Osteoporosis: Prevention and Treatment
What Men Should Know About Osteoporosis
This brittle bone disease should be on every man's radar, here's why.
By Regina Boyle Wheeler
Medically Reviewed by Farrokh Sohrabi, MD
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John Warner, 56, didn’t give five minutes of thought to osteoporosis before his diagnosis. "It was just another big word that I didn’t need to use,” he says.
Unfortunately, this unknown-to-him condition put the brakes on Warner's active lifestyle. The Washington, D.C.-based corporate communications director was a veteran competitor in endurance events like and the 24 Hours of Moab mountain bike team relay race in Utah.
Often thought of as a woman’s disease, osteoporosis, a condition in which bone tissue has deteriorated, making bones weak and brittle, is actually not uncommon in men. Some two million American men have osteoporosis-related bone loss, and another 12 million are at risk, according to the National Osteoporosis Foundation.
A Sports Injury Leads to a Diagnosis
During a typical training run in November 2014, Warner felt a tug in his back, as though he had pulled a muscle. The back pain intensified and interfered with his marathon training over the next few weeks. “I could complete the distances and the weekly speed work, but painfully and slowly,” Warner recalls.
Still, he thought this was just another sports injury, and he treated it as such. He went to physical therapy, and after a few weeks without improvement, his therapist recommended an X-ray. It showed a compression fracture in his spine, and advanced demineralization of the bones. He was eventually diagnosed with osteoporosis.
Warner’s series of diagnostic tests included a dual-energy X-ray absorptiometry (DEXA) scan, which is the gold standard for diagnosing osteoporosis in both men and women, says , clinical director of the National Osteoporosis Foundation and director of bone densitometry in the department of obstetrics and gynecology at MedStar Georgetown University Hospital in Washington, D.C.
Osteoporosis is called a “silent disease” because it progresses without symptoms until a break, says Dr. Singer, who treats Warner. Typically, it develops less often in men than in women because men have larger skeletons, their bone loss begins later and advances more slowly, and they don’t have the rapid hormonal changes that women experience during menopause, according to the . But by the time men are 65 or 70, they are losing bone at the same rate as women.
Related: 10 Things Your Doctor Won't Tell You About Your Bones
It's especially important for men to find out whether they have osteoporosis or low bone density, says Gisele Wolf-Klein, MD, director of geriatric education at the North Shore-LIJ Health System in New Hyde Park, New York. Men suffer more disability after a break and also tend to die more often than women from complications of a break, she says.
Ultimately, osteoporosis can affect men and women, young and old. Knowing what makes you susceptible to this bone condition may help you prevent it from occurring. According to the National Osteoporosis Foundation, risk factors for osteoporosis include:
Also, if you're over 50 and experience a low-impact fracture (breaking a bone for no apparent reason) or are shrinking in height, you could have osteoporosis, Singer says. Warner doesn’t know why he developed osteoporosis at such a young age, because he has no apparent health or lifestyle risk factors. Ask your doctor if you should get a DEXA scan. But be prepared to pay out of pocket, she warns, because some insurance (including Medicare) covers screening in men only under certain conditions.
Treatment Options for Osteoporosis
Several drugs have been approved for use in men, Singer says, so “hopefully that means we can find something that’s right for people who need to be treated." These medications work by either slowing bone loss or rebuilding bone. When choosing a drug, your doctor will look at what other drugs you are taking and other medical conditions you have.
Singer and Warner are still working out his treatment plan, but Warner expects to be on a bone-building drug soon. He says he's made some minor dietary changes and takes 2,000 IU of vitamin D daily.
How Osteoporosis Has Changed Warner’s Life
Warner can’t run or ride his bicycle or motorcycle right now because of the risk of another fracture. But he's found other ways to stay active.
“I'm allowed to lift weights in the gym, and can swim and use a stationary bicycle,” he says. Gentle exercise is important in fighting bone loss. “I like those activities, and they can keep me strong and help me manage weight and feel good.”
He wishes he'd learned about his condition earlier, and urges others to get a DEXA scan. “I imagine early intervention would have reversed, slowed, or stopped this decline before it became advanced,” Warner says.
Video: New Drugs Improve Osteoporosis Treatment
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