth.gov also says it is best to get calcium from food, and that a calcium supplement may be worth considering if food does not provide enough.

What drink makes your bones stronger?

Womenshealth.gov names milk as a natural source of calcium, and calcium-fortified orange juice and soymilk as added sources. It also says long-term, heavy drinking can cause bone loss, and that for women, one drink a day is the most you should have.

Can taking too much vitamin D3 cause osteoporosis?

Womenshealth.gov gives the recommended amounts for women: 600 IU a day up to age 70, and 800 IU a day from age 71. Those are the amounts it recommends. Tell your doctor or pharmacist about every vitamin D3 supplement you take. The NIA’s guide to taking medicines safely says to mention every vitamin, supplement and herbal remedy at each visit, because mixing them with other medicines can cause problems.

Which foods should I avoid if I have osteoporosis?

Womenshealth.gov names habits that harm bone: smoking, and heavy drinking. NIAMS adds that a diet low in calcium and vitamin D can raise your risk, and that excessive dieting or poor protein intake may increase bone loss. The practical focus is getting enough calcium, vitamin D and protein, and cutting back on the habits above.

Can you work with osteoporosis?

Womenshealth.gov says a broken bone can cause severe pain and disability, and can make everyday tasks such as walking harder. It also says a spine fracture can happen during ordinary tasks like climbing stairs, lifting objects or bending forward. Whether your job suits you depends on your bone density results, your fracture risk and any treatment you take. Write down the lifting, bending and stair-climbing parts of your workday so you can go over them at your appointment.

What are the treatment options for secondary osteoporosis?

Treatment starts with the cause. Mdsearchlight.com says that until underlying conditions are addressed, you may not get the full benefit of standard osteoporosis treatments. For osteoporosis linked to hormone disorders, it says the problem can often be managed by addressing the underlying disease. The options named across NIAMS, womenshealth.gov and mdsearchlight.com are below.

Womenshealth.gov says your doctor may also suggest more calcium, vitamin D and physical activity. It says all medicines have risks, and gives menopausal hormone therapy as its example. The NIA’s guide to taking medicines safely adds that you should not stop a prescription medicine unless your doctor says it is okay, and that some medicines need to be stopped slowly.

For the drug options in more depth, including costs and side effects, see Osteoporosis treatment 2026: options, costs, side effects.

What do the Japanese take for osteoporosis?

Most of the guidance on this page comes from US health agencies, so it cannot tell you what is typical in Japan. The options in the table are the ones the NIAMS, womenshealth.gov and mdsearchlight.com pages name.

What is still being studied?

The Frontiers topic says secondary causes of bone fragility “are still poorly understood and insufficiently addressed in standard clinical practice.” Its stated aims include better tools to tell secondary from primary bone fragility, and treatments tailored to specific conditions. It describes a research collection on this subject rather than a single study.

What will testing and treatment cost?

Prices change and depend on your plan, so check the cost of any test or medicine with your insurer, clinic or pharmacy before you go. The public guidance says:

• Screening: womenshealth.gov says osteoporosis screening is covered by most insurance plans, including Medicare Part B, and depending on your plan you may be able to get it at no cost.
• Medicare: womenshealth.gov says to find out about Medicare coverage for bone density tests.
• Medicaid: benefits differ by state, so check with your state’s Medicaid program.
• No insurance: womenshealth.gov says you may be able to get a no-cost or low-cost bone density test. Its health center finder searches by ZIP code, and HealthCare.gov shows whether you qualify for low-cost coverage.
• Medicines: the NIA guide says a generic drug is just as safe, and of equal strength and quality, as its brand-name version. People with financial hardship who receive Medicare drug benefits may qualify for the Medicare Extra Help Program.

What should I ask at my appointment?

Bring your symptom log and any DXA results you already have. Then ask:

• Could my bone loss have a secondary cause, and which tests check for it?
• What do my DXA results mean, including my T-score?
• Which of my current medicines, conditions or habits might affect my bones?
• Is my calcium and vitamin D intake right for me, and do I need a supplement?
• Which activities are safe for my bones and my balance?
• Which treatment options fit my cause, and what are their risks?
• Should I see a primary care physician, an endocrinologist or a rheumatologist?

Take this list and your log to your clinician.

