Osteoporosis Signs and Symptoms

What to Look For

The most debilitating diseases are often the ones we don’t see coming, and osteoporosis is a sneaky one. In fact, osteoporosis is often called the silent killer because there are few warning signs, and the ones that do show up are sometimes so benign that they’re easy to overlook.

But knowledge is power, and knowing the signs, symptoms, and potential causes can prepare us and even help avoid osteoporosis altogether. (Yes, it can be done!)

Unfortunately, most people get diagnosed after they’ve had a fall and broken a bone. And it only gets worse from there. Statistics show that 13% of the population will die within six months of hip fracture.¹ Alarmingly, that number rises to 20% within two years after fracturing a hip.

No one wants to be a statistic. One way to avoid becoming another number is to be proactive and have your bone mineral density (BMD) checked by a doctor. The most accurate test to determine your BMD is the DEXA scan, a dual x-ray that measures the porousness of your bones.

DEXA scans can determine your bone strength and are an important tool in determining overall bone health. Depending on your results, your doctor may recommend anything from lifestyle changes to bone-building calcium supplements. Adding regular weight-bearing exercises like dancing, jogging and walking can make a big impact. Making changes like these, and others we’ll talk about later, can help reduce or eliminate the impact of osteoporosis.

Knowing what to look for is a huge part of early osteoporosis detection. While one symptom on its own may not be cause for concern, multiple symptoms may be a good indicator that it’s time to get in touch with your doctor.

There are, of course, genetic factors too. Women are more likely to get osteoporosis, as are older folks and people of Caucasian or Asian descent.² However, at least 2 million men in the United States have osteoporosis, too.³ Men and women who are shorter and have smaller bone structure have greater risk of the disease. And your chances of having osteoporosis are increased if a parent or sibling has it.

To see if it’s time to schedule your next DEXA scan, or simply to put your mind at ease, keep reading to learn more about osteoporosis signs and symptoms below.

In the early stages of bone loss, known as osteopenia, you generally have few symptoms. And the ones you do experience may be so mild or mundane you don’t link them to anything other than a natural part of aging. But when coupled together, these symptoms can be a sign of larger health issues.

Discover some of the common signs and symptoms of low bone density:

Brittle Fingernails

The most common reasons for brittle fingernails are hormonal changes and nutrition. Women who are going through menopause have fluctuating estrogen levels. On top of causing dry skin and thinning hair, this can also affect nail strength and may be a sign of early bone loss.

Anecdotally, increased fingernail resilience has been reported from patients diagnosed with osteoporosis within months of starting osteoporosis treatments.⁴ We have had customers report improved nail and hair strength after starting the AlgaeCal program, too.

Researchers have tried to investigate potential associations between osteoporosis or fracture risk and nail composition. One study showed correlation between BMD (bone mineral density) and fingernail elements.⁵ However, no correlation between osteoporosis or fracture risk and fingernail elements were found. Another study looked at nail mineral content and concluded that calcium and magnesium concentrations could be indicators for BMD.⁶

The discrepancies of these studies may reflect the complex nature of different techniques and bone metabolism. Multiple preliminary studies are now suggesting that there is a possible relationship between osteoporosis, fracture risk and fingernails⁷ by using Raman spectroscopy⁸ (a technique used to understand the make-up and chemical composition of materials).

Therefore, the properties of bone and nail health may be linked in a measurable and comparable way. Although, further investigation is needed.

Brittle nails can also be a sign of a nutritional deficiency, like vitamin C, calcium, or folic acid. That’s why it’s important to maintain a balanced diet rich in these nutrients as well as protein and healthy fats.

Nails that easily break, split, chip, or curl around the fingertips are all characteristics of brittle nails.⁹ Dryness, discoloration, and ridges are important indicators too.

Receding Gums

Bone loss is directly related to oral and dental health. After all, 99% of the calcium in your body is in your bones and teeth!¹⁰

Research suggests bone loss in your jaw and mouth can be a sign of bone loss in other areas of your body.¹¹ If your jaw bone is deteriorating, your gums will follow suit and begin to recede. So next time you give your pearly whites a scrub, take a moment to look around and notice any changes to your gumline.

Studies show a correlation between tooth loss and bone mineral density.¹² In fact, postmenopausal women suffering from osteoporosis were 2.5x more likely to experience tooth loss than those with normal bone mineral density!¹³

Weak Grip Strength

Manufacturers are notorious for over-tightening jam jar lids. Yes, those vats of bulk-buy pasta sauce are a great deal, but if you’ve noticed those jars getting heavier and harder to open, the real cause could actually be your bones.

Grip strength may be an indicator of your overall bone density, according to a study published in Rheumatology.¹⁴ The study was conducted with European men and women over the age of 50. It looked at the connection between low grip strength and bone mineral density. Female participants showed a link between grip strength and bone mineral density. Those with low grip strength has correspondingly low bone mineral density measurements in the spine and hip. Risk of vertebral fracture also increased as grip strength decreased.

