What You Need to Know About Osteoporosis and Bone Health
Osteoporosis is a common yet often overlooked condition that quietly weakens bones over time. It’s defined by low bone mass and deterioration of bone microarchitecture, which increases the risk of life-altering fractures — often without any warning signs.¹ Fractures from osteoporosis carry a significant toll, both physically and emotionally, often resulting in reduced mobility, loss of independence, and elevated mortality. In some populations, the number of women who die annually from osteoporotic fractures exceeds those who die from breast cancer — a striking and often overlooked reality.
Yet many people put off screening or preventive action. Too often, the assumption is: “If I’m not taking prescription drugs, why test?” But early awareness and intervention are key. Bone health isn't just about avoiding medications — it’s about understanding how to protect and strengthen your bones through holistic, evidence-based strategies.
How bone health declines
Bone is a living tissue, constantly undergoing a cycle of breakdown and repair. As people age, this cycle becomes imbalanced. Bone resorption by osteoclasts (the cells that naturally break down bone to release calcium and minerals into the bloodstream) increasingly exceeds bone formation by osteoblasts (the cells that build bone tissue). This shift results in gradual bone loss and deterioration of the bone’s internal structure.
This cellular environment sets the stage for osteoporosis, particularly when compounded by inflammation, poor nutrition, or inactivity.
Osteoporosis is not just a “women’s disease”
While osteoporosis is more commonly diagnosed in postmenopausal women — largely due to the protective role estrogen plays in bone metabolism — it's not a condition that affects women alone. Men and younger adults can also be affected, especially if they have risk factors such as glucocorticoid (steroid drugs) use or certain chronic diseases.²
One challenge is that osteoporosis in men is often under-diagnosed. Cultural assumptions can prevent men from seeking screening or acknowledging risk. But data shows that men who sustain osteoporotic fractures face mortality rates equal to or higher than women, especially after hip fractures. Recognizing that osteoporosis is a universal risk is the first step in changing that.
What most people get wrong about osteoporosis
A major misconception is that osteoporosis presents with symptoms — something you’ll feel or notice. In truth, the condition is typically asymptomatic until a fragility fracture, which are breaks in the bone that occur from a low-impact event, like a fall from standing height or less. Many confuse joint pain or arthritis with bone weakness, but these aren’t reliable indicators of bone density.
Another common myth: osteoporosis can be diagnosed with a routine blood test. In reality, bone density must be measured using a specialized scan, typically a DEXA scan. Unfortunately, some patients may avoid testing altogether because of side effects or broader impacts of pharmaceutical treatments — not realizing that a diagnosis can open the door to powerful non-drug strategies.
And while calcium gets most of the spotlight, bone health isn’t dependent on one nutrient alone. A diet rich in a variety of bone-supportive nutrients, combined with exercise and lifestyle changes, plays a crucial role in prevention and recovery.
Foundations of strong bones: lifestyle and nutrients
Supporting bone health naturally starts with lifestyle. Weight-bearing and resistance exercises help stimulate bone formation. Avoiding tobacco, moderating alcohol, and minimizing fall risk are equally important.
On the nutrition front, several nutrients are essential for bone support:
Calcium (1000–1200 mg/day, ideally from food)³
Vitamin D (800–2000 IU/day to maintain serum 25(OH)D ≥30 ng/mL)⁴
Vitamin K2, which helps regulate calcium distribution⁵
Magnesium, essential for bone metabolism (along with Vitamin K2)⁶
Emerging evidence also supports the use of melatonin, ortho-silicic acid, omega-3 fatty acids (EPA and DHA), and curcumin. ⁷ ⁸ ⁹ ¹⁰ These compounds have shown promise in supporting bone metabolism and reducing inflammation, offering natural ways to help protect and rebuild bone strength.
When hormones matter
Sex hormones play a foundational role in bone density, particularly estrogen in women and testosterone in men. After menopause, declining estrogen levels accelerate bone loss, making postmenopausal women especially vulnerable to osteoporosis.
Hormone therapy may be appropriate for some women as part of a comprehensive bone health strategy. Men, too, may benefit from addressing hormone levels when clinically indicated. Optimizing hormone balance is about more than symptom relief — it’s about preserving bone integrity for the long term.
