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Bone Biomarkers: What They Are and Why They Matter in Osteoporosis Care

Bone Biomarkers: What They Are and Why They Matter in Osteoporosis Care

by | May 6, 2025 | Healthy aging

Most people with osteoporosis are familiar with the DEXA scan—the go-to test for measuring bone mineral density. Yes, I may tell you how much bone you have, but what it doesn’t do is tell you what’s happening inside your bones right now.

That’s where bone biomarkers come in!

Bone biomarkers are simple blood or urine tests that measure bone turnover: the rate at which your bones are breaking down and rebuilding. They offer something the DEXA scan can’t—real-time insight into your bone metabolism.

Whether you’re using medication, supplements, exercise, or a gut-focused healing plan, these tests can help you assess your progress months before structural changes appear on a DEXA scan.

What Are Bone Biomarkers?

Bone biomarkers are biological indicators that reflect your current rate of bone remodeling—the natural process where old bone is broken down and new bone is formed.

They fall into two key categories:

Bone Formation Markers (showing how much bone is being built):

    • P1NP (Procollagen Type 1 N-Terminal Propeptide): Indicates new collagen production—essential for building strong, resilient bone.
    • BSAP (Bone-Specific Alkaline Phosphatase): An enzyme associated with active bone formation.
    • Osteocalcin: A protein made by osteoblasts that plays a role in both bone-building and metabolic regulation.

Bone Resorption Markers (showing how much bone is being broken down):

    • CTX (C-terminal telopeptide): Detects fragments of collagen released as bone is broken down.
    • NTX (N-terminal telopeptide): Similar to CTX, often measured in urine.

Together, these biomarkers give a more complete picture of your bone health—one that goes beyond static bone density scores.

Why Bone Biomarkers Matter in Natural Bone Health Care

Bone biomarkers are commonly used in conventional medicine to monitor the effects of osteoporosis medications. But they are just as valuable—if not more so—for those taking a natural, holistic approach to building stronger bones.

If your bone health plan includes:

    • Weight-bearing or resistance exercise
    • Bone-supportive supplements
    • Anti-inflammatory nutrition
    • Digestive support
    • Stress and hormone regulation

…then bone biomarkers can give you tangible, timely feedback on whether your approach is working.

These tests help you:

    • Measure the impact of your program
    • Make adjustments based on data
    • Track short-term shifts while waiting for long-term changes in bone density

Who Can Order Bone Biomarker Tests?

Most bone biomarker tests can be ordered by a wide range of healthcare providers—including your primary care physician. You don’t need to see a specialist or functional medicine practitioner to access them.

And if your doctor isn’t familiar with these tests, don’t worry—I can order them for you as part of a personalized, holistic bone health consultation.

These labs are often used to monitor medications, but they’re just as valuable for tracking your progress with a natural, lifestyle-based approach. In many cases, they may even be covered by insurance.

When and How to Test

Bone biomarkers are typically measured through a blood draw, though some (like NTX) can be tested in urine. To ensure the most accurate results:

  • Test in the morning, preferably fasting
  • Repeat every 3–6 months when starting a new diet, exercise, or supplement plan
  • Measure both formation and resorption markers for a complete picture

A Real-Time Window Into Your Bone Health

Bone loss is silent—until a fracture occurs. Bone biomarkers give you the power to detect imbalances before they cause visible damage. They also offer validation that your efforts are paying off.

If you’re seeing positive changes in your CTX or P1NP levels, you’ll know that your bones are responding.

This kind of data is incredibly empowering for anyone taking a root-cause, whole-body approach to osteoporosis.

Ready to Go Deeper?

Bone biomarker testing can offer powerful insight into what’s happening inside your bones—often long before changes show up on a DEXA scan. But the real value comes from understanding how these labs fit into the bigger picture of your health.

Join me for a free live webinar on Thursday, May 22nd at 7 PM ET:
“Beyond the Bone Scan: What Your Doctor Isn’t Testing (But Should Be)”

In this webinar, I’ll walk you through:

    • The key bone tests your doctor might not be using
    • The essential lab markers I recommend monitoring for overall and bone health
    • How to use testing—like biomarkers, inflammation labs, and nutrient levels—to support your lifestyle and supplement plan
    • Why relying on DEXA alone can leave you in the dark—and how to get a fuller picture

Bonus for live attendees:
You’ll receive a downloadable Bone Health Testing Tracker to help you organize your results and track your progress over time.

Click here to register – it’s free!

You don’t have to guess if your efforts are working. Let’s explore the tools that can bring you greater clarity, confidence, and direction on your bone health journey.

What Hormones Impact Your Bones After Menopause?

What Hormones Impact Your Bones After Menopause?

by | Apr 21, 2025 | Sleep & stress reduction

Estrogen protects your bones for most of your life—but when levels drop after menopause, bone breakdown speeds up. And while you may not be able to dramatically boost estrogen, you can influence two other key hormones that impact bone health: cortisol and insulin.

Hormones and Bone Health: More Than Just Estrogen

Hormones play a major role in bone health—especially as we age. Most of us know that the decline of estrogen during menopause can trigger bone loss. Estrogen helps maintain a delicate balance between osteoclasts (cells that break down bone) and osteoblasts (cells that build new bone). When estrogen levels fall, that balance tips, and bone breakdown begins to outpace bone formation.

But estrogen isn’t the only hormone affecting your skeleton.

Two other hormones—cortisol and insulin—also influence bone density. Unlike estrogen, which is difficult to replenish naturally in significant amounts, cortisol and insulin are directly influenced by your daily habits. And when they’re out of balance, they can quietly sabotage your bones.

Estrogen: Your Lifelong Bone Guardian

Throughout your reproductive years, estrogen helps preserve your skeleton by slowing bone resorption (the breakdown of bone) and supporting calcium absorption. But during the menopause transition, estrogen levels drop dramatically, often leading to rapid bone loss, particularly in the spine and hips.

According to the National Institutes of Health, women can lose up to 20% of their bone density in the five to seven years after menopause.

While hormone therapy is one way to mitigate this loss, many women are seeking natural approaches to bone health, which is why it’s essential to also look at the other hormonal influences you can control.

Cortisol and Bone Loss: Can Stress Weaken Your Skeleton?

Cortisol is your body’s primary stress hormone. It’s helpful in short bursts, but when stress becomes chronic, elevated cortisol can weaken bones over time by:

  • Increasing bone resorption
  • Suppressing osteoblast activity (bone-building cells)
  • Decreasing calcium absorption from the gut
  • Promoting inflammation, which further drives bone loss

One study published in Annals of Internal Medicine found that postmenopausal women with consistently high cortisol levels had significantly lower bone mineral density.

You can’t always eliminate stress, but you can train your body to respond differently.

Insulin: The Surprising Bone-Building Hormone

Insulin does more than regulate blood sugar—it also acts as an anabolic (building) hormone for bone. It supports the activity of osteoblasts and helps maintain proper bone turnover. However, when insulin levels are chronically high, as in insulin resistance or prediabetes, this balance is disrupted.

Insulin resistance also drives inflammation, which in turn fuels bone breakdown and increases the risk of fractures.

Recent research reported in Acta Endocrinologica (BUC) highlights a clear link between insulin resistance, inflammation, and osteoporosis, particularly in postmenopausal women.

What Can You Do to Support Healthy Hormone Balance?

While estrogen’s decline is a natural part of aging, you can actively support bone health by managing cortisol and insulin through lifestyle. Here’s where to start:

To Lower Cortisol (Stress Hormone):

  • Prioritize rest and deep sleep (aim for 7–9 hours)
  • Practice daily stress-reducing techniques: breathwork, meditation, nature walks
  • Eat regular, balanced meals to avoid blood sugar spikes
  • Avoid overexercising—too much intense exercise can raise cortisol levels

To Improve Insulin Sensitivity:

  • Focus on whole foods rich in fiber and protein
  • Limit processed carbs and added sugars
  • Add strength training and regular movement to your routine
  • Consider time-restricted eating if it works for your body

These may seem like small changes, but over time, they can help stabilize your hormones, reduce inflammation, and support bone health.