But fear not! You can change this through exercise.

Another study, published in the Journal of Bone and Mineral Research, showed a positive effect on grip strength and bone density during exercise, particularly weight-bearing exercise.¹⁵ A total of 649 postmenopausal women participated and had their bone mineral density measured at their wrist and forearm. Grip strength was also measured in both the dominant and nondominant hands.

Turns out, the women who exercised had a significant increase in grip strength in their non-dominant hand. Researchers concluded that grip strength is a marker for fragility and general health. The connection also reinforces the benefits of weight-bearing exercise to improve grip strength.

Decrease In Overall Fitness

Another early indicator of osteoporosis is an overall decline in physical fitness. Some things to look out for are decreased muscle strength, poor balance, and decreased aerobic abilities. So if you’ve been finding it increasingly difficult to walk, dance, or just do everyday activities, this is important:

A study published in The Lancet divided premenopausal female participants into two groups.¹⁶ One was a control group, which maintained a sedentary lifestyle, while the other spent 18 months on a rigorous exercise regime. Classes were held three times a week for an hour, and focused on a combination of high-impact exercises and low-impact stretching.

The results were undeniable. Skeletal integrity, balance, and muscle strength improved throughout the training group. A significant increase in bone mineral density compared to the control group was also noted in the femur, an important weight-bearing bone in your legs. The training group participants’ bone mineral density increased one full percentage point, while the control group’s average dropped by 0.6%.

No significant differences were found between the groups for bone mineral density in non-weight bearing bones like the forearm.

Another study had a group of postmenopausal women engage in high-intensity strength training for one year versus a control group. The control group saw a significant loss (-2.5%) in bone mass compared to the high-intensity strength training group.

The exercise group’s muscle mass and overall conditioning also improved. Researchers concluded these positive results could decrease the risk of a fall and bone fractures in the future.¹⁷

No matter your age or current level of health, a little exercise can go a long way towards improving muscle strength. Resistance and strength training exercises are great ways to improve muscle mass. Or try walking, jogging, hiking, pilates, tennis, and dancing to help improve bone health.

For a few easy exercises you can try yourself, check out our osteoporosis exercises page.

Late Stage Osteoporosis Signs and Symptoms

As bones become weaker with continued bone density loss, the signs become more and more evident. Late stage osteoporosis comes with a whole host of problems that get more severe as the disease progresses.

Bone loss from full blown osteoporosis is more pronounced than osteopenia or low bone density. It often reveals itself through stooped posture, compression fractures, and easily broken bones.

Keep reading to discover more signs and symptoms of osteoporosis…

Break a Bone Too Easily

The most common sign of osteoporosis is a bone fracture from a fall. Sadly, this is how many people discover they have osteoporosis. A bump you wouldn’t have thought twice about a couple of years ago can now be enough to break or fracture a bone.

Fractures or breaks from low impact bumps or falls are both significant signs of bone loss and potentially signs of osteoporosis. If you suffer from a fracture, be sure to have your doctor test your bone mineral density (BMD) with a DEXA scan.

Loss of Height

Ever get the feeling that you’re shrinking? Well, you might be! And there’s a chance it’s not just age-related.

While it’s normal to lose a little height as you age, too much height loss can be a warning sign of a vertebral fracture. In fact, it is not uncommon for someone to report back pain, only to discover it’s actually a fractured vertebra in their spine.

In addition to loss of height, typical signs of a spinal fracture from osteoporosis include a sudden onset of back pain, limited mobility in the spine, and increased pain or discomfort when standing or walking. However, sometimes a vertebral compression fracture may not cause any pain or other obvious symptoms, according to Spine Health.¹⁸ That’s why it’s so important to regularly consult with a physician, especially if you know or suspect you have osteoporosis.

Another giveaway that your bone health is compromised is kyphosis. Kyphosis is often known as a curved spine or sometimes a Dowager’s Hump, and can be caused by multiple spine fractures. The bones of the vertebrae become so weak they crumble like weathered bricks.

Kyphosis from osteoporosis can be treated through surgery, pain management, and by improving overall bone health through vitamins, minerals, and supplements like AlgaeCal Plus. For postural kyphosis, improving your posture and core strength is often enough to do the trick.

Cramping and Aching Muscle or Bone Pain

If the old idiom “I can feel it in my bones” starts to take on a much more literal meaning than in years past, you may want to start listening to what your body is trying to tell you. Especially if those achy bones come with a side of sore, cramping muscles.

Some level of discomfort can go along with aging, but when it’s from osteoporosis, the discomfort goes beyond the aches and pains of old age. Insufficient vitamin and mineral intake can also play a role.

