Dear Dr. Garner,
About five weeks ago, I was walking outside my home in Queens and fell. When I tried to get up, I couldn’t. An ambulance took me to the hospital, where I found out that I had a hip fracture and osteoporosis as well.
I thought this was a woman’s disease. My doctor never even discussed the topic prior to this, although he’s sent my wife for several tests regarding osteoporosis.
I am 70 years old and am now in rehab. I’m doing much better, but this whole thing is such a surprise to me.
Brittle Bones in Briarwood
Dear Brittle Bones,
I was just discussing this topic with my brother, noted rheumatologist Dr. Bruce Garner.
Most people think of osteoporosis, or brittle bones, as a woman’s disease. This is because it is so prevalent in women: More than one out of two women have it over the age of 50.
Unfortunately, much of the concern that patients and doctors show toward this disease is for women. Even the tests we use to diagnosis it are based upon standard measurements that pertain to women.
It is important to get the disease on the radar screen for all men.
By the Numbers
• One in eight men will have osteoporosis in their lifetime.
• About three million men will develop osteoporosis each year.
• 90 percent of fractures that occur in the elderly are due to osteoporosis.
• 24 percent of men die within a year of sustaining a hip fracture.
Why do more women get the disease than men? Men are born with thicker and denser bones than women, and it takes much longer (until about the age of 65) for them to lose a significant portion of it, as hormone levels (testosterone) drop slowly. Women, on the other hand, are born with thinner bones and bone density and tend to lose it quickly at the time of menopause due to rapidly decreasing hormone levels (estrogen).
Some risk factors for developing osteoporosis include:
1. Genetics and ethnicity – Caucasians are at increased risk for osteoporosis. Also having a parent with the disease increases your risk.
2. Alcohol, cigarettes, caffeine and inadequate calcium intake increase risk of brittle bones.
3. Rapid weight loss increases risk of osteoporosis.
4. Certain medications, such as steroids, weaken bones.
5. Chronic disease, such as kidney or thyroid disease, can lower calcium levels and increase risk for brittle bones.
Some ways to decrease your risk include:
1. Playing on a high school sports team
2. Eating a diet rich in calcium
3. Avoiding rapid weight loss
4. A lifetime of physical activity
5. Maintaining a normal testosterone level
There are no definite guidelines as to when to obtain tests for osteoporosis in men. Many doctors screen at age 65. The best test for screening is a dual-energy X-ray absorptiometry (DXA) scan. This test uses very little radiation. It can help your doctor determine how strong and dense your bones are and alert your doctor if you are at increased risk to develop fractures.
A simple test you can do at home is to measure your height every six months. If there is any decrease, there is a possibility you have osteoporosis.
Treatment consists of medications, lifestyle and diet change, exercise and treating any underlying causes such as thyroid disease.
Many doctors use calcium supplements as a means of prevention.
A word about that: About a month ago, several studies were released that showed that calcium supplements could be harmful to the heart, with some reports showing a 30 percent increase in heart attacks.
The use of calcium supplements must be discussed with you doctor. Safe ways to get calcium include leafy vegetables and dairy products.
I hope your letter alerts other men to be aware that osteoporosis is not exclusive to women and that men are also at risk.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.