How do we know whether our bones are healthy or not? We can’t see them like we can our skin, or listen to them like the heart or lungs. Bone density scans are one way to look inside bone, but we rarely get a bone density test until after menopause and even so, bone mineral density technology has a long way to go in my opinion. As a medical anthropologist, I’m always wondering what nature can tell us on her own about our health. And it turns out, there are many outward signs and symptoms that may shed light on the health of your bones.
I refer to these signs and symptoms as “tips” from nature about our bone health. They certainly aren’t definitive or meant to scare you into thoughts of osteoporosis, but if you’re the type of person who’s planning to be active and strong well into old age like I am, it doesn’t hurt to assess your bones from the outside.
Let’s take a look at some signs and symptoms that may be indicators of early bone loss. Investigating these tips early on may save you from unwanted treatment or therapy down the line and offer you the freedom of strength and movement for the rest of your life.
1. Receding gums. Receding gums are quite common and can be attributed to a variety of factors, one of which is bone loss. Our teeth are connected to the jaw bone and if the jaw is losing bone, gums can recede. In studies of women, jaw bone loss has also been associated with lower bone mineral density in areas such as the vertebral bodies of the lumbar spine. The standard panoramic x-rays during your visits to the dentist can provide a well-informed dentist with an opportunity to screen you for bone loss. So ask your dentist to share any information and insight he or she may glean from your exam and x-rays regarding your bone health.
2. Decreased grip strength. As we grow older, one of the surest ways to keep the risk of fracture to a minimum is through fall prevention — and for that, good balance, overall muscle strength, and grip strength are fundamental. In a recent study of postmenopausal women, handgrip strength was the most important physical test factor related to overall bone mineral density. And fortunately, improving handgrip strength and overall muscle strength is within your reach, no matter what your age. For more information on increasing muscle strength, see my article on exercise and bone health.
3. Weak and brittle fingernails. I often observe that after women start a plan for better bone health, their fingernails grow stronger and healthier right along with their bones. We always consider it a good sign when nail strength improves, and recent science suggests this nail-bone health observation is indeed valid. However, spending time in water, exposure to harsh chemicals, digging in the garden, or other work can be tough on your nails, so take these into consideration as you assess your own nails.
For most people, vitamin D deficiency is neither difficult nor costly to diagnose and correct. Have your own levels checked twice yearly with the change of seasons, and supplement accordingly. (See the ABC’s of vitamin D testing and treatment for recommendations.) This simple, low-cost practice will go a long way towards halting unnecessary bone weakening.
4. Cramps, muscle aches, and bone pain. As we get older, many of us accept aches and pains as a part of life, but these symptoms may indicate that your bones are in need of some support. Muscle and bone pain is an often overlooked, but well-documented symptom of severely inadequate vitamin D — an important bone builder. According to experts, vitamin D deficiency has reached alarming proportions, and researchers worldwide have been evaluating its association with muscle pain.
Cramps are another symptom to pay attention to. There can be a number of mechanisms causing leg and foot cramps, but leg cramps that occur at night are often a signal that your calcium, magnesium, and/or potassium blood levels have dropped too low during the night, when you are not consuming food. If this situation were to persist over time, excessive bone loss could occur. At the Center for Better Bones, I recommend that women experiencing nocturnal calf and foot cramps take their calcium–magnesium supplements closer to bedtime.
5. Height loss. Losing height is very common as we age and there are many precursors to it, including poor posture and vertebral fractures. Poor posture may not mean you have bone loss, but it can indicate weakening of the muscles around your spine, and since bone and muscle work in one unit and typically gain and lose strength in synchrony, it’s likely that a loss in muscle is connected to an eventual loss in bone.
Try testing your pH. If your first-morning urine pH (after at least 6 hours of sleep without getting up to urinate) is below 6.5, or, if your first-morning saliva pH is below 7.0, your bone alkali mineral reserves are likely being drawn out of your skeleton to buffer metabolic acids.
Following the 10 steps outlined in our Alkaline for Life Diet can help you rebuild your bone’s alkali mineral reserves and maintain your optimum pH balance without depleting your bone mass.
Spinal fractures are another reason we lose height. An estimated two-thirds of all spinal fractures happen without us knowing they’ve occurred — and therefore they go unreported. Yet, having even such a silent vertebral fracture indicates bone weakening, and may increase your risk of future fractures. So keep those muscles in the back strong!
6. Low overall fitness. Osteoporosis has been linked to overall decline in physical fitness, as measured by aerobic capacity, muscle strength, and even balance. If your general fitness declines, it is likely that bone mass will also decline. Instead of feeling scared or worried by these changes, take the opportunity to put more attention on your personal health and longevity by taking care of your bones. Even women who have been sedentary their whole lives can make significant gains, including better physical coordination, when they undertake a moderate, self-paced exercise program designed for their needs. And even people in their 80s and 90s have the ability to adapt and respond to both endurance and strength training. For ideas, read my article on exercise and bone health.
