New research on sleep and bones


Bet you feel healthier after a good night’s sleep — well, so do your bones. Here’s what the scientists have found in their latest research about the connection between sleep and your bones:

• Reduced sleep duration was associated with lower bone density in middle aged and older women in one Chinese study.

• Obstructive sleep apnea, with its loss of sleep and oxygen deprivation, weakens bone.  A recent Taiwanese study found the incidence of osteoporosis to be 2.7 times higher among those with sleep apnea.

• Insomnia was associated with a 52% increased risk of osteoporosis in a recent Norwegian study.

• In animal models lack of sleep was found to halt new bone formation, cause cell damage,  and produce abnormal bone marrow, all likely to be associated with poor bone repair.

These studies highlight that sleep is essential to give us a time and environment for crucial bone repair and regeneration. Inadequate sleep is a pro-inflammatory stressor that results in “repair deficit” — a deficit that goes bone deep.

How much sleep is enough?

While the amount of sleep needed varies by individual, the scientific evidence suggests 7 hours of sleep per night is needed to help reduce physiological and neurobehavioral deficits. Personally I feel best with 8 hours of sleep in the dark winter months, but do just fine with a bit less in the sunny summer.

Better Bones tips for restorative sleep

  1. Take care with caffeine. Try a few days without this stimulant and note any sleep improvement.
  2. Try a non-electronic quieting down period in the evening. Instead of plugging in, try a hot bath, short meditation or the Yoga Nidra sleep audio.
  3. Melatonin regulates nocturnal circadian rhythms. Using 3 mg before bed helps many women sleep better and also builds bone. There is good data that melatonin enhances bone formation, reduces bone breakdown, and has cancer-protective properties to boot.
  4. Finally, sharing my own story of sleep success. I am no stranger to sleep disruptions, and I suspect it’s due to mental over-activity and a “worry-wart” tendency (as my mother would say). Recently I have found the cortisol-controlling adrenal support formula known as Serinisol from Women’s Health Network to be a godsend. Using the natural product I feel more calm and at ease during the day and sleep happily, solidly through the night. If you give it a try, let me know how it works for you.


References for the studies mentioned above:

Chen, Y. L., S. F. Weng, Y. C. Shen, C. W. Chou, C. Y. Yang, J. J. Wang, and K. J. Tien. 2014. Obstructive sleep apnea and risk of osteoporosis: A population-based cohort study in Taiwan. Journal of Clinical Endocrinology and Metabolism 99(7):2441–2447.

Everson, C. A., A. E. Folley, and J. M. Toth. 2012. Chronically inadequate sleep results in abnormal bone formation and abnormal bone marrow in rats. Experimental Biology and Medicine 237(9):1101–1109.

Everson, C. A., C. J. Henchen, A. Szabo, and N. Hogg. 2014. Cell injury and repair resulting from sleep loss and sleep recovery in laboratory rats. Sleep 37(12):1929–1940.

Fu, X., X. Zhao, H. Lu, F. Jiang, X. Ma, and S. Zhu. 2011. Association between sleep duration and bone mineral density in Chinese women. Bone 49(5):1062–1066.

Sivertsen, B., T. Lallukka, P. Salo, S. Pallesen, M. Hysing, S. Krokstad, and S. Øverland. 2014. Insomnia as a risk factor for ill health: Results from the large population-based prospective HUNT study in Norway. Journal of Sleep Research 23(2):124–132.

Swanson, C. M., S. A. Shea, K. L. Stone, J. A. Cauley, C. J. Rosen, S. Redline, G. Karsenty, and E. S. Orwoll. 2015. Obstructive sleep apnea and metabolic bone disease: Insights into the relationship between bone and sleep. Journal of Bone and Mineral Research 30(2):199–211.

1 minute with Dr. Brown: What is the most important thing for bone health?

Got a minute? Every week I receive dozens of questions from women like you with concerns about their bone health. In my new series, “1 Minute with Dr. Brown,” I will try to answer your most pressing questions. If you have a question, send it in to us at

Question: What is the single most important thing I can do to take care of my bone health?

Melatonin: Sleeping Your Way to Better Bones

older woman deeply sleeps in the bed

I’ve written before that adequate rest and sleep have been part of our innate healing process for hundreds of thousands of years. Melatonin, a naturally-occurring hormone that helps you maintain a healthy circadian rhythm, is essential to this process. Melatonin makes us less alert and more ready for sleep, which benefits bone by reducing the bone-depleting cortisol and pro-inflammatory responses in our body.

You may not realize that as we get older — after the age of 40 — our bodies naturally make less melatonin.
For the best sleep, melatonin should increase during the evening before bedtime, remain high during the night and then drop when morning comes. When that doesn’t happen, you may not feel sleepy or struggle to fall asleep when you do go to bed.  Supplementing with melatonin can help improve your ability to sleep by acting on the brain receptors that regulate the body’s circadian clock.

Melatonin and age-related bone loss

Given everything we know about the benefits of melatonin, researchers decided to take a look at how using a melatonin supplement might affect the strength of aging bones. Using animal models — whose age was about 60 in human years — the researchers found a significant increase in bone volume, flexibility and density among those receiving melatonin supplements. Also, preliminary human studies suggest that melatonin may enhance osteoblast differentiation and may restore imbalances in bone remodeling. Of course, further studies need to be done, but I am always excited when studies of a natural therapy look promising!

3 tips for getting to sleep

For help with falling asleep, I like to take about a half hour to relax before bedtime. Your individual relaxing time can be anywhere from as little as 15 minutes to up to an hour, so I suggest you experiment to find out the amount of time that works best for you. I also find these tips helpful:

  • Set a nightly time limit for technology use. At times, I certainly am guilty of staying plugged in right up until I close my eyes. But when I avoid this overactivity, I notice the difference almost immediately.
  • Develop a focused, positive intention to sleep through the night, rather than worrying that you won’t be able to fall asleep.  Some women find meditating before bed or deep breathing or listening to a Nidra yoga tape is calming and speeds the transition to sleep.
  • Boost your body’s natural hormones with a Melatonin supplement. If it helps your sleep, I suspect it is also helping your bones!

I hope you are able to feel rested and renewed!


Tresguerres, I, et al., Melatonin dietary supplement as an anti-aging therapy for age-related bone loss.Rejuvenation Research, 2014; 140311120122003 DOI: 10.1089/rej.2013.1542

Witt-Enderby et al., Therapeutic treatments potentially mediated by melatonin receptors: potential clinical uses in the prevention of osteoporosis, cancer and as a adjuvant therapy. Jr. of Pineal Research, Vol 41, #4, Nov. 2006: 297-305

Radio, N M, et al., Melatonin enhances alkaline phosphatase activity in differentiating human adult mesenchymal stem cells grown in osteogenic medium via MT2 melatonin receptors and the MEK/ERK (1/2) signaling cascade. Jr of Pineal Research, Vo. 40, #4, May 2006:332-342


You can try Dr. Brown’s comprehensive supplements in her at-home bone health program, developed with Women’s Health Network. Get her exclusive formulations along with her detailed lifestyle and diet guidance, plus telephone support whenever you need it. Learn more about the Better Bones Health Program.

We created the Better Bones blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.

What’s the cause of your osteoporosis? Diagnostic tests and what they mean

How healthy are your bones?

Information on these common osteoporosis and bone health tests:

One of the basic principles of the Better Bones Program® is that all osteoporosis, all excessive bone loss, or all real increased risk of low-trauma fracture has a cause. To better understand any undetected causes of bone loss, it is important to obtain a medical work-up — that is, further tests that can help find the causes of osteoporosis.

In addition to the standard DEXA bone density test, we suggest that our clients discuss the following tests with their doctor to see which ones are appropriate. Below are examples of tests that could be helpful and the basics of what the test results mean so that you can better discuss your personal situation with your doctor.

Tests to help reveal what causes osteoporosis

Vitamin D 25(OH)D blood test

This test determines your blood level of vitamin D. The results tell you the amount of vitamin D supplementation needed to reach a therapeutic blood level of vitamin D, which is important for adequate calcium absorption and basic bone support.

What your results tell you: The reported “normal” range is very wide, often from 30 to 100 ng/mL. We now know that anything less than 32 ng/mL is likely to seriously limit calcium absorption and lead to bone loss. At the Center for Better Bones, we strive for a 50-70 ng/mL blood level of 25(OH)D.

Ionized calcium test

This is a simple blood test to measure the level of free calcium — that is, the metabolically active portion of calcium not bound to proteins in the blood. This test isn’t meant to assess the appropriateness of your calcium intake as much as it is meant as an indirect test of parathyroid functioning (see below). It can also indirectly tell us some things about vitamin D status.

What your results tell you: The body controls free calcium in the blood very tightly, with a normal laboratory range between 4.8 and 5.2 mg/dL (between 1.2 and 1.3 mmol/L) as reported by the Merck Index. When thinking of bone health, we look for high ionized calcium as a possible indirect indicator of excessive parathyroid hormone activity. A low ionized calcium level might be related to low albumin and low protein status.

Intact parathyroid hormone blood test (iPTH)

High parathyroid hormone levels are associated with excessive bone loss, as an overactive parathyroid gland draws calcium from bone. The medical reasons for this overactivity need to be addressed to halt the excessive bone loss. Also, a normal parathyroid reading in the face of vitamin D deficiency can indicate magnesium inadequacy

What your results tell you: At the Center for Better Bones, we look for an intact parathyroid hormone level within the normal range established by the particular testing laboratory. Two common causes of an excessively high parathyroid hormone level are vitamin D deficiency (which is easily corrected with proper vitamin D3 supplementation and monitoring); and an overactive parathyroid, which is most often due to benign tumors on the parathyroid glands. Correction of this situation often requires surgery to remove the overactive glands.

Excessively high parathyroid hormone levels cause the body to release too much calcium from the bone contributing to bone loss, and more importantly, high blood calcium. A high parathyroid condition is best treated by an endocrinologist.

24-hour urine calcium excretion test

This test looks at how much calcium is being excreted in the urine. For this test, you collect all your urine over 24 hours in a large container for laboratory analysis to measure the amount of calcium in the total volume of urine. Excessive urinary calcium excretion is a common cause of bone loss and osteoporosis.

What your results tell you: The normal laboratory range for a person eating an average diet is around 100 to 250 mg of calcium lost in the urine each day. I consider a calcium loss of more than 250 mg to be a concern. In such cases, the first step is to stop all calcium supplements for 4 to 5 days and then retest the 24-hour urine calcium. If the urine calcium loss is still high, then steps should be taken to reduce this loss of calcium in the urine, as it can cause bone loss. Nutritional, lifestyle, and medical approaches can help.

Thyroid hormone function test (TSH)

TSH is a hormone produced in the pituitary gland that signals the thyroid to produce more of its hormones. If TSH is high, it usually means that the thyroid isn’t producing enough T3 and T4, so checking your TSH level is a simple way of screening for an underactive thyroid. Thyroid hormone levels that are too high or too low can contribute to osteoporosis, as can a dose of thyroid medication that is too high. To screen for overactive thyroid, or to make sure your dose of thyroid medications isn’t too high if you’re already being treated for hypothyroidism, you’ll need tests for free T3 and free T4.

What your results tell you: The common laboratory range for all adults is 0.35 to 5.50 and a more ideal level is 0.35 to 2.0.

Markers of bone resorption tests

Bone resorption (or breakdown) tests measure the amount of one specific bone protein in the urine or blood. As one loses bone this bone protein fragment shows up in the urine and blood in increased amounts. At the Center for Better Bones, we generally use the N-telopeptides crosslinks (NTx) urine test, but there are several others available. One commonly used test is the urine Dpd test (deoxypyridinium crosslinks test). There is also an NTx serum test and the CTX serum test..

As there can be a great deal of day-to-day variation in urine bone breakdown markers, we’ve developed a two-day collection procedure for bone resorption testing for greater accuracy. These instructions can be used for either the urine NTx or the Dpd test.

N-telopeptides crosslinks (NTx) urine marker of bone resorption test

What your results tell you: The test result “normal” range often listed on the test report is very broad. For example, test reports from our local lab list the premenopausal normal range for women as 17-94 nM BCE/mM creatinine and the postmenopausal range as 26-124 nM BCE/mM creatinine. The male range is 3-51. These ranges are far too wide to be useful.

Ideally, a woman would like to have an NTx level near that of the average premenopausal woman, which in the urine is around 35, but levels often soar into the 60s to 80s or higher in and around menopause. For adult men, the mean NTx is 27, which is a more ideal value than the higher numbers. Also, these markers can get very high in rare diseases such as Paget’s Disease and bone cancer. These situations are unusual and understood by a knowledgeable physician familiar with bone resorption testing.

We use the NTx urine test from Osteomark to judge the success of our bone building program. We look to bring the urine NTx level down to the 40’s, which in most cases indicates that bone breakdown has normalized. There are some cases, however, where bone breakdown is very low, but bone build-up is even lower. This condition, known as “low turnover osteoporosis,” is detected when a person has a low NTx, but is still losing significant bone (5-6%) as seen on bone density testing.

N-telopeptides crosslinks (NTx) serum marker of bone resorption test results

What your results tell you: The NTx bone-breakdown marker can also be measured in the blood. The female range listed by the manufacturer is 6.2-19.0 nM BCE/L, with a mean of 12.6. The male range is often listed as 5.4-24.2 nM BCE/L, with a mean of 14.8. Again, this range is too wide to be useful for us at the Center for Better Bones. We look for a result of 12 or somewhat lower in women, and 14 or somewhat lower in men.

Dpd urine marker of bone resorption test (deoxypyridinium crosslinks test)

What your results tell you: This bone resorption test also lists a broad range of normal values — for women, 3.0 to 7.4 nM/mM and for men 2.3 to 5.4 nM/mM. Clinically, adult women should strive for a Dpd test score in the 4’s, and in men an ideal level would likely be somewhat lower.

Vertebral deformity assessment

This is another x-ray test for bone that images each vertebral body of the spine and looks to see if there are deformities or fractures. The Vertebral Deformity Assessment can be done on newer bone density testing machines, with special software that takes a “lateral” view of the spine.

What your results tell you: The radiologist will give a full report of what he or she sees for each vertebral body, reporting any abnormalities, deformities, or fractures.

Free cortisol test (blood or saliva)

Cortisol is a corticosteroid hormone produced by the adrenal cortex, which is part of the adrenal glands. It is usually referred to as the “stress hormone” as it is involved in response to anxiety and stress. Abnormally high cortisol levels are damaging to bone and as such represent a major risk factor for osteoporosis and low-trauma fractures. This test can be done with blood or saliva.

What your results tell you: Cortisol is the “get up and go” hormone that should rise in the early morning and decline during the day. Thus, test results vary by what time of day the test was taken. Testing labs will give their normal range readings and the timing of the test should be taken into account when interpreting test results.

DHEA test (blood or saliva)

Dehydroepiandrosterone (DHEA) is a hormone produced by both the adrenal glands and the ovaries. DHEA helps to neutralize the effects of cortisol. DHEA helps to protect and increase bone density. Stress reduction activities like yoga and meditation can help maintain youthful DHEA level as we age. Low levels of DHEA are a risk factor for osteoporosis. This test also can be done with blood or saliva.

What your results tell you: In saliva testing, the results are often correlated with the results of the cortisol testing. It is also often measured as DHEA-S, that is, DHEA in its sulfated form. Again, each lab will offer its normal range depending on the test used.

C-reactive protein test (high sensitivity if possible)

C-reactive protein is a plasma protein that is held to be a marker of general inflammation within the body. It is a known risk factor for heart disease because heart disease is largely an inflammatory disorder. Osteoporosis is also inflammatory in nature and this test is helpful in detecting unwanted inflammation, which may contribute to bone health problems.

What your results tell you: Generally, in the C-reactive protein (or CRP) test, the lower the score the less inflammation and thus the better reading. I look for a high sensitivity CRP level less than 1.0mg/dL.

Homocysteine test (plasma or serum)

Homocysteine is a non-dietary amino acid, a product of the metabolism of a dietary amino acid, methionine. In the absence of adequate B vitamins, homocysteine can accumulate in the body. High levels of this substance damage collagen and represent powerful risk factors for both cardiovascular disease and for osteoporotic fractures.

What your results tell you: Normal levels of homocysteine in the blood range from 5 to 15 mM/L. At the Center for Better Bones we like to see a homocysteine level of 8 or below.

Celiac disease and gluten sensitivity test

Celiac disease, or even just sensitivity to gluten, can lead to inflammation of the gut. This inflammation is related to a complex inflammatory cascade which can increase bone loss. Also, those with celiac disease suffer from weak indigestion and malabsorption of many nutrients including vitamins A, K, and D. These deficiencies in turn damage bone. If there is any suggestion of gluten sensitivity or celiac disease, appropriate testing should be considered

What your results tell you: There are varied tests used to help determine if one is suffering from the autoimmune disease known as celiac disease, or if there exists the intolerance of gluten sensitivity. Talk with your healthcare practitioner about what might be right for you.

Sex hormone test results

Post-Menopausal Females: Progesterone, Estrogen
Female sex hormones drop naturally at menopause among all women, so I don’t generally suggest testing of these hormones. Those interested in this type of hormone testing, or those taking hormone replacement medications, should be tested for hormone levels by their physician.

Pre-Menopausal Females (reproductive years hormone testing): Progesterone, Estrogen
For women from their teens to menopause, proper levels of sex hormones are very important to bone health. Low levels of either estrogen or progesterone can limit development of optimum peak bone mass. Irregular, or frequently missed, periods should be studied by a knowledgeable physician.

According to noted progesterone researcher, endocrinologist Dr. Jerilynn Prior, some 25% of young women in the US and Canada fail to develop optimum peak bone mass due to undetected ovulatory disturbances which result in low progesterone levels. Testing of estrogen and progesterone can be helpful in pre-menopausal women with a bone health concern.

Both blood and saliva testing are available for pre-menopause sex hormone testing. Each testing laboratory will have its range of normal sex hormone test results.

Sex Hormone Testing in Males: Testosterone and, at times, Estrogen
A common cause of osteoporosis in men is low testosterone; thus a medical work-up for osteoporosis in men almost always includes a test for testosterone. Interestingly enough, estrogen also plays a role in male bone health and at times the physicians will test for estrogen in men with osteoporosis.

Both blood and saliva testing are available for sex hormone tests in men. Each testing laboratory will have its range of normal sex hormone test results.

Everyone deserves the full story on their health

It seems like healthcare has become a knee-jerk reaction of “see a symptom, take a pill,” but we believe that everyone deserves better than that. Your bone loss is a symptom of something that’s just not right in your body — and rather than treating the symptom with medications (and living with the side effects involved, some of which are plain frightening!), I encourage everyone to dig deeper and find out the source of the problem.

Nature’s tips on bone loss — 6 signs and symptoms of bone health

How healthy are your bones?

susanHow 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 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. They certainly aren’t definitive or anything 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 therisk 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. At the Center for Better Bones, I often observe that after women start a program 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, exposed 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.

Low vitamin D is easy to correct

For most people, vitamin D deficiency is neither difficult nor costly to diagnose and correct. Have your own levels tested twice yearly with the change of seasons, and supplement accordingly. This simple, low-cost practice will go a long way towards halting unnecessary bone weakening.

  1. 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.
  2. 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.

    Want to know if you’re losing 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 ourAlkaline 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!

  3. 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 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 80’s and 90’s 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 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.

Better bones, better body for National Women’s Health Week

Excited African American female isolated over white background

This year, Mother’s Day also marks the first day of National Women’s Health Week — running from May 10 to 16 — so I’m planning to continue my celebration all week long. Especially since the goal of the week is to empower women to make their health a priority.

As a healthcare practitioner, I’m always talking with women about the importance of their health.  But I realize that many women are short on time.  That’s why one of the things I emphasize is that with a natural, life-supporting bone-building program, you can easily create multiple benefits for your entire body.   Here are just a few examples.

As you build your bones, you can also….

1) Control your weight and belly fat
Hormonal signals sent between bones and other organs regulate sugar metabolism and prevent diabetes, reduce the risk of metabolic syndrome, and limit “belly fat.” My natural Better Bones program will enhance the production of osteocalcin, which is the hormone-like molecule that actually signals the body to reduce unwanted fat.

2) Build muscle
If we’re building bone, we’re building muscle, and vice versa. Exercise studies show that women in early post-menopause can not only maintain, but gain an average of 1.5% in bone mineral density in as little as nine months with rigorous strength-training regimes. This is compared to the 2% of lost bone that might otherwise occur. Wearing a weighted vest is a time saving way to build both muscle and bone.

3) Promote healthy teeth and gums
There are direct links between poor oral health and poor overall health as well; periodontal disease is linked not only to osteoporosis, but also to heart disease, stroke, diabetes, and respiratory illnesses such as COPD or pneumonia. Receding gums are often an early sign of body-wide bone loss.  Our teeth can be thought of as the “strongest bone.” Over and over again I see the teeth, gums and the jaw bone benefit from the Better Bones Program.

4) Get optimal blood pressure
Many nutrients key to bone health, including the calcium, magnesium, potassium, and vitamin D, are key to regulating healthy blood pressure.  We consider potassium to be especially powerful for both heart and bones, as it helps maintain healthy blood pressure, electrolyte balance, calcium levels, and bone-crucial acid-base balance.

5) Give yourself a healthy heart
In a natural Better Bones program, everything you do for bone will also help your heart. For example, vitamin K — particularly K2 as MK-7 — improves arterial flexibility and helps reduce the risk of arterial calcification.

Plus…new connections for skin and nails
Finally, bone is high in protein collagen, and new research connects the health of our bone to that of our skin and nails, which are also collagen-abundant tissues.  Better Bones plus less wrinkles, and stronger nails—sounds good to me.


Happy National Women’s Health Week!

Am I Losing Bone Right Now? The NTx Test

Dr_BrownAs May is National Osteoporosis Awareness and Prevention Month, we at the Center for Better Bones want to congratulate you for already being aware of the importance of maintaining bone health.

I suggest we celebrate by turning May into “National Action for Bone Health” Month. And so each one of you can get started — for yourself or by encouraging a friend to do so — we’re sharing what you need to answer the following important question…

Are your bones breaking down NOW?

Every day women are worried because they’ve been told that a DEXA test shows their bone density is that of an 80-year-old, or that they “must” take bone drugs.

But what worries me is that most of these women have NOT been told whether or not their bone loss is ongoing or if it occurred in the past. Knowing if your bone loss is still taking place is critical when it comes to your risk of excessive bone loss, osteoporosis and fracture.

The NTx test measures current bone loss

I recommend anyone worried about bone loss get an NTx (N-telopeptide) test. Unlike bone density tests which only provide a static snapshot of your bones, an NTx test tells you if your bones are currently breaking down. It does this by measuring molecules from bone excreted in the urine.

Get your free video download about the NTx

For the entire month of May, you can get a free video download that features my explanation of the NTx test, how to get one and how to understand the results. This 9 ½-minute video download also includes a transcript for those who prefer the read the information. You can also help educate your physician about the use of the NTx test and why you would like her/him to order this test for you. Get the video now at

To all, happy National Osteoporosis Awareness & Prevention Month AND Action for Bone Health Month!


You can try Dr. Brown’s comprehensive supplements in her at-home bone health program, developed with Women’s Health Network. Get her exclusive formulations along with her detailed lifestyle and diet guidance, plus telephone support whenever you need it. Learn more about the Better Bones programs.

We created the Better Bones blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.

What your weight tells you about your bones

BMIIs being overweight protective for bone health? Does being underweight jeopardize bone? What happens to bone when we lose weight?

While these might seem like simple questions, the weight-bone link is far from straight-forward.  Hundreds of papers have been written on the topic, with contradictory findings.  Nonetheless I did promise to address this weighty issue, so here’s my synthesis of what we know.

  • Being significantly underweight increases the risk for fracture. Numerous studies suggest that being thin is associated with an increased risk of hip fracture compared to people of normal weight. Thin women with low bone density and little muscle mass are especially at risk.
  • Being slightly overweight may have a small protective effect on hip fractures. Weight-bearing hip fractures may be a bit less in slightly overweight women as compared to women of normal weight However, being even slightly overweight seems to be associated with a somewhat greater risk for fractures of the upper arm.
  • Being significantly overweight doesn’t protect against fractures. Even though weight-bearing bones may become stronger to carry extra weight, this doesn’t appear to ward off fractures.  Abdominal fat likely produces inflammatory compounds detrimental to bone. Being overweight is often associated with metabolic diseases like diabetes which increase fracture risk.
  • Lean body mass is important. Whatever your weight, the amount of muscle mass or lean body mass is very important. Lean body mass protects against fracture— which is why a thin person with good muscle mass will be at a lower risk than a heavy person with a lower percentage of muscle mass. Muscle mass is associated with bone mineral density, and a higher bone density associated with lower fracture risk.
  • Weight loss is associated with bone loss. Simply said, when you lose weight you lose bone.  This is especially true as we grow older, as bone loss from weight loss in post menopause isn’t regained easily.  In fact, losing weight as we age after menopause is considered a risk factor for fracture.
  • Weight cycling increases fracture risk. Weight cycling — or the losing and then gaining back of weight— is associated with increased rates of both spinal and hip fractures fracture. A stable weight, if bit above normal, is more favorable to bone.

If you’d like, in a subsequent blog I can discuss what this all might mean for you.  For now let me suggest that for women of normal or low weight, gaining a few pounds as we age is not a bad thing at all.  Read more about your possible bone health risk factors here.


You can try Dr. Brown’s comprehensive supplements in her at-home bone health program, developed with Women’s Health Network. Get her exclusive formulations along with her detailed lifestyle and diet guidance, plus telephone support whenever you need it. Learn more about the Better Bones programs.

We created the Better Bones blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.

Capturing the innate healing process

Susan Brown, PhD

In a perfect world, the bones can manage wear and tear quite efficiently but when they are bombarded daily by large concentrations of toxins, chemicals, or even prescription drugs, it becomes impossible to maintain homeostasis. The bones literally can’t keep up with the demand placed on them and the orderly ebb and flow between bone breakdown and rebuilding goes haywire.

Over the course of studying bones, their structure, and function, I’ve learned that, if we would just listen, our bones will tell us how to keep them healthy. When we understand and respect the complex and dynamic nature of osteoporosis, we are given the tools to naturally improve the condition of our bones. We can put the magical nature of our bones to work for us by using methods which are logical and easy to comprehend. Harnessing this innate intuition for healing and protection is one of the “secrets” of healthy bones and it is within our grasp to do.

A note about prescription drugs for osteoporosis:

Today, medications known as bisphosphonates are commonly prescribed for women who are at risk for or diagnosed with osteoporosis. Bone mineral density may increase after taking these drugs, but this change alone is not enough to recover bone health or structural integrity. In addition, new evidence suggests that long-term use of bisphosphonates may harm the bone, with some women even reporting strange fractures. I don’t recommend these drugs and instead advocate the safer, more effective approach of using nutrition and environmental management to return your bones to a healthy state.

The weight of our world

Just what sorts of things could jeopardize the health of our bones to such a great extent that osteoporosis has become so common in American women? In a word: lifestyle. Inadequate nutrition, dieting, smoking, hormonal imbalance, lack of exercise, and a long list of other factors, have a negative impact on the state of our bones. Ideally, there is a balance between the processes of bone depletion and bone regeneration. This equilibrium is maintained through proper nutrition and other factors, but it is quickly reordered when the bones do not get what they need. Bones require certain elements to stay healthy: the right nutrients in steady supply, appropriate exercise, protection from toxins and poisons, etc., and when these elements are delivered regularly, the bones respond by growing stronger and more resilient.

While our bones might be able to tolerate the effects of a few damaging practices, the hazard grows exponentially in relation to the total number of the “burdens” we might be carrying. One look at our overloaded camel will give you an idea of how easy it is for our bones to collapse under the weight of the typical American lifestyle. Adding to or taking away just one or two burdens can have a significant effect on your bone health, one way or the other. The journey towards healthier bones starts by taking one step away from your own personal tipping point.

Total load model of bone-depleting factors ©2009.
Please click here for a printable version.

How heavy is your burden?

If you are living a hectic lifestyle, you may feel as if you have no control over anything that happens to you or your body during your day. But the fact is, only 20 percent of our total burden is beyond our reach — things like gender, genetic makeup, and age. In actuality, we have a tremendous amount of power over the elements which affect bone health. Some of us may indulge in addictive habits, or eat too much sugar, or not get enough sleep. Many women allow stress to balloon out of control for days or weeks until they get so used to having chronic stress that it becomes “normal.” But all of these issues — and more — can be reduced or eliminated and that can dramatically lighten our overall burden.

The American way of life often exposes us to a wide spectrum of environmental toxins which accelerate the process of bone loss, usually without us even knowing. The body has several means for naturally ridding itself of poisons, but it can only handle so many “emergency calls.” Removing or neutralizing the effects of toxins is possible using a variety of natural methods for detoxification.

Suggestions include:

  • Drinking purified or filtered water, or teas, to help dilute toxins and move them out of the body
  • Eating natural, organic foods which are nutrient-rich and free of antibiotics and hormones
  • Washing fruits and vegetables to remove pesticides and contaminants

Inflammation and stress

Reducing the burden that inflammation places on our bodies is absolutely critical to maintaining optimal bone health. An overactive inflammation response can push the bone breakdown mechanism into overdrive and cause actual bone loss. If you have certain chronic health conditions, such as asthma, diabetes, or fibromyalgia, these are signposts that inflammation could be a particular problem for your individual bone health.

De-stressing our lives and learning to relax is as important to our bones as it is to overall wellness. Stress, negative emotions, and depression can all figure prominently in the deterioration of bone health. If we are in stressful states for long periods, it can end up harming the bones through the effects that “stress chemicals” such as cortisol and adrenaline have on the metabolism. So take this as another reminder to focus on finding ways to remove some of the emotional stressors from your life and invite more relaxation in.

It’s never too late to turn your attention to improving bone health. Even long-term patterns and habits can be changed or moderated so you can reduce the weight of your personal burdens and restore the internal balance required for good bone health.

A new way to live each day

Recovering bone health starts with a new understanding of osteoporosis. Osteoporosis in itself is not something that has gone wrong. Instead, osteoporosis is a natural process of bone breakdown and regeneration that is intended to be used as a short-term measure. For many women, though, it has become an enduring pattern that damages the bones and has an unhealthy impact on general wellness. For so long, American women have been taught to ignore what their bodies tell them about how to live well and stay healthy. Finding an appreciation for the natural processes which allow us to function, and listening to the messages our bodies send, helps us get in touch with the instinctive intelligence we all have within.

So often, the treatment methods women encounter in traditional medicine, especially those for osteoporosis, actually work against the body’s normal biology and upset the balance even more. Knowing — and accepting — how your particular lifestyle is affecting your bone health makes it even easier to adopt a healthier new lifestyle which harmonizes with the natural way your body works. The Women’s Health Network Better Bones Package is a comprehensive plan for attaining bone health which helps guide you away from the heavy burdens of a harmful lifestyle, and offers you a wholesome new blueprint to follow. When you incorporate the natural components of our Program into your daily life, you can prevent, halt, or even reverse, the effects of osteoporosis.

It’s not too late — so don’t wait

The sneaky thing about osteoporosis is that you won’t notice any symptoms and probably won’t have any outward indication that your bone health is at risk. That’s why it’s important to take action now so your bones can stay healthy and strong for life. And because of the magical healing nature of our bones, it genuinely doesn’t matter how old you are, you just need to make the commitment. When you make that pledge, it sends a signal to your body to prepare for the positive changes you are about to embrace. so your new behaviors become part of a fresh, healthy lifestyle.

Teenagers bone health

Susan E. Brown, PhDAdditional bone health topics for other ages can be found here:

During the teen years (ages 13-19)

While it is not as easy to build bone during the teen years as during early adolescence, this stage still offers substantial opportunity. Nearly a quarter of all bone is formed during the years of the adolescent growth spurt, and half of the bone mass you will build during your life is laid down from puberty through the teen years. This is the time for exercise and good nutrition.

A wholesome diet, strenuous and regular exercise, and the avoidance of toxins are all especially important. Unfortunately, at this time more than ever, young people’s diets tend to deteriorate; exercise, especially among girls, drops; and dieting increases, along with anorexia, menstrual irregularities, and tobacco and recreational drug use.

While teens would benefit from supernutrition, minimal nutrition is more the standard. Teenage girls consume on average only 68% of the RDA for calcium, making it unlikely that many will reach their full genetic potential for bone mass development. While teenage boys consume more calcium, many still underconsume a variety of essential bone-building nutrients. For example, 30% of all adolescents consume less than two-thirds the RDA for magnesium. Teenage girls consume inadequate amounts of manganese, and average male intake is rather marginal.

To reverse this trend, teens can be encouraged to:

  • Consume at least the RDA of all essential nutrients. Use supplements as necessary to achieve this goal.
  • Strive to consume two cups of vegetables for lunch and dinner, and four servings of fruit a day.
  • Avoid smoking, recreational drugs, and excessive dieting.
  • Seek and address the underlying causes of conditions requiring steroid medications or chronic antibiotic use.
  • Participate daily in outdoor physical activity.

Please click here for information on bone health at any age.