Is weight training with osteoporosis at 59 years safe?

Question

Hello doctor,

I am a 59-year-old postmenopausal woman who was recently diagnosed with osteoporosis. My dual-energy X-ray absorptiometry (DEXA) scan showed a T-score (standard deviation score compared to a young healthy adult) of –2.8 at the lumbar spine and –2.4 at the femoral neck. I also sustained a wrist fracture last year.

I am currently taking calcium and vitamin D supplements, and I have just started taking Alendronate (bisphosphonate) once weekly. However, I am concerned about the long-term safety of bisphosphonates, especially since I have heard that they can cause jaw-related issues.

I am also unsure whether weight training is safe in my case.

Could you please help me understand?

How long might I need to continue Alendronate, and what kind of monitoring is required during treatment?
Are there safer or newer alternatives available for maintaining bone health?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Given your T-scores (–2.8 at the lumbar spine and –2.4 at the femoral neck) and a history of wrist fracture, your diagnosis of osteoporosis is accurate. Early treatment is essential to reduce the risk of further fractures.

Alendronate (bisphosphonate) – duration and monitoring

Alendronate, a medication from the bisphosphonate class, helps strengthen bones and significantly reduces fracture risk. The typical treatment duration is three to five years, after which a drug holiday may be considered if your fracture risk is stabilized. This decision is usually based on a repeat dual-energy X-ray absorptiometry (DEXA) scan and the absence of new fractures.

Monitoring recommendations:

Bone mineral density (DEXA scan) every one to two years.
Blood tests to check serum calcium, vitamin D levels, and renal (kidney) function.

The concern you mentioned about jaw problems (osteonecrosis of the jaw) is a known but rare side effect, more commonly associated with high-dose intravenous bisphosphonates or following dental surgeries. Maintaining good oral hygiene, scheduling routine dental check-ups, and informing your dentist about your medication can help minimize this risk.

Weight training and exercise safety.

Yes, weight-bearing and resistance exercises are not only safe but highly beneficial in osteoporosis, especially when performed under professional guidance.

Recommended exercises:

Low-impact strength training.
Posture improvement activities (e.g., yoga or pilates under supervision).
Balance and coordination exercises to prevent falls.

Avoid:

High-risk movements include heavy lifting.
Spinal flexion exercises (e.g., sit-ups or crunches) should be performed without proper supervision.

Always warm up and cool down gently, and wear supportive footwear.

Calcium and vitamin D.

Calcium: Continue taking 1000 milligrams per day, preferably in divided doses for better absorption.
Vitamin D3 (cholecalciferol – vitamin D supplement): Take 60,000 IU(International Units) once weekly (1 tablet per week) for about eight weeks, or as advised by your healthcare provider based on your vitamin D levels.
Stay well-hydrated throughout the day.

I hope this helps.

Thank you.