DEAR DR. ROACH: I am a 68-year-old female who was first diagnosed with osteopenia and now osteoporosis. My physician has highly recommended medication or a monthly injection. I have completed hours of research and am very unhappy with the many personal stories of side effects. Evenity, the one drug that actually claims to rebuild bone, is not covered under Medicare, and the price is $2,086 per shot/per month for one year. (So sad!)

I read with great interest an article on the Osteoboost belt, which is the first medical device approved by the Food and Drug Adminstration. The clinical trial showed an average of 85% reduction in bone loss, and it was also used by astronauts to avoid bone loss while in space. Can this be true?

I asked my doctor about Osteoboost, and she stated that she doesn’t know anything about it. This was discouraging for me. I am hoping you have some insight or research you can share. I stay active with exercise and moderate weights, but Osteoboost has my interest. I hope some of the claims hold true. The price is over $900, so I’m hoping to hear some real and trusted information. — K.S.R.

ANSWER: Osteoporosis is a big issue for many women and a few men, so new therapies are always of interest.

First, though, romosozumab (Evenity) is not the only medicine to rebuild bone. Older drugs like alendronate (Fosamax) slow the breakdown of bone, allowing the body’s natural rebuilding of bone to catch up. Anabolic agents like parathyroid hormone analogs (teriparatide) also directly increase bone growth.

Evenity is unique because it both slows down bone breakdown and stimulates new bone growth. It is usually covered 80% by Medicare in the United States when given in a doctor’s office, with most supplemental plans paying the rest. You should check with your insurance provider to see how much you would pay. There is a concern about Evenity increasing the risk of heart disease, so I have so far avoided recommending it to people who are at a higher risk for heart disease.

I have written before about the use of vibration machines like Osteoboost. Recent trials have shown an increase in bone density with the device but have not shown a reduction in fracture rates, as those trials need to be larger and of a longer duration than the trials that have been published so far.

Alendronate, teriparatide and romosozumab all have clinical trial data showing reductions in fracture rates. The vibration devices may reduce fall rates, which may help with fracture reduction.

Astronauts in space typically used resistive exercises to combat bone loss in low-gravity situations, although vibration studies performed on Earth were promising, and I saw a proposal for a trial on the International Space Station. Note that the device is not FDA-approved, but it is FDA-cleared, which requires less stringent scrutiny.

Drug-free regimens would be a large addition to the available therapies for osteoporosis, but I still await more studies before recommending vibration devices.

In addition to exercise, a diet high in natural calcium (such as dairy and fish with tiny bones, like anchovies and sardines) as well as vitamin D supplements can help prevent the progression of osteopenia and the worsening of osteoporosis. Five or six prunes a day also help to strengthen bones.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved