[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/betterbones.com\/fractures-and-healing\/marys-broken-leg-part-1\/#Article","mainEntityOfPage":"https:\/\/betterbones.com\/fractures-and-healing\/marys-broken-leg-part-1\/","headline":"Mary\u2019s broken leg – Part 1","name":"Mary\u2019s broken leg – Part 1","description":"Print PDF eBook Facebook Twitter Gmail LinkedIn Pinterest I often say it\u2019s never too late to build strong, healthy bones, but I could just as easily say it\u2019s never too early! Here\u2019s a case that\u00a0illustrates that point. Recently I did a consultation with a young woman from Maine who\u2019d had a severe, and rather strange, […]","datePublished":"2010-04-07","dateModified":"2026-04-22","author":{"@type":"Person","@id":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/#Person","name":"Dr. Susan E. Brown, PhD","url":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/","identifier":72,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Center for Better Bones","logo":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","width":150,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2019\/01\/osteoporosis-blog.jpg","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2019\/01\/osteoporosis-blog.jpg","height":512,"width":1024},"url":"https:\/\/betterbones.com\/fractures-and-healing\/marys-broken-leg-part-1\/","about":["Fractures & Healing"],"wordCount":1058,"keywords":["bone repair"],"articleBody":" Print PDF eBook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tFacebook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTwitter\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tGmail\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tLinkedIn\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPinterest\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tI often say it\u2019s never too late to build strong, healthy bones, but I could just as easily say it\u2019s never too early! Here\u2019s a case that\u00a0illustrates that point.Recently I did a consultation with a young woman from Maine who\u2019d had a severe, and rather strange, leg fracture. Mary is 27, active, and mostly healthy, if a little overweight. In February of 2009, she was standing in line at a skating rink (wearing rollerskates) when someone behind her fell and knocked her down. She doesn\u2019t recall falling particularly hard, yet a sudden, excruciating pain in her leg turned out to be a bone fracture. But this was not just a garden-variety fracture \u2014 her right tibia and fibula were shattered. Repairing them would require 16 screws and two metal plates inserted surgically to hold the bone together, followed by months of rehabilitation. I spoke to her by phone after the accident and encouraged her to use the 20 key bone-building nutrients to speed her healing along.After she was healed, Mary came back to me for a consultation because the extensive damage to her leg had her worried. Why had such a simple fall caused her such serious damage? Friends of hers had had much less injury with similar falls, or even worse falls, than the one that shattered her leg bone. What was going on? Was she at risk of another serious fracture if she fell again?When we first sat down to review her medical history, about 9 months after the initial accident when she was pretty well healed up, I asked if she\u2019d had a bone scan or a vitamin D test when she was first evaluated by the bone specialist who\u2019d repaired her leg. She hadn\u2019t, so I suggested she go back to her own doctor and ask for both tests. When we looked at the results, there was one point that stood out: her DEXA showed that her bone density was normal for a woman her age, but her vitamin D was surprisingly low \u2014 only 24 ng\/mL, and this was after she\u2019d been taking close to 3000 IU daily for many months.If you\u2019ve been reading my blog posts, you already know that Vitamin D deficiency has a huge impact on bone strength. I felt certain that this was one piece of the puzzle. Unfortunately, Mary\u2019s vitamin D status before the accident was unknown, because her doctor, like many others, doesn\u2019t routinely test his patients\u2019 vitamin D levels. But if Mary was this low after supplementing for many months, it\u2019s realistic to think she was even lower last spring after going through a Maine winter with no extra vitamin D.But there was more to her story. Mary also told me that she\u2019d gone to her doctor not long before the break because of dysfunctional uterine bleeding and highly irregular periods. Estrogen-based birth control pills did nothing to change it \u2014 and at around the same time she broke her leg, her menstrual cycles stopped altogether. When they resumed, six months after the accident, she was prescribed progesterone-based birth control pills that seemed to address the issue \u2014 her menstrual cycles became regular again. These hormonal irregularities offered another clue: it was likely that added progesterone was what brought Mary\u2019s menses into balance, and low progesterone might be linked to her leg fracture. Years ago, endocrinologist Dr. Jerilynn Prior reported that 25% of all young women in North America suffered from hidden ovulatory disturbances resulting in low progesterone levels and subsequent sub-optimal bone mass development.\u00a0 So now I started wondering why she might experience progesterone deficiency and if there were other hidden endocrine disorders contributing to her menstrual irregularities. Could a thyroid, adrenal, or other sex hormone imbalance be affecting her bones? I asked if she\u2019d had any hormone tests, and she said her thyroid was tested.\u00a0 Her doctor had reported that she\u2019d had a \u201cnormal\u201d TSH at her last visit\u2026 but the records didn\u2019t specify the exact TSH level. So that\u2019s another place for us to look, since different physicians have different (and sometimes erroneous) ideas of what\u2019s \u201cnormal.\u201d\u00a0 No other hormones were tested.Mary is also working full time and attending graduate classes to obtain a Master\u2019s degree in public policy. She told me that her irregular periods started about the time she moved out of her parents\u2019 house (she has a big, close-knit family) and started living on her own. This raised a red flag for me that stress, and the stress hormone cortisol, could also be an issue here.Right now, Mary is increasing her dose of vitamin D to around 7000 IU per day (the usual protocol when vitamin D is severely depleted is to take 50,000 IU a week for 8 weeks, then retest to see if it\u2019s gone up). When she goes back for her vitamin D retest, she\u2019s planning to request several of the other tests I recommend to look for signs of bone loss: ionized calcium, intact parathyroid, NTx bone resorption test, and if available, free cortisol and DHEA tests to see whether excess stress hormones are a piece of the puzzle. Mary is still in her bone-building years, so being proactive right now to find out why her bones are weak may save her a lot of trouble later.This particular case is of interest to me because it\u2019s not often that we see this kind of bone weakness in a young person \u2014 but I strongly suspect it\u2019s becoming a lot more common than most of us might wish. We have a lot of bone-weakening factors in our modern lifestyles and diets, not to mention high levels of stress! I\u2019ll be coming back to this case from time to time to talk about what we can learn from it, but for now, I think the take-away is this: bone health isn\u2019t just a concern for older people. There are so many risk factors that can contribute to weak bones that it\u2019s worth stopping to take a look at them and think about which ones you can change right now. Because every little bit helps! To understand the underlying bone health picture, visit our natural osteoporosis support guide."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Fractures And Healing","item":"https:\/\/betterbones.com\/fractures-and-healing\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Mary\u2019s broken leg – Part 1","item":"https:\/\/betterbones.com\/fractures-and-healing\/marys-broken-leg-part-1\/#breadcrumbitem"}]}]