For instance, vitamin D deficiency has been linked with back pain. A study conducted by the Indian Journal of Clinical Biochemistry found ties between vitamin D and chronic back pain.¹⁹ Further, magnesium deficiency has been linked to osteoporosis, muscle weakness, and cramps.¹⁹

Makes sense, right? Our bodies need proper vitamins and minerals to function and the same goes for bone health. If there is a deficiency in any crucial bone-supporting mineral, it can lead to any number of health issues, including osteoporosis.

Stooped Posture or Compression Fracture

One of the most common causes of osteoporosis pain is a spinal compression fracture, and one of the most common symptoms is a curved spine.²¹

Spinal compression fractures cause sudden, severe back pain that worsens when you are standing or walking. Bending and twisting will also make it worse, but laying down can provide some relief.

Sometimes you can experience a spinal fracture even if you haven’t fallen. Remember the crumbling bricks we talked about? Weak, structurally compromised vertebrae can break on their own.

The effects of spinal fractures can cause a person to become shorter because fractures can shorten the spinal column. In some instances, bone fractures may require surgery.

What To Do If You Have Symptoms

Osteoporosis can creep up on you, particularly in the early stages. Many of the symptoms are subtle and can even be indicators of something else entirely, so listen to your body. It knows when something is up.

From prevention to treatment, below is a number of ways you can help build new bone, improve bone strength, and support a healthy, well-rounded lifestyle.

Diet and Nutrition

Certain minerals and nutrients will help you rebuild and maintain healthy bones, so focus on adding those to your diet.

The big five you want to make sure your diet is jam-packed with are calcium, magnesium, vitamin K2, vitamin D3, and omega-3 fatty acids. This is your A-Team.

Calcium-rich foods include milk, yogurt, cheese, canned sardines, sesame seeds, kale, and salmon.

Vitamin D3 plays well with calcium and helps your body properly absorb calcium. While you’re not going to get a ton of vitamin D3 from food, you can get all you want from the sun for free. If you live in northern latitudes with long, dark winters, you can also find D3 in supplement form.

Look to sesame seeds, almonds, dark chocolate, and black beans to get your fill of magnesium, and fermented foods like traditional Japanese natto or sauerkraut to stock up on vitamin K2.

And last but not least are the omega-3 fatty acids, EPA and DHA. These are critical for bone health because they reduce inflammation. Inflammation is problematic because it disrupts your body’s natural bone rebuilding processes. You can get your fill of omega-3s by eating cold water fatty fish like sardines, mackerel, salmon, and fish oil.

The FDA states that “Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.”

These don’t cover all that you need, but they’re critical to begin with. For more, go here for your complete Osteoporosis Diet and Nutrition plan.

Exercise and Lifestyle

Even if you have yet to show any symptoms of osteoporosis, take the opportunity to build up bone density and improve your fitness before you have problems.

Try to think of your bone health and your overall health as a bank account: if you frequently make deposits with healthy activities, good food choices, and multi-vitamin and mineral supplements, your account will stay full. But make too many withdrawals without topping up, and you’ll find yourself in the red.

Introduce lifestyle changes gradually. Not only does this make it less overwhelming, but it makes it a lot easier to stick with.

Start small by whipping up bone-healthy meals twice a week, or by running through a series of osteoporosis-friendly exercises three times a week.

When To See A Doctor

If you’re over 40 and have even one of the symptoms we talked about earlier, ask your doctor if you’re a candidate for a DEXA scan to check your overall bone health.

Whether or not you have a DEXA scan done, it’s important you see a doctor as soon as possible if you develop a backache or sudden, severe back pain. That’s because both of these issues can be symptoms of a spinal compression fracture caused by osteoporosis.

Listen to other health practitioners, like your dentist or chiropractor, and tell your doctor about any concerns they may have. Give your doctor as much information as you can to help with your diagnosis. This includes whether you’ve taken corticosteroids for any length of time, if you went through or are going through menopause, and if you have a history of osteoporosis in your family.

What Will You Do To Stop Bone Loss?

Some things are just out of your control, but that doesn’t mean you’re without hope. Things like your gender, age, race, family history, and even your body type all play a role in how likely you are to develop osteoporosis. Genetics are a gamble, but because they are only one part of what may cause your osteoporosis, positive results can be seen when exercise, healthy diet choices, and balanced vitamins and minerals are prioritized. After all, the lifestyle you live and the nutrients you put into your body are just as important whether you’re 5’2″ or 6’2″.

Take your health education into your own hands and do as much research as you can on influencing factors like body chemistry, existing diseases, and drug interactions. To get you started, check out our list of drugs that cause osteoporosis and speak with your doctor about natural alternatives or other options if you are on one of those drugs.

And if at any point you start to feel discouraged or overwhelmed, check back in with our success stories. Anyone can improve their bone health, and the folks you’ll meet on that page are proof of that!

