hi carrie, have you been doing any dietary interventions? there are strong correlations between nutrients that are low in ms and ones that are important to bone health. if you are feeling bone pain it could be vit d3 or mineral deficit. thoughts?
excerpts from:
Nutrition in Bone Health Revisited: A Story Beyond Calcium
http://www.jacn.org/content/19/6/715.full
(i'm leaving out some of the no-brainers eg calcium and vit d3, but you can read about these and more if you follow the link above)
PHOSPHORUS
Although P is an essential nutrient, there is concern that excessive amounts may be detrimental to bone. For example, a rise in dietary P increases serum P concentration, producing a transient fall in serum ionized Ca resulting in elevated parathyroid hormone (PTH) secretion and potentially bone resorption. The primary function of PTH is to prevent hypocalcemia by increasing bone resorption of calcium. The hypothesis that excess dietary P is harmful to bone was tested in young adults consuming controlled diets containing 1660 mg P and 420 mg Ca. Within 24 hours, the diet resulted in elevated indexes of PTH action [89] that persisted for four weeks [90]. Animal data confirm that the combination of high P and low Ca diets is deleterious to bone mass [91]. ... Dietary P intakes have risen 10% to 15% over the past 20 years because of the increased use of phosphate salts in food additives and cola beverages [8].
MAGNESIUM
Magnesium deficiency alters calcium metabolism, resulting in hypocalcemia, vitamin D abnormalities and neuromuscular hyperexcitability. The primary reason for the hypocalcemia commonly observed in Mg deficiency is impaired PTH secretion [101]. ... In osteoporotic postmenopausal women, Mg supplementation for one year improved radial bone mass [112].
IRON
We recently examined the relationship between bone mass and ferritin in a four-year clinical trial of Ca supplementation in adolescent girls [133]. There was a trend for a positive association between BMD of forearm and serum ferritin at baseline.
ZINC
The human body contains one to two grams of zinc (Zn) and about 90% is found in muscle, bone, skin and hair, while blood contains less than 1%. Zn plays an important role in connective tissue metabolism, acting as a cofactor for several enzymes, such as alkaline phosphatase (necessary for bone mineralization), and collagenase (essential for the development of the collagenous structure of bone) [148].
Zn deficiency results in impaired DNA synthesis and protein metabolism, which lead to negative effects on bone formation [148]. The role of Zn in bone formation is well documented in animal models [149], and low serum levels of Zn and excessive urinary excretion are related to osteoporosis in humans [150,151]. Zn concentration in bone is greatly reduced during Zn deficiency [152]. A beneficial effect of Zn supplementation was observed in vertebral and femoral bone mass in rats during strenuous treadmill exercise [153].