Bones: Building Strength From the Inside Out
Originally sent on 10 August 2025
This week I broke my foot… saving a life. Not a person. Not a pet. A caterpillar. One awkward sidestep to avoid crushing it on its way to butterflyhood… and my toe took the hit instead. It made me think even more about bone health — how easy it is to take it for granted until something snaps. Let’s dive into bones and the foundation that literally carries you through life.
DATA — Where insight becomes impact
What I’ve been looking at this week…
Bones aren’t static. They’re living tissue, constantly remodelling. Osteoblasts are the cells that build new bone and osteoclasts are the cells that crush old bone. Real risk numbers: 1 in 2 women and 1 in 5 men over 50 have fractures triggered by minimal trauma (I became one of those statistics!). Bone density declines early — loss of bone begins in your 30s unless you actively protect it. Tiny gains, huge impact: increasing bone strength by just 3 % can slash your hip fracture risk by over 45 %.
When it comes to bone health, here are the key blood biomarkers I test and target:
Vitamin D — Did you know it’s not just for bones? It’s for muscles too. Low levels mean less calcium absorption and weaker muscle fibres, increasing fall risk before a fracture even happens.
Calcium — Ninety‑nine percent is in bone, but the 1 % in blood is vital; low levels trigger calcium withdrawal from bones to keep your nerves and muscles firing.
Parathyroid Hormone (PTH) — This hormone finely tunes your calcium levels. Too high? It’s leaching calcium from your bones. Too low? You may be over‑supplementing.
Phosphorus — Partners with calcium to form bone crystals. Too high (from processed foods or kidney issues) makes bones brittle.
Magnesium — Needed to activate vitamin D and keep calcium in the right places. Low levels = lower bone density.
Homocysteine — High levels weaken bone collagen, making bone more likely to snap even if density looks okay.
DEVICES — Track it to hack it
What I’ve been monitoring this week…
DEXA (Dual‑Energy X‑ray Absorptiometry) — the traditional gold standard for measuring bone strength. It looks at bone mineral density (BMD). The scan uses two X‑ray beams — one high, one low — to separate bone from soft tissue and calculate density in g/cm².
T‑Score — Compares your BMD to a healthy 30‑year‑old: 0 to –1 = normal; –1 to –2.5 = osteopenia (thinning bones); –2.5 or lower = osteoporosis (brittle bones).
Z‑Score — Compares you to peers of your own age, sex and size.
Lesser‑known fact: try and use the same DEXA machine for follow‑ups. Different models can give slightly different readings, masking real change.
REMS (Radiofrequency Echographic Multi‑Spectrometry) — the next step in bone health diagnostics. Where DEXA measures density, REMS assesses both density and microarchitecture — the 3D structural organisation of bone tissue, including trabecular connectivity and cortical bone porosity. Trabecular bone is the inner, spongy network that acts like shock‑absorbing scaffolding. Think of it as the intricate cross‑beams inside a building — its strength comes from how well those beams connect. Cortical bone is the hard outer shell — the walls of the building. If it’s too porous (full of microscopic holes), it becomes thinner and weaker, making the whole structure less stable. Microarchitecture can predict fracture risk more accurately than density alone. Even with a “good” density score, weak inner scaffolding or a thin outer shell can still lead to breaks. Strong numbers on a DEXA scan mean strong bones, and REMS reveals whether your bone’s internal scaffolding can truly bear the load.
DECISIONS — From knowing to doing
What this means for you…
Test smarter – Get a DEXA scan early (not just post‑50) and consider REMS for a full view of bone density and quality. When testing, include vitamin D, calcium, magnesium, PTH, phosphorus and homocysteine. This helps detect risks before a fracture happens.
Nutrient precision – Aim for 1,200 mg of dietary calcium with at least 1,000 IU of vitamin D daily. Spread calcium intake throughout the day for better uptake. Strong bones need a steady supply of nutrients.
Lifestyle loading – Add 30 jumps twice a day and three strength sessions each week. Impact plus resistance exercises stimulate bone growth.
Mind the micro‑environment – Lower homocysteine with folate, vitamin B6 and vitamin B12. Cut processed foods high in phosphates and increase protein. These steps keep bone collagen tough and resilient.
Track progress – Retest blood biomarkers every six months and rescan bones every 1–2 years. Regular checks confirm that your interventions are working.
Case in point:
My personal broken‑toe takeaway: Absence makes the heart grow fonder — and sometimes the same is true for toes! The hallux (great toe) carries the weight of your entire body in every step and propels you forward. In yoga philosophy, the big toe is your anchor to the earth, central to stability and rootedness. Without it, you realise just how much your balance, gait and confidence in movement depend on that small but mighty joint. While my fracture heals, I’m immobilising my great toe by strapping it and giving it the rest and respect it deserves!
DIARY — Where you’ll find me…
Last week: I was in Kerala, India exploring the concepts and delivery of clinical wellness (more on that to come!).
This week: I’m delighted to have been featured in The Times. Very emotional seeing my story in print. And even more emotional watching my children read it. Thank you all so much for all the wonderful messages I've received.
Next week: Making it up to my Million Hour Club!! Yes, I woefully neglected you this week with all the dramas that unexpected twists of health can create. My attention is now back on you. Just shows how the smallest niggle in your health can hijack your focus from what truly matters — which is exactly why it's so important to make proactive health the priority. Million Hour Method reminder: The stronger your health foundation, the fewer distractions life can throw at it.
DISTINCTION — A thought to pause on…
“I saved a caterpillar so it could become a butterfly — a reminder to save your bone strength now, so it can carry you into every transformation your life still holds.” So here’s my question for you this week: What are you doing today to ensure your bones can carry you through to the next decade of your life?