It’s a popular misconception that bone loss is a “female problem.” But osteoporosis can affect either gender, and progresses in both men and women as we age.
Which is why the Ridgefield Men’s Club was so interested to hear Rick Pope, a physician’s assistant, give a talk on male osteoporosis recently.
Mr. Pope is a member of Danbury Orthopedics’ Department of Rheumatology. He has worked with Dr. Michael Spiegel for the last five years.
An audience of 150 Men’s Club members was present for the one-hour presentation, and learned these salient points:
- Approximately 2 million men have osteoporosis and 12 million are at risk.
- According to the U.S. Preventative Task Force, the incidence of male osteoporosis was estimated at 20% in the year 2000, and will increase up to 34% by 2025 — a 14% increase over 25 years.
It’s cause to be alarmed, but there’s good news, too. Men lose bone much more slowly than women in general. And because men have bigger bones they are at lower risk for fractures.
A loss in height of 1.5 inches can be a tip-off to the need for medical evaluation. Otherwise, the disease is silent until the first fracture.
Medicare pays for BMD (bone medical density) testing for those at high risk and for all men over the age of 70.
Dual energy X-ray absorptiometry is the gold standard for measuring bone strength. If you are osteopenic, an MD, NP or PA should calculate your 10-year probability of fracture with the FRAX tool, which can be found online at www.shef.ac.uk/FRAX.
Compression fractures of the spinal vertebrae are often non-painful and discovered incidentally on X-ray. If you have a compression fracture of the spine that was not traumatic, you should still be treated, says the National Osteoporosis Foundation. If your BMD T-score is less than 2.5 standard deviations below the mean, you should be treated for osteoporosis with FDA-approved medications.
A fragility or osteoporotic fracture is one that occurs from a standing height or less. This type of fracture is considered a sentinel event for evaluation of bone strength.
The two biggest risk factors for men and women are age (over 70) and prior low-trauma fracture after the age of 40. In addition, smoking, excess alcohol intake (over two drinks per day), quadriceps atrophy, postural instability, or falls in the preceding 12 months are also risk indicators — as are poor visual acuity, hypogonadism, parent with a hip fracture, rheumatoid arthritis, corticosteroid treatment, and COPD. Caucasians are more at risk than other races.
Secondary causes of osteoporosis include vitamin D deficiency, particularly in northern climates from November to April. Vitamin D allows for calcium absorption from the GI tract. Sun exposure is a great source of activated vitamin D.
The adult RDA is 1,200-1,500 mgs per day, including dietary sources such as milk and milk by-products. PPIs have been associated with decreased absorption of calcium but citrate is the preferred formula for calcium supplementation.
Consider taking calcium and vitamin D, but speak to your health care provider before adding any supplements to your regimen.
Walking on a regular basis and weight lifting can help build bone density and should be done by all older adults when possible. Strengthening the quadriceps muscle is key to transferring from bed to chair and standing and walking.
While there are many causes of bone loss, with adequate exercise, calcium intake and vitamin D levels, most men can promote bone health. But statistically, for 34% of men this may not be enough. Rely on your health care provider to assess your risk of fracture and help you take the appropriate steps.
For more information, call 203-797-1500 or visit www.dortho.com.