Your next step

Start the symptom log this week. Note any back ache, height change or bone break with the time of day and what you were doing. Check the causes table for anything that matches your history. Bring both to your appointment. When you are ready to compare the drug options, read Osteoporosis treatment 2026: options, costs, side effects.

By BackToHealthTroy.com Editorial Team

If you want to know what a magnesium bottle actually gives you, start with the serving size, then find the amount of elemental magnesium per serving. The big number on the front may not be the magnesium itself. Cleveland Clinic notes that 2,000 mg of magnesium L-threonate \”may provide only about 140 to 150 mg of elemental magnesium,\” so the number you see first and the number your body gets can be far apart.

Where do the serving size and other ingredients appear?

Check the serving size before anything else. MedlinePlus, the U.S. National Library of Medicine’s patient guide to reading food labels, says to \”always check the serving size first\” because all the information on the label is based on that serving. The same rule helps with supplements. Every amount on the panel applies to one serving, and a package can hold more than one.

Cleveland Clinic’s nutrition label guide adds that \”people routinely underestimate what a serving is.\” Measure what you actually take, and write it down next to the label amounts.

Then read the full ingredient list, not just the front of the package. Cleveland Clinic’s sleep article urges readers to read the product information carefully to understand key features like ingredients, dosing and safety considerations.

What does elemental magnesium mean on a label?

Elemental magnesium is the magnesium itself. A magnesium compound also has a weight from the molecule it is bound to, and that weight is usually the bigger number. Two examples show the gap:

The trial’s per-capsule figures are reported in the 2025 magnesium bisglycinate sleep trial in Nature and Science of Sleep.

How do I check for duplicate magnesium and other overlapping ingredients?

Cleveland Clinic says magnesium L-threonate supplements often contain other ingredients too, such as vitamins C or D. Its integrative medicine specialist, Naoki Umeda, MD, says it is important to know what you are taking, \”especially if you already take a multivitamin or other supplements.\”

So add up the elemental magnesium from every product you take, including multivitamins and powders. Cleveland Clinic says powders, gummies and drink mixes can also contain a lot of other ingredients.

How do proprietary blends limit comparison?

Look for a separate elemental magnesium amount in the Supplement Facts panel. Check the actual Supplement Facts panel on your product for that number.

In that case, ask the maker for the elemental magnesium per serving in writing before you compare. Write down the blend’s total weight and the maker’s number as separate entries.

What should I record from a multi-ingredient sleep product?

Sleep products often combine magnesium with other ingredients. Record these items for each one:

• The serving size, copied exactly as printed.
• The elemental magnesium per serving, in mg.
• The magnesium compound’s name and its weight, if listed.
• Each other ingredient with its own amount, such as vitamins C or D or glycine.
• Any testing or quality wording, copied word for word.

In the 2025 bisglycinate trial, each capsule contained 893 mg of magnesium bisglycinate, which corresponds to 125 mg of magnesium and 761.5 mg of glycine. That is the kind of split you want to see on a label. The trial itself is one example of a product with more than one active ingredient.

Add your magnesium across every product. Cleveland Clinic says that taking more than 350 mg per day from supplements can cause side effects like diarrhea, nausea and stomach cramps. For more on supplement safety, see Nerve Health and Supplement Safety.

What does a testing or quality claim mean?

Cleveland Clinic explains that if a product is verified by the United States Pharmacopeia (USP), that \”means it meets basic quality standards, but it doesn’t guarantee the product works.\” Read the wording on the label exactly to see which product and what testing the claim covers.

A quality certification is not FDA approval or clinical efficacy proof. It tells you about quality checks, not whether the product works for sleep or anything else.

Claims on marketing also matter. In a warning letter dated November 5, 2020, the U.S. Food and Drug Administration told Quten Research Institute that website claims established its products as drugs under section 201(g)(1)(B) of the Federal Food, Drug, and Cosmetic Act, which covers products intended for use in \”the cure, mitigation, treatment, or prevention of disease.\” That letter concerned two other products, CoQ10 and turmeric. As of October 5, 2026, the letter is posted on the FDA’s website. This is information, not legal advice.

What can the research tell me about magnesium and sleep?