The bigger picture: risks beyond bone loss
The primary concern with osteoporosis isn’t just low bone density — it’s the fractures that result. Fragility fractures — especially of the hip, spine, and wrist — are the most serious complication. A single fragility fracture significantly increases the risk of subsequent fractures, often within the first year, creating a cycle of recurrent injury and disability.
Long-term impacts of fragility fractures may include:
Chronic pain and decreased mobility
Loss of independence and functional decline
Increased risk of future fractures
Need for long-term care or rehabilitation
Elevated risk of death, particularly following hip or vertebral fractures
Preventing falls is critical. That includes home safety modifications, strength and balance training, and minimizing medications that impair coordination. These strategies help reduce the risk of injury and preserve quality of life.
What’s new in bone health: the power of strength training
One of the most promising advancements in osteoporosis care is resistance training. While traditional guidelines have emphasized low-impact activity, new research shows that lifting heavy weights — when done safely — can significantly improve bone density.
The LIFTMOR (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation) program uses twice-weekly, high-intensity sessions with progressive resistance and impact training. The results speak for themselves: increased bone mineral density at the spine and hip, improved posture and strength, and a low risk of injury when supervised properly.¹¹
Final thoughts: prevention is power
Bone health is foundational to lifelong strength, mobility, and independence. And while the risks increase with age, the tools for prevention and support are within reach — no matter your stage of life.
By embracing a holistic approach that includes movement, targeted nutrition, and informed screening, it’s possible not only to slow bone loss but to rebuild what’s been lost. Empowerment starts with understanding, and every step toward stronger bones is a step toward a stronger future.
Sources
1 National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2024). Osteoporosis. National Institutes of Health. https://www.niams.nih.gov/health-topics/osteoporosis
2 Briot, K., & Roux, C. (2015). Glucocorticoid-induced osteoporosis. RMD Open, 1(1), e000014. https://pmc.ncbi.nlm.nih.gov/articles/PMC4613168/
3 National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2022). Calcium and vitamin D: Important for bone health. National Institutes of Health. https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health
4 National Institutes of Health Office of Dietary Supplements. (2022). Vitamin D: Fact sheet for health professionals. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
5 Ma, M.-l., Ma, Z.-j., He, Y.-l., Sun, H., Yang, B., Ruan, B.-j., Zhan, W.-d., Li, S.-x., Dong, H., & Wang, Y.-x. (2022). Efficacy of vitamin K2 in the prevention and treatment of postmenopausal osteoporosis: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Public Health, 10, 979649. https://www.frontiersin.org/articles/10.3389/fpubh.2022.979649/full
6 Liu, L., Luo, P., Wen, P., & Xu, P. (2024). The role of magnesium in the pathogenesis of osteoporosis. Frontiers in Endocrinology, 15, 1406248. https://pmc.ncbi.nlm.nih.gov/articles/PMC11186994/
7 Yang, K., Qiu, X., Cao, L., & Qiu, S. (2022). The role of melatonin in the development of postmenopausal osteoporosis. Frontiers in Pharmacology, 13, 975181. https://pmc.ncbi.nlm.nih.gov/articles/PMC9585202/
8 You, Y., Ma, W., Wang, F., Jiao, G., Zhang, L., Zhou, H., Wu, W., Wang, H., & Chen, Y. (2021). Ortho-silicic acid enhances osteogenesis of osteoblasts through the upregulation of miR-130b which directly targets PTEN. Life Sciences, 264, 118680. https://www.sciencedirect.com/science/article/abs/pii/S0024320520314338
9 Liu, Z., Cai, S., Chen, Y., Peng, Z., Jian, H., Zhang, Z., & Huang, H. (2025). The association between dietary omega-3 intake and osteoporosis: A NHANES cross-sectional study. Frontiers in Nutrition, 11, 1467559. https://www.frontiersin.org/articles/10.3389/fnut.2024.1467559/full
10 Yang, S., Sun, Y., Kapilevich, L., Zhang, X., & Huang, Y. (2023). Protective effects of curcumin against osteoporosis and its molecular mechanisms: A recent review in preclinical trials. Frontiers in Pharmacology, 14, 1249418. https://pmc.ncbi.nlm.nih.gov/articles/PMC10544586/
11 Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2017). High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: The LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research, 32(7), 1486–1493.https://doi.org/10.1002/jbmr.3284
