8 Sneaky Signs Your Bones May Be Weaker Than You Think

Silent Signs Your Bones May Be at RiskThe Good Brigade – Getty Images"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links."

Breaking a bone hurts—a lot. But the bone-thinning conditions osteoporosis and its precursor, osteopenia, are often called "silent diseases" because they have few signs before you develop a fracture.

That said, subtle changes may alert you that your bone health could be at risk. And sometimes, part of your medical history or a current lifestyle habit boosts your chances of a crack.

It's important to pay attention to these harbingers, because proactively addressing bone health can preserve your function and independence as you age, says Heidi Prather, D.O., sports medicine and hip preservation physiatrist and founder and medical director of the HSS Lifestyle Medicine Program.

Meet the experts: Heidi Prather, D.O., sports medicine and hip preservation physiatrist and founder and medical director of the HSS Lifestyle Medicine Program; Adam Rivadeneyra, M.D., sports medicine physician with Hoag Orthopedic Institute in Southern California

You might think of your bones as solid structures, but they're living tissue, just like your muscles and tendons. Throughout life, they're constantly breaking down and repairing.

The balance of those two activities changes with age. Until about 20 or 30, your body rebuilds bone faster than it's resorbed, allowing you to reach what's called your peak bone mass. From 30 to 50 or so, the process plateaus, so your bones stay at about the same strength.

And then, after 50, the construction process slows, a drop-off that's especially steep in women. Menopause brings declines in the female sex hormone estrogen, which in turn leads bone-building cells called osteoblasts to die off. "You can get this really rapid, dramatic bone loss within those first five to seven years in that transition into menopause," Dr. Prather says.

All this means that a decline in bone density is entirely predictable—it happens to pretty much everyone, says Adam Rivadeneyra, M.D., sports medicine physician with Hoag Orthopedic Institute in Southern California. But staying alert for the signals that it's accelerating particularly quickly can give you time to take bone-boosting actions before you sustain a break.

The so-called sunshine vitamin helps your body absorb the mineral calcium, which builds strong bones. And it's easy to fall short—according to a 2025 review in the New England Journal of Medicine, it's one of the most prevalent deficiencies in the United States, with 41% of people in a large national database coming in below 75 nmol per liter, the level deemed optimal for bone and muscle health by the Endocrine Society.

To find out if you're among them, ask your doctor for a lab test to check your levels. If needed, you can raise your vitamin D levels with a few strategic minutes in the sun, foods like fatty fish and mushrooms, or supplements.

For the most part, you can't see what's happening to your bones, since they're buried underneath your skin. But if you—or your dentist—spot problems in your mouth, it may reveal more about what's going on beneath the surface. People with poor oral health have a greater risk of getting a fracture, according to a systematic review in the journal Ageing Research Reviews.

Though they're both hard and white, teeth and bones are made of different stuff. Still, some of the underlying processes that affect bone health—including shifting hormone levels and low levels of calcium and vitamin D—can contribute to conditions like gum disease and missing teeth, the review authors note.

Maybe you grew up playing soccer or running track and cross country. Or, perhaps you got into marathons or triathlons as an adult. At some point, if you were really training hard, you might have noticed that your periods were farther apart—or maybe even disappeared altogether.

Contrary to what some coaches have told women athletes, missing periods isn't a sign of dedication, Dr. Prather says—it's actually a warning sign of low energy availability, which occurs when athletes or active people don't eat enough to replace the energy they're expending through their workouts.

When your body's starved for energy, it shuts down nonessential functions, including reproduction. As a result, you lose bone-boosting estrogen, leaving you at risk for tiny cracks in the bone called stress fractures while it's happening. And—especially if it occurred during your peak bone-building years—low energy availability raises the risk of osteopenia and osteoporosis for years down the line, notes a review in the journal Physiological Research.

Your mom wasn't lying when she told you to drink calcium-rich milk for your bones. Your body can't produce this vital mineral, which forms a key building block of a strong skeleton. After age 50, you should aim for between 1,000 and 1,200 milligrams per day.

While milk, yogurt, and cheese are particularly good sources of calcium, you can also find calcium in leafy green veggies, fish like sardines and canned salmon, and fortified cereal, tofu, or fruit juices. If you're having trouble meeting your needs through diet alone, talk to your doctor about supplements.

Weight-bearing cardio workouts, like walking and running, are beneficial for bone health. But to truly mount your best defense against osteoporosis and fractures, you also need to pick up heavy stuff once in a while.

"Bone responds to pressure by getting harder and more resilient the more you use it," Dr. Rivadeneyra says. As you lift a dumbbell or pull on a resistance band, your muscle tugs on your bone, stimulating osteoblasts to build new bone. Moves like bodyweight squats, step-ups, and wall push-ups target important—and particularly vulnerable—areas like the hips, spine, and wrists.

And strength training also improves balance and stability, which reduces fall risk. That means even if your bones are weaker, you can reduce your risk of a fracture, he says.

By now, it's not news that drinking too much is bad for your liver, heart, and brain. But excessive alcohol might also wreak havoc on your bones, Dr. Prather points out.

According to a systematic review and meta-analysis in the journal Drug and Alcohol Dependence, people who had a drink or two per day had a 34% greater risk of osteoporosis than those who didn't imbibe. Downing more than two alcoholic beverages daily, meanwhile, boosted the risk to 63% greater.

Why? Booze can interfere with your body's ability to absorb calcium and vitamin D, as well as further suppress hormones like estrogen and testosterone, notes another review, in the International Journal of Environmental Research and Public Health. And of course, inebriation can increase your risk of falling, which can lead directly to fractures.

For some medical conditions—including lupus, asthma, eczema, and rheumatoid arthritis—medications called corticosteroids are important for improving health and quality of life, Dr. Rivadeneyra says.

But there's a trade-off. As many as half of people who use these medications for more than three months will develop osteoporosis, in part because the drugs interfere both with the breakdown of old bone and the building of new tissue, according to a review in Open Access Rheumatology.

While the biggest risk comes when you first start taking them, there's some evidence the effects linger even after you stop. That doesn't mean you shouldn't take these drugs, Dr. Rivadeneyra notes—but as with any other medication, you should be aware of the risks as well as the benefits.

You might think you'd automatically notice when you've broken a bone. However, breaks called vertebral compression fractures—small cracks in the bones of your spinal column—often occur without any identifiable trauma, Dr. Prather says.

If you have osteoporosis, even everyday movements like coughing, sneezing, or getting out of a car can cause these fractures. Afterward, you may notice back pain that you never had before. Or, you might suddenly notice you're a bit shorter, as the fracture causes the bone to collapse.

None of these signs means you're doomed to develop a fracture—although backaches may mean you already have one. But they all do point to potential problems and should prompt a discussion with your doctor, who may suggest a DEXA scan to check your current bone density status, Dr. Prather says.

From there, you can work together on a bone-health strategy, which might include exercise, diet, reducing risks like smoking and alcohol use, and, if needed, medications. "The years around menopause are a good time to figure out your baseline bone density, or quality of your bones," she says. "Building strength and a plan around that early on can really protect you in the decades to follow."

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