Cleveland Clinic’s sleep article quotes Dr. Umeda saying: \”Overall, the evidence for magnesium as a sleep aid is thin. But some people find it helps them.\”

A 2025 randomized, placebo-controlled trial published in Nature and Science of Sleep enrolled 155 adults aged 18 to 65 who reported poor sleep quality. The magnesium bisglycinate group had a greater drop in Insomnia Severity Index scores than the placebo group from baseline to Week 4 (−3.9 vs −2.3, p = 0.049). The authors describe the effect size as small (Cohen’s d = 0.2), indicating a modest benefit. They also say future research should include objective sleep assessments and longer intervention periods. For a wider view of magnesium human studies, see the magnesium human studies (our research library) overview.

Blood tests are another question. Cleveland Clinic points out that less than 1% of your body’s magnesium is found in your bloodstream, and more than 99% is stored in your cells and bones. A standard blood test does not give the full picture.

Who should check with a clinician first?

Cleveland Clinic says to talk to your healthcare provider before taking magnesium if you use prescription medications, and if you have chronic kidney disease or other kidney problems. It lists certain antibiotics, osteoporosis medications and diuretics as medicines that can interact with magnesium. Ask your pharmacist or clinician to check your full list, including every magnesium product on it.

What are the practical alternatives, and what is my next step?

You do not have to buy a supplement to work on magnesium or sleep. Cleveland Clinic lists food sources, including leafy greens like spinach and Swiss chard, nuts and seeds, legumes, whole grains, dark chocolate and certain fish like salmon.

For sleep, Cleveland Clinic recommends starting with proven strategies: a consistent sleep schedule, limiting caffeine and alcohol, a cool dark bedroom and no screens before bed. The NHS page on how to fall asleep faster and sleep better offers similar small changes to habits and routines.

Cleveland Clinic also says a true magnesium deficiency is not very common in healthy adults, but your risk may be higher if you are over age 65, have Type 2 diabetes, have a gastrointestinal condition such as Crohn’s disease or celiac disease, or have chronic alcohol dependence. If muscle cramps are part of your question, the guide to magnesium for muscle and nerve health covers that topic.

Elemental magnesium label worksheet

Fill in one row per product. Copy the wording from the label, not from memory.

Your next step: record the complete serving, the elemental amount and the other ingredients, then verify any product-specific testing claim before you compare.

Before you decide

• Ask the maker for the elemental magnesium per serving and the full list of other ingredients.
• Ask which product any testing claim covers, and check it against the label wording.
• Add up the magnesium across every product you take, and ask a pharmacist or clinician to review your list.

By BackToHealthTroy.com Editorial Team

If you are trying to work out whether testosterone could help your bones after menopause, the short answer is this: a small new study saw spine bone density scores rise when estrogen was combined with testosterone, but the 2019 global expert consensus found the available data did not support a bone density effect at 12 months. Here is what each finding means for you, and where the research still falls short.

What the new small study found

According to The Menopause Society press release, the study followed 51 women for an average of 4.1 years. The women received estrogen therapy for a mean of 3.5 years and estrogen plus testosterone for 3.1 years. Bone density was measured with DEXA scans at baseline, after at least one year of estrogen alone, and after at least one year of estrogen plus testosterone. The lead author is Sona Davis of the Keck School of Medicine of the University of Southern California.

Estrogen alone did not produce significant increases in T-scores at any location. Estrogen plus testosterone significantly increased lumbar spine T-scores. The femoral neck and hip T-scores stayed stable across both treatment periods.

The study measured T-scores on DEXA scans. It did not measure fractures. The release describes it as a meeting presentation and does not cite a published full paper. It also does not report the size of the spine change, the testosterone dose, the product or route, or whether the women were randomized.

Why the spine result and the hip result mean different things

The researchers concluded that testosterone may have a synergistic effect with estrogen on trabecular bone, especially at the spine. That is a statement about where the effect may act. It is not a fracture result.

The spine and hip matter for a specific reason. The NIAMS guide to bone mineral density test numbers explains that the weak bones that tend to break most often are the hip and spine, so DXA usually measures those two sites. A rise at the spine is a change at a relevant site. In this study, though, the hip did not change.

A T-score also compares your bone with a healthy young adult. It is a measurement, not a count of breaks. The NIAMS guide says the risk of broken bones increases by 1.5 to 2 times with each 1-point drop in the T-score. A higher T-score at the spine is therefore not the same as a known drop in fracture risk.

