Bone Health: What You Can Do About It

When it comes to osteoporosis, people tend to think of an elder woman. But millions of men currently have osteoporosis, and many millions more are at risk of getting it.

In Canada, one in four women and one in eight men over the age of 50 has osteoporosis, according to BC-based McLeod Medical, which adds that in Canada, some 80 per cent of fractures in people over 50 are related to osteoporosis.

Both women and men typically reach peak bone mass in their early 20s. As mid-life begins, men and women alike see a decline in bone mass, though women typically lose bone mass at a faster rate, owing to menopause. But, by the time they reach age 65, men and women tend to lose bone mass at a similar rate, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

Over 200 million people worldwide suffer from osteoporosis, according to the International Osteoporosis Foundation, which points out that incidence of osteoporosis is far more common than other diseases that tend to receive much more notice and coverage.

For a long time, osteoporosis was regarded as an inescapable result of the aging process. However, the current view is not nearly so fatalistic, and many in the medical community “now believe that osteoporosis is largely preventable,” according to NIAMS.

Osteoporosis has been called a “silent disease” because it typically progresses without any noticeable signs until a fracture takes place. Fortunately, there are things you can do instead of waiting around for that first fracture. A DXA (dual X-ray) bone density test can detect osteoporosis pre-emptively, as well as predict your chances of suffering fractures in years to come. The DXA bone density test is painless and takes only about 10 minutes.

With both women and men, osteoporosis targets different racial groups at different rates. Non-white Hispanics and Asians see an increased probability compared to those of other racial backgrounds. That said, any ethnicity can suffer from this condition.

Though some sources contend that testosterone deficiency is the main cause of male osteoporosis, not everyone in the medical community is convinced.

“I’m not sure it is fair to say though that the most common cause of male osteoporosis is related to testosterone deficiency,” says Dr. Kevin McLeod. “Age is the most common reason followed by genetic risk and then followed by medications and other risks that can contribute.”

McLeod practices Internal Medicine in both North Vancouver and in the Yukon Territory. He also operates the North Shore Osteoporosis Clinic (further info can be obtained at mcleodmedical.com).

About the causes for male osteoporosis, McLeod says, “It’s more complicated than just a testosterone level. We all have different hormone levels. The hormone has to bind to a receptor and tell other hormones what to do. There are so many parts to the pathway that can be different between us. If, say, one person has a testosterone level of 10 and another [person has] 30, the person with the value of 30 isn’t automatically better off bone-wise. The person with the level 30 may not be able to use it well or have other factors that have affected them.”

McLeod adds that, “Some studies show taking testosterone helps and others show it makes no difference on bone density or fracture risk.”

A link between osteoporosis and long-term use of certain medications also exists. Among these are some anti-clotting and anti-seizure medications, along with other such medications as cortisone and prednisone. Additionally, some medications for prostate cancer can contribute to an increased risk. “Avoid medications that can lead to bone loss unless they are absolutely necessary,” says McLeod.

An initial fracture puts a senior at an increased risk for an ensuing fracture. Distal forearm fractures, in particular, are an “early and sensitive marker of male skeletal fragility,” according to the International Osteoporosis Foundation.

Anorexia earlier in life increases the risk of osteoporosis, as does alcoholism. Another factor is a sedentary lifestyle, which puts you at increased risk of suffering bone fractures. Additionally, there is some research indicating that smoking is linked with osteoporosis.

As with so many other conditions, nutrition plays a significant role. With calcium and Vitamin D being essential to bone health, long-term deficiencies put you at increased risk.

NIAMS recommends that males and females obtain at least 1,000 mg of calcium per day. Women over 50 and men over 70 should aim for at least 1,200 mg. You need to keep in mind, however, that people over age 50 should not intake more than 2,000 mg of calcium daily.

Canada has a national organization, Osteoporosis Canada (osteoporosis.ca), which offers the latest information on the condition. In British Columbia alone, there are seven chapters of Osteoporosis Canada. For further information, visit: https://osteoporosis.ca/

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