Strong bones are your fountain of youth
Call me biased, but I think strong, healthy bones are the fountain of youth. If your bones are healthy and strong, it’s likely your muscles are too, and it’s also likely you have a great reserve of minerals tucked away for the future. Strong bones mean you have the ability to be active and even flexible into your older years. You don’t have anything to lose by taking good care of your bones — and you have everything down to the bone to gain.
1 Kozłowski, A. 2002. [Tomographic evaluation of mastication in women with osteoporosis.] Ann. Acad. Med. Stetin., 48, 243–254. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/14601481 (accessed 09.02.2010).
Jeffcoat, M. 1998. Osteoporosis: A possible modifying factor in oral bone loss. Ann. Periodontol., 3 (1), 312–321. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/9722715 (accessed 09.02.2010).
2 Vlasiadis, K., et al. 2007. Mandibular radiomorphometric measurements as indicators of possible osteoporosis in postmenopausal women. Maturitas, 58 (3), 226–235. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/17923346 (accessed 09.02.2010).
3 Marin, R., et al. 2010. Association between lean mass and handgrip strength with bone mineral density in physically active postmenopausal women. J. Clin. Densitom., 13 (1), 96–101. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/20171571 (accessed 08.26.2010).
“…Body weight was strongly and positively related to BMD in all sites, but the most important component of body composition was lean mass, also significantly related to all BMD sites, whereas fat mass was weakly related to the femoral neck BMD. Percent fat did not correlate with any BMD site. Of all the physical tests, the handgrip strength was most importantly related to lumbar spine, femoral neck, and total body…”
4 Hossein–Nezhad, A., et al. 2008. The fingernail protein content may predict bone turnover in postmenopausal women. Iranian. J. Publ. Health, 1, 55–62. URL (PDF): http://journals.tums.ac.ir/upload_files/pdf/12894.pdf (accessed 08.20.2010).
Moran, P., et al. 2007. Preliminary work on the development of a novel detection method for osteoporosis. J. Mater. Sci. Mater. Med., 18 (6), 969–974. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/17221317 (accessed 08.26.2010).
Towler, M., et al. 2007. Raman spectroscopy of the human nail: A potential tool for evaluating bone health? J. Mater. Sci. Mater. Med., 18 (5), 759–763. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/17136606 (accessed 08.20.2010).
Pillay, I., et al. 2005. The use of fingernails as a means of assessing bone health: A pilot study. J. Women’s Health (Larchmt), 14 (4), 339–344. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/15916508 (accessed 08.26.2010).
[No author listed.] 2005. Fingernail test for bone disease. URL: http://news.bbc.co.uk/2/hi/health/4663287.stm (accessed 08.20.2010).
5 Holick, M., & Chen, T. 2008. Vitamin D deficiency: A worldwide problem with health consequences. Am. J. Clin. Nutr., 87 (4), 1080S–1086S. URL: http://www.ajcn.org/cgi/content/full/87/4/1080S (accessed 08.26.2010).
6 Knutsen, K., et al. 2010. Vitamin D status in patients with musculoskeletal pain, fatigue and headache: A cross-sectional descriptive study in a multi-ethnic general practice in Norway. Scand. J. Prim. Health Care, 28 (3), 166–171. URL: http://informahealthcare.com/doi/full/10.3109/02813432.2010.505407 (accessed 09.03.2010).
Atherton, K., et al. 2009. Vitamin D and chronic widespread pain in a white middle-aged British population: Evidence from a cross-sectional population survey. Ann. Rheum. Dis., 68 (6), 817–822. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/18697776 (accessed 09.03.2010).
Plotnikoff, G., & Quigley, J. 2003. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin. Proc., 78 (12), 1463–1470. URL: http://www.mayoclinicproceedings.com/content/78/12/1463.long (accessed 08.26.2010).
7 Ørstavik, R., et al. 2000. [Vertebral fractures in osteoporosis — silent fractures of clinical importance.] Tidsskr. Nor. Laegeforn, 120 (24) 2891–2894. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/11143411 (accessed 09.07.2010).
8 Haczynski, J., & Jakimiuk, A. 2001. Vertebral fractures: A hidden problem of osteoporosis. Med. Sci. Monit., 7 (5), 1108–1117. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/11535963 (accessed 09.07.2010).
9 Kattenstroth, J–C., et al. 2010. Superior sensory, motor, and cognitive performance in elderly individuals with multi-year dancing activities. Front. Aging Neurosci., 2, 31. URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917240/ (accessed 09.20.2010).
Kramer, A., et al. 2010. Front. Aging Neurosci.
10 American College of Sports Medicine, et al. 2009. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med. Sci. Sports Exerc., 41 (7), 1510–1530. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/19516148 (accessed 09.20.2010).
[No authors listed.] 1998. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med. Sci. Sports Exerc., 30 (6), 992–1008. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/9624662 (accessed 09.20.2010).
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