A Consultant-Led, Reversal-First Approach

The BoneRevive® Programme

The BoneRevive® Programme is the London Osteoporosis Clinic’s consultant-led, structured bone health pathway — combining clinical assessment and monitoring, personalised pharmacological treatment where indicated, progressive therapeutic exercise, and clinical nutrition into a single integrated programme with regular outcome measurement.

• Initial Consultant Assessment — comprehensive clinical history, fracture risk stratification using FRAX, baseline DXA scan with trabecular bone score, blood panel, and personalised treatment plan.
• Medical Treatment (where indicated) — consultant-prescribed pharmacological therapy matched to the patient’s clinical profile, risk factors, co-morbidities, and preferences.
• Therapeutic Exercise — a progressive, clinically designed osteogenic loading programme delivered by a specialist Strength & Conditioning Coach, adapted to the patient’s DXA findings and fracture risk.
• Clinical Nutrition — personalised calcium, Vitamin D, and micronutrient strategy from a registered nutritional therapist, addressing absorption, deficiency, and anti-inflammatory dietary factors.
• Regular Monitoring — DXA follow-up at 12–24 month intervals to measure treatment response objectively. Treatment is adjusted based on results, not assumptions.

Pharmacological Treatment

Pharmacological treatments for osteoporosis fall into two broad categories. Understanding the distinction is important when discussing treatment options with your consultant:

• Antiresorptive Agents: Slow or prevent further bone loss by inhibiting osteoclast activity — the cells that break down bone. They stabilise bone density and reduce fracture risk but do not directly build new bone. (Examples: bisphosphonates, denosumab, raloxifene, HRT)
• Anabolic Agents: Stimulate new bone formation by activating osteoblast activity — the cells that build bone. They can achieve meaningful bone density gains and are particularly appropriate for patients with very low bone density or high fracture risk. (Examples: teriparatide, romosozumab, abaloparatide)

Antiresorptive Group

Anabolic Group

A Note on Sequential Therapy

For many patients with osteoporosis, the most effective long-term strategy involves a planned sequence of treatments rather than a single agent. Anabolic therapy is often used first to build new bone, followed by antiresorptive treatment to preserve the gains achieved. The specific sequence — and the duration of each phase — is determined by the individual patient’s clinical profile, bone density trajectory, fracture history, and tolerability.

Treatment holidays, sequential switching, and combination approaches are all part of the modern management toolkit for osteoporosis. Your consultant will discuss the most appropriate treatment strategy for your specific situation at each review appointment.

Therapeutic Exercise

Exercise is not an optional adjunct to osteoporosis treatment — it is a clinical intervention. The mechanical loading of bone through weight-bearing and resistance exercise provides the stimulus that osteoblasts need to form new bone tissue. But not all exercise is equal, and the type, intensity, and progression of the exercise programme matters significantly.

At the London Osteoporosis Clinic, therapeutic exercise is delivered by our specialist Strength & Conditioning Coach and clinical exercise team — in clinic, in our exercise classes, or with a personalised home programme designed alongside the consultant’s assessment findings.

All exercise prescriptions are adapted to individual DXA results, fracture history, and physical capacity.

Clinical Nutrition & Lifestyle

Nutrition plays a crucial role in preventing the development of osteoporosis, but many people aren’t aware that food also aids treatment. It plays such a vital role that drug treatment and other interventions are rendered less effective without adequate nutrition. After all, to form new bone tissue, your body requires certain raw materials to work with. This includes minerals like calcium, magnesium, and phosphorus.

At the London Osteoporosis Clinic, nutritional assessment and supplementation guidance is provided by our registered nutritional therapist as part of the BoneRevive® Programme — personalised to your clinical profile and absorption status, not a generic supplement list.

For more nutritional information, we offer this free educational programme →

Essential Nutrients

Lifestyle Adjustments

• Avoid smoking: Smoking is independently associated with accelerated bone loss through multiple mechanisms — suppression of osteoblast activity, reduced calcium absorption, and accelerated oestrogen metabolism in women. Cessation at any age reduces ongoing skeletal damage, and the benefit of stopping is measurable within a relatively short timeframe.
• Avoid excessive alcohol: Chronic alcohol consumption suppresses osteoblast function, increases falls risk through balance impairment, and is associated with reduced Vitamin D and calcium absorption.
• Prevent falls: Wear low-heeled shoes with non-slip soles, and check the house for hazards that might cause you to trip or fall. Keep rooms brightly lit, install grab bars inside and outside your shower door, and ensure you can quickly get in and out of your bed. Targeted balance, strength, and posture work reduces falls risk substantially.