Keeping Bones Strong for Life

Written By Amir Mahajer

How Our Bones Change Over Time


At Dr. Amir Mahajer Sports Medicine & Spine Center at Osso Health, our team is here to support you in keeping your bones strong and healthy for life. Osso means “bone” in Italian, and bone health is truly at the heart of what we do.

Bones are living tissue, constantly broken down and rebuilt by two key cell types:

  • Osteoclasts – break down old bone.

  • Osteoblasts – build new bone.

In youth, osteoblasts work faster than osteoclasts, helping us gain bone rapidly. Peak bone density happens around age 25–30. After that, breakdown gradually overtakes building. Most adults lose 0.5–1% of bone density per year after midlife. In women, menopause can accelerate this loss, up to 20% in the first 5–7 years due to reduced estrogen. Men also lose bone with age, particularly when testosterone declines.

Why Bone Health Matters
Weakened bones lead to osteopenia or osteoporosis, increasing fracture risk. Hip and spine fractures can cause lasting disability, loss of independence, and even raise mortality risk. Because bone loss is silent, many people don’t know they have it until they fracture.

Testing for Bone Loss
The gold standard is the DEXA scan (dual-energy X-ray absorptiometry), measuring Bone Mineral Density (BMD) in the lumbar spine and hips.

  • T-score compares you to a healthy young adult:

    • Normal: −1.0 or above

    • Osteopenia: −1.0 to −2.5

    • Osteoporosis: −2.5 or lower

  • Z-score compares you to people of the same age, sex, and size.

Testing Guidelines

  • Women ≥65 and men ≥70, or earlier if at risk.

  • Repeat every 2 years, or sooner with a fracture, major medication change, or rapid bone loss.

Understanding Your Risk – FRAX Score
FRAX estimates your 10-year fracture risk. A 20% score means that 20 out of 100 people like you will fracture in the next decade — helping guide treatment plans.

Lifestyle Ways to Support Bone Health
It’s never too late to start building stronger bones.

  • Strength Training / Resistance Work – Lifting weights or using resistance bands signals bones to strengthen and maintains muscle to support balance.

  • Weight-Bearing Activities – Walking, hiking, dancing, stair climbing all promote bone strength.

  • Balanced Nutrition –

    • Calcium: 1,200 mg/day from food or supplements

    • Vitamin D: 400–800 IU/day (more if deficient)

    • Adequate protein for bone repair and muscle health

  • Avoid Bone-Harming Habits – Quit smoking, limit alcohol.

Medical Treatments (when lifestyle changes aren’t enough)

  • Bisphosphonates

  • Calcitonin

  • Denosumab

  • Estrogen

  • Oxytocin

  • Parathyroid

  • Romosozumab

  • SERMs

  • Testosterone

Osteoporosis, Sarcopenia, and Aging
Bone loss (osteoporosis) and muscle loss (sarcopenia) often occur together, raising the risk of falls, fractures, and disability. Strength training supports both, making it one of the most powerful anti-aging strategies available.

Key Takeaways from Dr. Mahajer and the Osso Health Team

  • Build peak bone density early, protect it for life by strength training.

  • Menopause and hormonal decline accelerate bone loss.

  • Strength training is your lifelong ally for bone and muscle health.

  • Get tested at the right intervals, know your FRAX score.

  • Combine lifestyle changes with medical treatments when needed.

Bottom Line: Your bones are the framework of your independence and active life. At Osso Health, we’re here to help you keep them strong, because strong bones mean a stronger you.

Amir Mahajer
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