Osteoporosis is one of the commonest metabolic bone disorders that is associated with decreased bone strength. This progressive systemic skeletal disorder increases the susceptibility to fractures.

Different therapeutic modalities like hormone replacement therapy, as well as calcium and vitamin D supplements are commonly used to manage this condition, yet, the outcome is far from satisfactory. This is where natural remedies come to the rescue. Several drugs have been mentioned in classical Ayurvedic texts for their anti-osteoporotic activity. These include Nigella sativa, Cissus quadrangularis, Punica granatum, Tinospora cordifolia, Curcuma longa, Nigella sativa, Asparagus racemosus, Moringa oleifera, Zingiber officinale and Sesamum indicum, among others.

The phytoestrogen-rich fraction (IND-HE) of C. quadrangularis has been shown to yield statistically significant increase in bone thickness, bone density and bone hardness in osteoporotic models. C. quadrangularis reduces bone loss and the osteoclastic activity, and thus promotes bone formation. The ketosteroids of C. quadrangularis promote bone health.

P. granatum has been associated with significant increase in femur length, weight and density, increase in serum calcium, phosphorus and reduction in alkaline phosphatase, tartrate-resistant acid phosphatase, and osteocalcin in experimental osteoporosis models. Sesame oil also reduces the significantly altered alkaline phosphatase activity and tartrate-resistant acid phosphatase activity. P. granatum promotes bone cell proliferation and stimulates osteoblastic bone formation. T. cordifolia has been shown to stimulate the growth of osteoblasts and increase the differentiation of cells into osteoblastic lineage. Curcumin has been shown to affect osteoclastogenesis and osteoblast proliferation. Curcumin decreases osteoclast number and enhances osteoblast count. It also relieves oxidative stress-induced apoptosis in osteoblasts. N. sativa seed oil has been noted to improve the microarchitecture and biomechanical properties of bone. A. racemosus has an effect on mineralization, ossification and osteoclastic activity suppression. Phytosterols and other active constituents of A. racemosus may exert an effect on estrogen receptor similar to estrogen and yield an antiosteoporotic effect. M. oleifera also has osteoblast stimulating potential. Z. officinale prevents the loss of bone mineral density.

There are several herbs that can lead to significant improvement in osteoporotic changes and are devoid of any side effects. This therapeutic armamentarium of herbal remedies can be used along with the known treatment options for osteoporosis to yield better results.