A 2021 two-year randomized trial in men aged 50 and older reported that testosterone increased areal bone density at both the lumbar spine and the total hip, predominantly via effects on cortical bone, with minor effects on trabecular architecture. The authors said implications for fracture risk reduction require further study. That trial was in men, so it does not transfer directly to women after menopause.

What the 2019 expert consensus says about bone

The 2019 global consensus position statement on testosterone therapy for women, endorsed by societies including the International Menopause Society, The Endocrine Society and the European Menopause and Andropause Society, says: “The available data do not support an effect of testosterone treatment on bone mineral density at the spine, total hip, or femoral neck at 12 months.”

The same statement says: “The only evidence-based indication for testosterone for women is for HSDD.” HSDD means hypoactive sexual desire disorder. It also calls for adequately powered randomized trials that measure both bone density and fracture risk. The 2026 study was published as a meeting presentation after that statement, so the consensus did not have it.

Side effects and what is still unknown

The 2019 consensus describes the side effects it found in women. The table below sets out its wording.

The statement notes that the trials excluded women at high cardiometabolic risk and were of relatively short duration. It advises blood level checks at baseline, at 3 to 6 weeks, and about every 6 months. At the time, it says, no female testosterone product was approved by a national regulator.

How bone density is measured and what the numbers mean

A bone mineral density test measures calcium and other minerals in your bone. The NIAMS guide explains that bones with more minerals are denser, and tend to be stronger and less likely to break. The most common test is the DXA, also written DEXA. It uses radiation to measure how much calcium and other minerals are in a specific area of bone, usually the hip and spine.

• A T-score of -1 or higher is considered healthy.
• A T-score from -1 to -2.5 means osteopenia, a less severe form of low bone density.
• A T-score of -2.5 or lower means you might have osteoporosis.

Women after menopause receive a T-score. Premenopausal women and men under 50 receive a Z-score, which compares them with people of their age, sex and ethnicity. The NIAMS guide says the U.S. Preventive Services Task Force recommends bone density testing for women over 65, and for women under 65 who have gone through menopause and are at increased risk of an osteoporosis-related fracture. Any diagnosis or treatment decision is based on the scan result along with your age and other fracture risk factors.

Why bone density drops after menopause

The Menopause Society release says women can lose 10% to 20% of bone density in the first five to seven years after menopause. The NIAMS guide notes that bones can become less dense as we age. When too much bone is lost, osteoporosis can develop, which makes bones weak and brittle and raises the risk of fractures.

Other options the research points to

The Menopause Society release lists weight-bearing and resistance exercise, adequate calcium and vitamin D, and hormone therapy as methods it calls proven to help protect bone health. It says standard estrogen therapy significantly lowers the risk of spine and hip fractures. Our vitamin d and bone health guide covers the vitamin D side in more detail.

The FDA consumer update on hormone replacement therapies says the approved hormone therapies for hot flashes, night sweats and related symptoms “may reduce chances of getting osteoporosis.” The 2022 hormone therapy position statement from The North American Menopause Society, now The Menopause Society, says the benefit-risk ratio is favorable for women younger than 60, or within 10 years of menopause onset, with no contraindications, for treating bothersome vasomotor symptoms and preventing bone loss. It says treatment should be individualized and periodically reevaluated.

Our joint, muscle and bone care section gathers related topics in one place.

Questions to bring to a clinician

• Which of my scores matters most for my fracture risk, given my age and other risk factors?
• Would a repeat DXA scan show whether my spine or hip bone density is changing over time?
• Is any hormone therapy I take already part of my bone plan?
• If testosterone were considered, what form would be used, how often would my blood levels be checked, and what would count as a response?
• What would happen if I did not notice a response after six months?
• Which side effects, including effects on cholesterol, blood clots and breast health, apply to my situation?
• Is any testosterone product approved for women where I live?

Where this leaves you

The research so far shows one small study with a spine T-score rise, a stable hip, and no fracture data. The 2019 global consensus statement said the available data do not support a bone density effect at 12 months, and it names HSDD as the only evidence-based indication for testosterone in women. Long-term safety has not been established. Bring your own DXA results, including both spine and hip T-scores, into that conversation.

By BackToHealthTroy.com Editorial Team

This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.

There is no single osteoporosis treatment that is best for everyone. Romosozumab (EVENITY) is an FDA-approved bone-building drug for certain postmenopausal women. Which option fits you depends on your bone density scan, your fracture history and your overall health, so make that choice with your clinician.

