Ask Dr. Kent . . .

While in my office today, I had the pleasure of seeing one of my favorite patients. He is in his 60’s and suffers from three compression fractures of the spine due to osteoporosis. They are very painful, and he cannot pick up anything heavier than a gallon of milk or risk developing another compression fracture. He has to take chronic pain medicine and has problems doing activities he did with ease prior to his fractures.

There is a great deal of information with regard to women and osteoporosis. However, very little attention is paid to men. Osteoporosis is often a problem that is overlooked in men. There are 1 to 2 million men with osteoporosis in the United States. And another 8 to 15 million men with low bone mass. Men will usually experience a peak of osteoperotic fractures 10 years after those in most women. Men are two times more likely to die after a hip fracture than women. 13% of Caucasian men older than 50 years will have at least one fracture from osteoporosis in their lifetime. The incidence of hip fracture increases a great deal in men older than 70.

Those at risk of developing osteoporosis are men with physical inactivity, sex hormone deficiency (testosterone), smoking, excessive alcohol intake, genetics, and low body weight, weight loss of more than 10% of body weight, steroid use, some therapies for prostate cancer, history of spinal cord injury, low calcium and vitamin D intake. A Dexa Scan test can diagnose osteoporosis or low bone mass (osteopenia) in men.

Men at risk of osteoporosis should speak to their doctor about having a Dexa Scan.

There are treatments available for osteoporosis in men-
Oral bisphosphomates (Actonel, Boniva, Fosamax)
IV bisphosphonates (Reclast)
Recombinant parathyroid hormone (Forteo).

Recommended daily calcium intake in men older than 50 is 1,200mg per day and 400 IU of vitamin D. In men older than 70, vitamin D intake should be increased to 600 to 800 IU per day.

All men should stop smoking and limit alcohol intake to less than two drinks per day and perform weight bearing exercises. Hormone replacement can help in men with low testosterone levels. For more information, patients should contact their local primary care physician.