Can you reverse osteoporosis?

I thought not, but then...

It’s spine time

When I was diagnosed with osteoporosis in my spine aged 42, the first thing I asked my oncologist was: “Can it get better? Or is it just a case of managing decline?”

She did that “eek, sorry” expression that people do when they want to be kind, but they have to be honest.

At the time, I was emerging from 18 months of breast cancer treatment. My body had been through the wringer, and this felt like adding insult to injury (more like adding injury to injury, but anyway).

I dealt with it by throwing myself into learning as much as I can about ways to stop my bones crumbling to dust before I turn 50.

As well as writing about it here at Well Well Well, I also wrote an article for the Telegraph for which I spoke to Mr Arman Memarzadeh, a consultant trauma and orthopaedic surgeon at Nuffield Health. Hoping for a different answer to the one I’d already had, I asked him: can osteoporosis be reversed? “You won’t like this answer,” he said, with the same expression as my oncologist. “But no.”

So, and here’s the twist, I was both delighted and baffled when my most recent DEXA scan showed that I no longer have osteoporosis. Errrrm what?

I call Kirsty Carne, senior osteoporosis specialist nurse at the Royal Osteoporosis Society, to ask wtf is going on.

“Well look, you can’t reverse osteoporosis,” she begins, “but there are fluctuations within that.”

In my case, for example, osteoporosis was brought on suddenly by cancer treatment and subsequent early menopause (my lifelong lack of inclination to exercise can’t have helped, either), so my first DEXA scan took place at my skeleton’s lowest ebb.

Since then, not only have I started actually doing exercise, but also I’m having six-monthly zometa infusions (a bisphosphonate medication for bone health), and I’ve been prescribed Adcal, a supplement of calcium and vitamin D.

Going from bone health rock bottom to throwing the kitchen sink at it has not “reversed” my osteoporosis, but it has caused what Kirsty would call a “fluctuation”, which has taken me out of the osteoporosis range, and into the osteopenia range.

If you’re interested in specifics of how DEXA scans are interpreted, it’s all on the ROS website.

So it’s not the medical miracle that I initially thought, but also it’s very positive news. And a good incentive to keep prioritising bone health.

Kirsty’s top 3 tips for strong bones are…

1. Eat well. Include a variety of plant foods at every meal (sprinkle seeds and berries on your porridge, throw some kale into your spag bol, snack on pistachios or edamame beans). Have at least 700mg of calcium daily - dairy is the best source, but plant based milks are fortified, and lots of veg is high in calcium too. and supplement with vitamin D in the winter months. I wrote this handy explainer of how much we actually need in the Sunday Times at the weekend.

2. Don’t smoke, and limit alcohol. There are lots of other options these days!

3. Exercise - specifically weight bearing and strength training. Boringly, it’s very important.

Yes, sorry, you do need to lift something heavy

If you have been prescribed Adcal, you might be wondering if there’s an alternative to the chalky chewable ‘tutti-frutti flavour’ pills. I recently discovered an American brand called Seen, which makes delicious calcium chews from real food. They don’t yet deliver to the UK unfortunately but, if you’re one of Well Well Well’s US subscribers, I have a code for 10% off.

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