Osteoporosis – in Men?
By Dr. Eric Rudin, Endocrinologist, Northern Westchester Hospital
You probably think of osteoporosis — thinning bones — as a woman’s problem. For the most part that’s true. But we see plenty of men with osteoporosis, too. According to the National Osteoporosis Foundation, about two million American men have the condition, and another 12 million are at risk.
Osteoporosis can be deadlier in men: Men have a higher risk of mortality than women following a hip fracture. Unfortunately, doctors are less likely to recognize bone thinning in men since they also tend to think of osteoporosis as a woman’s disease.
Should men get bone scans? It’s only necessary for men who have established risk factors. These include: A history of fracture in middle age or later, chronic steroid use for any reason (steroids weaken bone); testosterone deficiency, which can occur naturally with aging or following treatment for prostate cancer; or someone with parathyroidism or long-term digestive troubles such as irritable bowel syndrome or celiac disease —conditions that can interfere with the absorption of calcium.
Sometimes a radiologist, doctor or even a dentist can find evidence of thinning bones in an x-ray for a fracture, chest troubles, or dental work. When it’s diagnosed, osteoporosis is treated in men the same way it is in women. First we have to treat any underlying disease that may be causing the bone loss. Next up is vitamin D — which helps the body absorb calcium — and calcium supplements. I usually recommend about 1,000 international units of vitamin D daily. Gauging calcium can be a little trickier, since there are many dietary sources. I tell patients to aim for 1,200 milligrams a day through a combination of food and supplements.
After lifestyle changes, there are medications that can help build bone and protect against fracture. Two new classes of drugs are particularly helpful. But the bottom line is that men and their physicians need to be aware of osteoporosis as a possible risk. This is truly a silent disease. The only sign is usually after a hip fracture or compression fracture has happened. Men need to discuss their risk with their physicians and get a bone scan if necessary.