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Cribra cranii, orbitalia, humeralis, and femoralis were recorded as present\/absent, and elemental concentrations were assessed by portable x\u2010ray fluorescence (pXRF). A multivariate statistical approach was applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Well\u2010preserved skeletons with minimal diagenesis showed no sex\u2010related elemental variations or PSL associations. In contrast, age\u2010at\u2010death correlated with elevated Ca, P, Sr, and Pb levels. Cribra cranii increased with age while other cribra declined post\u2010adolescence. Higher concentrations of Fe and lower of S were linked to cribra cranii. Respiratory infections as COD increased the odds of expressing cribra femoralis (OR\u2009=\u20095.25, CI\u2009=\u20091.25\u201315.14), cribra cranii (OR\u2009=\u20092.91, CI\u2009=\u20090.97\u20138.69), and cribra orbitalia (OR\u2009=\u20092.76, CI\u2009=\u20091.06\u20137.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Feasible pXRF results and low cribra intraobserver error assure replicability. Elevated Ca, P, and Sr in older individuals may relate to skeletal growth, while increased Pb suggests bioaccumulation. Cribra's increase with age reflects different rates of marrow conversion and bone remodeling. Higher Fe and lower S in individuals with cribra cranii possibly reflects poor nutrition, early alcohol use, and sideroblastic anemia, aligning with 19th\u201320th\u2010century Portugal's living conditions. Respiratory infections increased cribra expression, revealing intricate interplays among inflammation, anemia(s), marrow expansion, and diet. 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