Let’s Talk About Your Hormones and Bone Health

If you’ve been wondering whether your hormone changes are affecting your bones, or you’re feeling overwhelmed by all the moving parts, you’re not alone.

Sometimes, all it takes is one conversation to get clarity.

I offer a complimentary 20-minute consultation where we can talk through your most pressing question—whether it’s about estrogen, stress, blood sugar, exercise, nutrition, or how to take a more holistic approach to building stronger bones.

Click here to schedule your 20-minute consult

Let’s create a path forward that supports your hormones, your bones, and your vitality.

 

What’s the Best Exercise for Osteoporosis? New Research Reveals the Answer

What’s the Best Exercise for Osteoporosis? New Research Reveals the Answer

by | Apr 15, 2025 | Exercise, Uncategorized

One of the most common questions I hear—and one I asked myself when I was first diagnosed with osteoporosis—is: What kind of exercise is best for building stronger bones?

Does walking really help? What about swimming or biking—are they good enough? Or do I need to lift weights and do impact exercises?

Honestly, it can be overwhelming to sort through all the advice, especially when you’re just trying to feel stronger, more stable, and more confident in your body. But now, thanks to new research published in Scientific Reports, we finally have some much-needed clarity—and hope.

What This Study Looked At

This 2024 study reviewed 49 clinical trials involving over 3,300 postmenopausal women—women just like you and me. The researchers set out to answer a key question:

Which types of exercise are most effective for improving bone mineral density (BMD), especially in the spine and hip—two of the most common sites for osteoporotic fractures?

The Most Effective Exercise for Bone Health

The clear winner?
A combination of aerobic exercise and resistance training (AE + RT).

This dynamic duo—think brisk walking, stair climbing, or dancing combined with strength training using weights, resistance bands, or bodyweight exercises—was the most effective in improving BMD at both the lumbar spine and femoral neck.

Here’s what else the research revealed:

  • Aerobic + Resistance Training (AE + RT) led to the greatest improvements in bone density
  • Resistance training alone also had a significant effect
  • Aerobic exercise alone provided benefits, but not as strong as when paired with resistance
  • Whole-body vibration was shown to improve BMD at the hip

Exercise Guidelines for Women with Osteoporosis

Based on the findings of this study, here’s a science-backed weekly exercise framework to support your bones:

  • Resistance Training: 2–3 sessions per week
  • Aerobic Activity: 2.5 to 5 hours per week (30–60 minutes most days)
  • Impact Exercises (if tolerated): Add low-impact hopping or jumping to boost bone loading
  • Balance Training: Daily practice to reduce fall risk and improve stability

But What If You Can’t Do High-Impact Exercise?

I get it. Not all of us can tolerate activities like jogging or even prolonged walking—especially if you’ve had joint replacements or deal with chronic pain.

If that’s your reality, please don’t feel discouraged.

While swimming and biking are often labeled “non-weight-bearing” and considered less effective for building bone, they still hold value.

Here’s why:

When your muscles contract—even during low-impact activities like swimming or cycling—they pull on your bones, creating a mechanical force that helps stimulate and maintain bone strength. While the force is less than what you’d get from weight-bearing or resistance exercise, it’s still a helpful signal to your skeleton.

So if swimming or biking is what you can do safely—or what you genuinely enjoy—keep doing it! These activities are great for your heart, your muscles, your joints, and your emotional well-being.

That said, for optimal bone support, consider adding in resistance training. You can start gently with bodyweight exercises, resistance bands, or light weights and build up from there.