What is the new osteoporosis breakthrough in the news?

Headlines about a new scientific breakthrough for bones can be hard to judge. A headline makes a claim, but it doesn’t tell you whether the finding came from a lab, from animals or from people. Before you act on it, check three things: whether the study was done in a lab, in animals or in people; how many people took part and for how long; and what it measured, such as bone density, fractures or both.

Bone density and fracture rates are different measures. A higher bone density reading on a scan and a lower chance of breaking a bone are not the same result, so don’t treat one as proof of the other.

Harvard Health puts the existing options plainly: “Many drugs available today can slow the rate of bone loss and can rebuild bone strength.” That describes drugs already in use. It doesn’t tell you what the new finding in the headline showed.

What osteoporosis treatments are approved?

The New York State FDA-approved osteoporosis medicines list was last revised in June 2020, so check the FDA for anything added since then. The list says FDA approval means the medication has been proven to slow bone loss, increase bone density and reduce fracture risk at the spine or hip. It sorts the medicines into two groups: antiresorptive medicines, which prevent bone loss, and anabolic medicines, which build new bone.

The NHS osteoporosis treatment guide covers the main groups. Here is what each one does and the side effects the NHS lists.

The NHS guide says the decision about what treatment you need, if any, depends on factors including your age, sex, risk of breaking a bone and previous injury history. It also says you may not need or want to take medicine.

Is EVENITY (romosozumab) the best treatment?

It is not the best choice for everyone, and no single option is. EVENITY’s own website describes it this way, as of October 2026: “EVENITY is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk of fracture, or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.”

EVENITY’s website says it “is proven to significantly reduce spine fracture risk in just 12 months” and that it “increases bone mineral density in 3 critical areas: the lower spine, at the hip, and the top of the thigh bone.”

The Arthritis Foundation reports that the FDA approved romosozumab for postmenopausal women who have fractures, are at very high risk for fractures or haven’t responded to other treatments. It says that in clinical trials romosozumab increased spine bone density “as much as 15%” and cut down on spinal fractures. A biotech analyst quoted by the Arthritis Foundation says hip fractures in the study decreased by only 25%.

The drug comes with a warning. The Arthritis Foundation says it carries an FDA warning for an increased risk of heart attack, stroke and cardiovascular death. EVENITY’s website says to tell your provider if you have had a heart attack or stroke, especially in the past year. It also says not to receive EVENITY if you have low blood calcium or are allergic to romosozumab or any of its ingredients.

Experts disagree about where it fits. A rheumatologist quoted in the Arthritis Foundation article thinks it will be best for postmenopausal women with “multiple Grade 2 or 3 [moderate to severe] vertebral fractures and a low T score [meaning severe osteoporosis] who haven’t been previously treated.” Another rheumatologist quoted there says a new osteoporosis drug should only get traction if it doesn’t have the rare side effects of atypical femur fractures and osteonecrosis of the jaw.

How much do the bone-building drugs cost?

The Arthritis Foundation article gives these figures. Prices change and depend on your insurance, so check today’s price with your pharmacy, your insurer or your prescriber’s office.

The same article says a rheumatologist expects the parathyroid drugs to be bought under Medicare Part D, while romosozumab is available under Medicare Part B, which he says should make it affordable for more patients. Ask your insurer which part applies to you.

What are the new treatments for osteoporosis in 2026?

The Osteoporosis treatment: current drugs and future developments review describes the approved drugs as “currently approved clinical therapeutic drugs” and covers newer ideas that are under development.

What newer ideas does the 2024 review cover?

Lab and animal results come before human trials, so they can’t tell you how a person would respond. That is our takeaway, not a finding from the review. The review covers these ideas in its own words.

What do Chinese people do for osteoporosis?

Traditional Chinese medicine (TCM) is one approach. The 2024 review describes TCM as “from a wide range of sources and mostly plants.” Its authors are based in China, with affiliations that include Chinese medicine institutions. They write that herbal plants have “unique advantages in regulating the relationship between osteoporosis and the immune system,” and that acupuncture “has significant therapeutic effects in combination with medicine for osteoporosis.” These are the authors’ views. The same review says the target cells and specific molecular mechanisms of TCM “have not been fully elucidated.” Herbs and acupuncture are not on the New York State list of FDA-approved medicines. Ask your clinician before you use any herbal product or acupuncture alongside your osteoporosis treatment.

