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Keeping your bones healthy and strong can require extra effort when you’ve got multiple sclerosis. That’s because people with MS have a higher risk of developing osteoporosis than the general population. Osteoporosis is a disease where low bone density causes the bones to become thin and brittle, making them more likely to break. 

Some of the reasons people with MS have an elevated risk of osteoporosis include:

Though brittle bones are more often associated with the elderly, even young people in the early stages of MS (who have few symptoms and walk well) have bone density loss. Because osteoporosis rates in MS are not in proportion to the person’s age and ambulation level, research suggests that there may be a pathological connection between MS and early bone density loss. 

Although osteoporosis risk is much higher among women regardless of coexisting diseases, research has shown the presence of MS heightens osteoporosis risk for men as well. 

People with MS also have a high risk for fractures because of falls, and osteoporosis significantly increases this risk. Among a sample of 9,346 people with MS, 25 percent reported having osteopenia or osteoporosis, and approximately 16 percent reported a history of fracture. Of these, 35 percent were wrist fractures, 11 percent were vertebral fractures, 7 percent were hip fractures, and more than 42 percent reported multiple fractures. 

Ask your doctor whether you should have a baseline bone density screening. A DEXA scan uses X-rays to measure the bone mineral density of your spine and hips. The risk of radiation exposure from a DEXA scan is low, especially when compared with the benefit of finding out whether you have osteoporosis or osteopenia, which is a less severe level of bone density loss.

Regardless of your current bone health, making healthy lifestyle and diet choices can give you the greatest advantage of preventing future bone density loss:

1. Make sure you’re getting the calcium your body needs for good bone health. It can be difficult to get enough calcium from diet alone, so ask your doctor if you should take a calcium supplement to provide the rest.

2. Monitor your vitamin D level. Low vitamin D can lead to reduced calcium absorption and bone mineralization, which is the process the body uses to turn minerals into bone structure. As with calcium, your doctor can provide you with the necessary vitamin D supplementation to get your level up to where it should be.

3. Don’t smoke! In addition to all the other ways smoking is bad for your body, smoking also can decrease your vitamin D levels.

4. Avoid drinking alcohol excessively. Alcohol inhibits the action of bone-forming cells. The result is decreased bone formation and ultimately, weak bones. Plus, when you’re drunk you’re more likely to stumble; raising the risk of falls and fractures.

5. Exercise regularly, particularly weight-bearing exercise. According to the National Osteoporosis Foundation, performing 30 minutes of daily weight-bearing exercises can not only prevent bone loss but can also help prevent falls. Weight-bearing exercises are those that force you to work against gravity, such as walking, jogging, or even marching in place while holding onto a sturdy piece of furniture. Always check with your doctor before starting any new exercise routine.

6. Eat your fruits and vegetables. Plant foods are full of nutrients that contribute to bone health. A Swedish study published in 2015 in the Journal of Bone and Mineral Research suggests a lack of produce in your diet may raise your risk of broken bones. Diets rich in fruits, vegetables, lean protein, calcium, and unsaturated fats are important for keeping your bones healthy and strong.