Final Thoughts

If you’re like me—a postmenopausal woman in her 60s who wants to stay strong, active, and vibrant—this study is a powerful reminder that movement matters, but the type of movement matters even more.

While aerobic exercise offers important benefits, it’s resistance training that truly helps build and protect bone. When you combine the two, your bones get the best of both worlds.

And remember:

It’s not about doing everything perfectly. It’s about starting where you are—and staying consistent.

Whether you’re walking, lifting, biking, or swimming, you’re sending your body a powerful message:
I’m committed to growing stronger.

Need Help Creating a Bone-Safe Exercise Routine?

Not sure if your current routine is supporting your bones—or potentially putting you at risk?

Book an Exercise Review Consultation with me!
Together, we’ll look at what you’re currently doing and explore ways to safely add bone-strengthening movements like resistance and weight-bearing exercises—customized to your body and your needs.

You can schedule your Exercise Review HERE or Email me at susan@nurturedbones.com to schedule your session.

Let’s build strength, stability, and confidence—together.

Are Your Supplements Safe: 8 Red Flags to Watch for in Your Bone Health Supplements

Are Your Supplements Safe: 8 Red Flags to Watch for in Your Bone Health Supplements

by | Mar 25, 2025 | Supplements

If you’re like many women looking to support your bones, prevent fractures, and stay strong as you age, you’ve probably turned to supplements. It’s a smart move—when done right. But here’s the reality: some supplements simply don’t deliver what they promise. Worse yet, a few may even interfere with your health goals rather than support them.

As a clinician who’s worked with women managing osteoporosis for over a decade, I’ve reviewed hundreds of supplement routines. Some are excellent. Many are misleading. And a few are downright dangerous.

So how can you tell if what you’re taking is truly supporting your health—or just clever marketing? Let’s break down the most common red flags to watch for—and explore how to confidently choose supplements that truly support your bone health.

  1. Watch Out for Misleading Labels

If a label lists a “proprietary blend” without revealing the amount of each ingredient, be cautious. These blends often include tiny, ineffective doses of the ingredients you actually want—just enough to list them on the label, not enough to help your bones.

Fish oil labels can also often be misleading. What really matters is the amount of omega-3s, not the total oil content. Some supplements labeled “1200 mg fish oil” may contain only 300 mg of omega-3s…so check for the actual amounts of EPA and DHA, the two key omega-3s.

Tip: Look for exact ingredient amounts, so you can tell what you’re really getting.

  1. Not All Forms Are Equal

The type of nutrient in your supplement affects how well it’s absorbed—and whether it does what you need.

For example:

    • Magnesium oxide is cheap and poorly absorbed. Magnesium glycinate or citrate are better for bone and nervous system support.
    • Calcium carbonate requires strong stomach acid, which many older adults lack. Calcium citrate is better tolerated and absorbed.
    • Turmeric root powder is not the same as a standardized curcumin extract, which is what most studies use for inflammation.

Tip: Choose bioavailable forms that your body can actually use.

  1. Don’t Be Fooled by Buzzwords

Terms like “pharmaceutical grade,” “FDA-approved lab,” or “clinically tested ingredients” may sound impressive—but they’re usually just marketing speak. The FDA doesn’t approve supplement labs, and “clinically tested” might only apply to one ingredient in a very different context.

Tip: Stick to what you can verify. Look for independent testing and third-party certifications instead of vague claims.

  1. Disease Claims = Red Flag

If a supplement says it can “treat osteoporosis,” “reverse arthritis,” or “cure anxiety,” it’s making illegal claims. Supplements are not drugs and cannot legally promise to cure or prevent disease.

Tip: Stick with products that support structure or function (like “supports bone strength”), and always check with a healthcare professional.

  1. Gummy Vitamins: Convenient but Questionable

Gummy vitamins can be easy to take, but they often degrade faster and contain artificial sweeteners, dyes, or excessive sugar. They’re also held to looser standards than capsules or tablets.

Tip: If you use gummies, look for ones that are third-party tested and made by trusted brands.