Is there a vitamin or food that rebuilds bone fast?

Here is what the NHS and the 2024 review say.

• Calcium. The NHS says that for most healthy adults, a varied diet should supply the recommended 700 milligrams a day. If you have osteoporosis you may need more, usually as supplements, so ask your GP.
• Vitamin D. It helps your body absorb calcium. The NHS says it is difficult to get enough vitamin D from food alone, so everyone should consider a daily supplement during autumn and winter.
• Food first. The 2024 review says “vitamin D and calcium from food, which can be the first choice for the prevention and treatment of osteoporosis.”
• Vitamin C. The review says “appropriate levels of vitamin C in the diet are beneficial to bone metabolism and the absorption of calcium ions.”
• Vitamin K2. The review discusses menaquinone, a synthetic vitamin K2 drug, and calls it a “second-line drug” for postmenopausal osteoporosis. It also reports that menaquinone reduced the incidence of vertebral fractures in the randomized trials it reviewed. That is a drug, not the over-the-counter vitamin K2 supplement, so it doesn’t settle whether those supplements help. Our Vitamin K2 for Osteoporosis guide covers the supplement question separately.

Is there a quick way to raise bone density? The NHS says bisphosphonates usually take 6 to 12 months to work, and you may need to take them for 5 years or longer.

Which six foods should I avoid? Ask your clinician or a dietitian before cutting out any food group, so you don’t lose nutrients you need.

What can I do myself alongside treatment?

The New York State Department of Health lists the everyday steps: eat a well-balanced diet, get the right amounts of calcium and vitamin D, exercise every day, don’t smoke, limit alcohol and try to prevent falls. Harvard Health covers the medicine options. The Arthritis Foundation adds that doctors recommend resistance training and weight-bearing exercise such as walking or running.

Falls are a big part of the risk. The NIA room-by-room fall prevention guide suggests handrails on both sides of any stairs, good lighting with switches at the top and bottom of stairs, and carpets fixed firmly to the floor.

Supplements are a separate question. The NIA says to talk with your health care provider before starting any new prescription, OTC medicine, or supplement.

When should I see a clinician about treatment?

Harvard Health says your doctor will measure bone density, usually at the hip and spine, using DEXA. Your doctor will likely recommend medicine if you have:

• a T-score of –2.5 or lower
• a history of a hip or spine fracture caused by a fall while standing
• a T-score between –1.0 and –2.5 and a high risk of a hip or osteoporosis-related fracture in the next 10 years, according to a fracture risk calculator

If you have already broken a bone because of osteoporosis, the NHS says you should still receive treatment to reduce your risk of further broken bones.

Before you talk to your clinician

• Based on my bone density scan and fracture history, which group do I fall into?
• Do I have a history of heart attack or stroke, and does that change which option fits me?
• Do I have low blood calcium, kidney problems or dental work planned?
• If a bisphosphonate is an option, do I need a dental check-up first? The NHS says a history of dental problems may call for one.
• What will I pay with my insurance, and which Medicare part covers it?

For the bigger picture on joints and bones, our Joint, Muscle and Bone Care section is a good next place to read.

By BackToHealthTroy.com Editorial Team

This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.

Gummies and capsules can both deliver magnesium, but they differ in how many pieces make a serving, how much sugar comes with them, and how easy they are to swallow. Format alone does not decide how much magnesium you get or how well it is absorbed. The number to compare is the elemental magnesium listed per serving on each Supplement Facts panel.

Do magnesium gummies work the same as pills?

The answer is not settled. BodySpec says direct gummy-versus-pill trials are rare, and that absorption depends mainly on the chemical form of the magnesium. It cites a 2021 systematic review by Pardo et al. that found organic salts such as citrate and glycinate generally have higher bioavailability than inorganic salts such as oxide, regardless of delivery method.

The sources disagree on the format itself. OLLY, a gummy maker, says a citrate gummy from a transparent brand delivers the same absorbable magnesium as a citrate capsule. Circle Organics, which also sells gummies, says capsules often hold an advantage in delivering a concentrated dose. A journal article on magnesium bisglycinate says clinical evidence directly comparing the absorption of organic and inorganic magnesium salts remains limited.

Dr. Stanfield’s supplement article says relatively few studies have compared capsule vitamins with gummy vitamins. It says gummies seem slightly better for absorbing some vitamins, but not all of them. Those were small studies of vitamins, not magnesium.

If you are looking at magnesium glycinate in particular, the magnesium glycinate page explains that form. The form on the label matters as much as whether it comes as a gummy or a capsule.

How many gummies equal a labeled serving?

There is no universal conversion. PUKO Nutrition, which sells capsules, says to compare elemental magnesium per labeled serving and units per serving on each product’s label. The Supplement Facts panel declares the elemental magnesium, not the weight of the whole magnesium compound. Check the serving size first, because the large number on the front may not describe one piece.

BodySpec says you may need to eat several gummies to match one pill. Dr. Stanfield’s article says a typical capsule multivitamin may include 125+ mg of magnesium, and that this would be 2-3 gummies’ worth of magnesium in dedicated magnesium supplements. Your product’s count will be different, so do the math from its own label.

Can a gummy contain less magnesium than the label says?

The sources point to a few reasons a gummy’s magnesium may not match what you expect. Circle Organics says gummies typically carry less elemental magnesium per piece than a tightly packed capsule. Dr. Stanfield’s article says gummies can melt together in humid conditions, and some ingredients can lose potency over time.

Circle Organics also says third-party testing helps the potency on the label match what is in every piece. Cleveland Clinic’s magnesium and sleep article points out that a USP verification “means it meets basic quality standards, but it doesn’t guarantee the product works.” Before you order, ask the brand for its third-party test report, and look for a USP or NSF seal.

What are the tradeoffs for dental health, sugar and child access?

Sugar

BodySpec says many gummies contain added sugars, and some servings pack 4 to 6 grams. It suggests considering brands sweetened with erythritol or stevia if you are diabetic or on keto. OLLY says gummies use a sweetener to taste good, and that a non-gummy format such as a capsule or softgel skips sweeteners entirely.

Dental health

Circle Organics says chewy, sugary supplements can stick to tooth enamel and feed oral bacteria. This is the gummy seller’s own statement. Ask your dentist whether sticky supplements matter for your teeth.

Children

BodySpec says gummies are designed for people who dislike swallowing pills, such as children. It says parents often look for low-dose gummies, around 50 mg, to stay well below the safety limits for children. BodySpec, citing the NIH, gives 65 to 350 mg as the upper intake level for children, depending on age. Circle Organics says to check with a pediatrician about serving sizes for children. Before you choose a format for a child, ask the pediatric care team which amount fits the child’s age.

What are the side effects of magnesium gummies?

The table lists what each source reports, with the source named in each row.

BodySpec, citing the NIH, gives 350 mg a day as the upper intake level for supplemental magnesium in adults. The magnesium overdose page covers upper limits in more detail.

OLLY says people with kidney conditions or those taking prescription medications should check with a healthcare provider before starting daily supplementation.

What the research can and cannot tell you

Cleveland Clinic’s magnesium and sleep article says: “Bottom line? Magnesium may help some people sleep better, but there’s still not enough research to know how well it works.” The same article says forms include powders, gummies and drink mixes, “but these can contain a lot of other ingredients as well.”

The research can tell you what a label says, how many pieces make a serving, what sugar comes with it, and what side effects have been reported. It cannot yet tell you whether one format leads to a better result for you. Format affects convenience and ingredients. It does not by itself establish absorption, efficacy or suitability for children.

Practical alternatives and your next step

Most magnesium supplements for sleep come in pill form, tablets or capsules, Cleveland Clinic says. Powders and drink mixes are other options. PUKO says powder taste and texture vary, and that dissolving a powder does not by itself establish better absorption.

Your next step is to compare the labeled serving with how you would actually take it. Then ask your pharmacist whether it fits your needs, especially if you take prescription medicine or have kidney disease.

Before you choose

• Elemental magnesium per serving on the Supplement Facts panel
• How many gummies or capsules make one serving
• Sugar and sugar alcohols in gummies
• The Other Ingredients list
• A USP or NSF seal and the brand’s test report
• The child’s age and the pediatric care team’s view, if a child will take it
• Your current medicines, reviewed with a pharmacist

By BackToHealthTroy.com Editorial Team

This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.