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 Hannan, E. L., Magaziner J., Wang, J. J., et al. (2001).Mortality and Locomotion 6 Months After Hospitalization for Hip Fracture: Risk Factors and Risk-Adjusted Hospital Outcomes. JAMA. 285(21), 2736–2742. doi:10.1001/jama.285.21.2736


 Cawthon, P. M. (2011). Gender differences in osteoporosis and fractures. Clinical orthopaedics and related research, 469(7), 1900–1905. doi:10.1007/s11999-011-1780-7


 Just for Men. (n.d.). Retrieved from https://www.nof.org/preventing-fractures/general-facts/just-for-men/.


 Beattie, J. R., Cummins, N. M., Caraher, C., O'Driscoll, O. M., Bansal, A. T., Eastell, R., … Towler, M. R. (2016). Raman Spectroscopic Analysis of Fingernail Clippings Can Help Differentiate Between Postmenopausal Women Who Have and Have Not Suffered a Fracture. Clinical medicine insights. Arthritis and musculoskeletal disorders, 9, 109–116. doi:10.4137/CMAMD.S38493


Hosseinimakarem, Z., Tavassoli, S. H. (2011). Analysis of human nails by laser-induced breakdown spectroscopy. J. Biomed. Opt. 16(5), 057002 doi:10.1117/1.3574757


Ohgitani, S., Fujita, T., Fujii, Y., Hayashi, C. & Nishio, H. (2005). Nail calcium and magnesium content in relation to age and bone mineral density. J. Bone Miner. Metab. 23, 318–322 doi:10.1007/s00774-005-0606-7


Pillay, I. et al. (2005). The Use of Fingernails as a Means of Assessing Bone Health: A Pilot Study. J. Women’s Heal. 14, 339–344 doi:10.1089/jwh.2005.14.339


Towler, M. R. et al. (2007). Raman spectroscopy of the human nail: A potential tool for evaluating bone health? J. Mater. Sci. Mater. Med. 18, 759–763 doi:10.1007/s10856-006-0018-9


Hochman, L. G., Scher, R. K., Meyerson, M. S. (1993). Brittle nails: response to daily biotin supplementation. Cutis. 51(4), 303–305. doi:10.1111/j.1473-2130.2004.00084.x


Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC): National Academies Press (US); 1997. 4, Calcium. Available from: https://www.ncbi.nlm.nih.gov/books/NBK109827/


Oral Health and Bone Disease. (n.d.). Retrieved from https://www.bones.nih.gov/health-info/bone/bone-health/oral-health/oral-health-and-bone-disease.


Mulligan, R., Sobel, S. (2005). Osteoporosis: Diagnostic testing, interpretation, and correlations with oral health-implications for dentistry. Dent Clin North Am. 49, 463-84. doi:10.1016/j.cden.2004.10.005


Mohammad, A. R., Hooper, D. A., Vermilyea, S. G., Mariotti, A., Preshaw, P.M. (2003). An investigation of the relationship between systemic bone density and clinical periodontal status in post-menopausal Asian-American women. Int Dent J. 53, 121-125.


Dixon, W. G., Lunt, M., Pye, S. R., Reeve, J., Felsenberg, D., Silman, A.J., O'Neill, T.W.; European Prospective Osteoporosis Study Group. (2005). Low grip strength is associated with bone mineral density and vertebral fracture in women. Rheumatology, 44(5), 642–646. doi:10.1093/rheumatology/keh569


Kritz-Silverstein, D., Barrett-Connor, E. (1994). Grip strength and bone mineral density in older women. J Bone Miner Res. 9(1), 45–51. doi:10.1002/jbmr.5650090107


Heinonen, A., Kannus, P., Sievanen, H., et al. (1996). Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet. 348(9038), 1343–1347. doi:10.1016/S0140-6736(96)04214-6


Russo, C. R. (2009). The effects of exercise on bone. Basic concepts and implications for the prevention of fractures. Clinical cases in mineral and bone metabolism: the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 6(3), 223–228.


Boden, S. (n.d.). Vertebral Fracture Symptoms. Retrieved from https://www.spine-health.com/conditions/osteoporosis/vertebral-fracture-symptoms.


Lodh, M., Goswami, B., Mahajan, R.D., et al. (2015). Assessment of vitamin D status in patients of chronic low back pain of unknown etiology. Indian J Clin Biochem. 30, 174–9. doi:10.1007/s12291-014-0435-3


Johnson, S. (2001). The multifaceted and widespread pathology of magnesium deficiency. Med. Hypotheses, 56, 163–170. doi:10.1054/mehy.2000.1133


Wong, C. C., & McGirt, M. J. (2013). Vertebral compression fractures: a review of current management and multimodal therapy. Journal of multidisciplinary healthcare, 6, 205–214. doi:10.2147/JMDH.S31659