  1. More Isn’t Always Better

Seeing 300% (or more!) of the Daily Value on a supplement label might look impressive—but it doesn’t necessarily mean it’s better for your bones or your health. Your body can only absorb and use a limited amount of nutrients at one time. The rest? Often wasted—or worse, it could build up to unsafe levels.

I see this often: someone is taking a multivitamin, plus a bone health formula, plus a separate antioxidant or B-complex—all without realizing how much they’re doubling or tripling certain nutrients. This can lead to nutrient overload, especially with fat-soluble vitamins like A and D or minerals like zinc and iron.

It’s essential to consider your total nutrient intake—not just from supplements but also from food and fortified products.

Tip: Avoid mega doses unless advised by your practitioner. Balance is key.

  1. Look for Reputable Certifications

When choosing supplements, always look for third-party certification seals from trusted organizations. These seals verify that the product contains what it claims and is free from harmful contaminants:

    • USP Verified – Most rigorous. Confirms ingredient identity, purity, and proper manufacturing.
    • NSF Certified – Verifies label accuracy and tests for contaminants and banned substances.
    • ConsumerLab.com – Independently tests off-the-shelf supplements for quality and price.
    • Informed-Sport / NSF Certified for Sport® – Ideal for athletes or those concerned about banned ingredients.
  1. Online Supplements—Especially on Amazon—Come with Extra Risk

Buying supplements online is convenient, and Amazon often has competitive prices. But when it comes to your health, convenience shouldn’t come at the cost of quality or safety.

Not all supplements sold on Amazon are legitimate. Several studies have revealed serious concerns:

    • Only 13 of the 30 supplements evaluated had accurate labels.
    • Many were missing listed ingredients or contained unlisted ones.
    • None had third-party certification seals.

Some sellers have even counterfeited trusted brands like NOW Foods and Pure Encapsulations. While Amazon does require certain high-risk products to go through third-party testing via organizations like Eurofins, NSF, and UL Solutions, there’s a loophole: sellers send the samples themselves, and they are not pulled from Amazon’s warehouses. That means a clean sample can pass inspection—while counterfeit or low-quality products continue to be shipped to customers.

Tips

    • Research the brand and look for independent certifications.
    • Buy directly from manufacturers or trusted platforms like Fullscript.
    • Avoid unknown brands and “too good to be true” deals.

Bonus Tips for Choosing Trustworthy Supplements

When choosing supplements to support your health, it’s crucial to be aware of several key factors that distinguish high-quality products from those that may be ineffective or harmful:

    • Look for Third-Party Certifications: Certifications from ConsumerLab, USP, NSF, or UL verify that the product contains the labeled ingredients and is free of contaminants.
    • Check for Evidence-Based Claims: Look for scientific support from credible sources like PubMed or the NIH’s Office of Dietary Supplements. Be skeptical of “miracle” claims.
    • Examine the Label Carefully: A trustworthy label should list:
      • Exact dosages
      • Expiration date
      • Lot number
      • Contact info for the manufacturer
      • Allergen info
      • Storage instructions
  • Consider the Manufacturer’s Reputation: Stick with well-known brands that disclose their sourcing and quality control practices.

Final Thoughts: Be a Smart Supplement Shopper

Supporting your bones with the right supplements can be a powerful part of your wellness plan. But not all products are created equal. Use the tips above to shop smarter, stay safer, and choose supplements that truly support your health.

Limited-Time Offer: Supplement Review Special Ends March 28

Not sure if your supplements are the right fit for you?

I’m offering a discounted supplement review now through Friday, March 28 to help you:

    • Identify where your current diet may be falling short in essential nutrients
    • Make sure your supplements are filling in the right gaps—not duplicating or overdosing
    • Spot harmful ingredients or low-quality brands that may be doing more harm than good

Only 4 spots left!  CLICK HERE to book your review before the spots fill up!

Let’s make sure everything you’re taking is supporting your bones—and your whole body—the way it should.