Michael Hunter, MD on Medika Life

Is Bone Loss a Male Problem, Too?

A new study reminds us that men get osteoporosis too

WITH OSTEOPOROSIS, THE BONES BECOME WEAK and brittle. Fall, and you may suffer a bone break. Even minimal activity such as bending over or coughing may result in a fracture. Osteoporosis causes such problems in the hip, spine, wrist, and other bones.

While many think of osteoporosis as a disease of women, while older women have the highest risk, we can get it. Men and women and all races.

Today we look at osteoporosis basics and new findings that remind us of the risk among men. We’ll end with some strategies that may reduce your risk of bone loss.

Osteoporosis basics

Our bones are dynamic — we constantly make new bone tissue and destroy the old. We made new bone faster than breaking it down in our younger days, increasing bone mass.

The bone-building process begins to slow in our early 20s, and we hit our peak bone mass by 30. After that, we lose bone mass faster than we make it.

Your chances of developing osteoporosis hinge on how much bone mass you achieved in your younger years. Bone mass peaks in our 20s and hinges on inherited genetics and ethnicity.

To my young readers: Do what you can to optimize your bone mass while you are young. Bank that bone mass for late in life. I’ll give you some tips at the end.

Photo by Eduardo Barrios on Unsplash

Osteoporosis: Fixed risk factors

Here are some of the factors that can make you more likely to develop osteoporosis or significant bone loss:

Age. As we observed above, bone density peaks around age 30. After that, you experience bone loss.

Gender. Women over age 50 have a higher risk. Compared with men, women are four times more likely to develop osteoporosis, as females have thinner bones and longer lives. But remember: Men can get significant bone loss, too.

Family history. Inherited genetics play a role: If your parents or grandparents had osteoporosis (or hints of it, such as a broken hip after a minor fall), your risk is likely higher.

Bone structure and body weight. Petite and thin women have a higher risk of osteoporosis. Thin men have a higher risk than men with larger body frames and higher weights.

Broken bones. If you have a history of bone breaks, you may have a higher risk.

Ethnicity. White and Asian women are more likely to develop osteoporosis than others.

Certain diseases. Rheumatoid arthritis and other conditions can raise your risk of osteoporosis. The risk of osteoporosis is higher in people who have some medical issues, including:

  • Celiac disease
  • Inflammatory bowel disease
  • Kidney or liver disease
  • Cancer
  • Multiple myeloma
  • Rheumatoid arthritis

Osteoporosis: Modifiable risk factors

Let’s take a look at some modifiable risk factors. We begin with this observation — osteoporosis is more common among individuals who have too much (or too little) of certain hormones.

For example, lower levels of sex hormones can cause weaker bones. With a drop in estrogen levels at menopause, the risk of osteoporosis rises among women. Some treatments for breast cancer (aromatase inhibitor pills) and prostate cancer can lead to more bone loss.

Making high thyroid hormone levels can accelerate bone loss. In addition, overactive parathyroid or adrenal glands lead to a higher chance of getting significant bone loss.

Some medicines, such as long-term steroids (for example, prednisone), can lift your chances of getting osteoporosis. Finally, smoking and heavy drinking — don’t do it.

Photo by Foto Sushi on Unsplash

Bone loss and men

I don’t think about osteoporosis when I think about my health. I don’t have any factors that put me at high risk. But am I being too casual about it? A new study reminds us that men get osteoporosis too.

Here are the new study findings:

Men with high body fat levels have lower bone density and appear more likely to experience a bone fracture than those with normal body fat levels.

Researchers from the University of Chicago Medicine (USA) analyzed bone mineral density and body composition of nearly 11,000 individuals under 60 years.

Listen to study author Rajesh K. Jain, M.D.: “We found that higher fat mass was related to lower bone density, and these trends were stronger in men than women. Our research suggests that the effect of body weight depends on a person’s makeup of lean and fat mass and that high body weight alone is not a guarantee against osteoporosis.”

Full disclosure: The study authors report receiving no external funding.

Dr. Jain wonders if we health care providers should consider osteoporosis screening for those with high body weight, also taking into account other risk factors.

So what can we do to try to reduce our risk of osteoporosis?

Osteoporosis — How can you reduce bone loss risk?

I often talk about aerobic-type exercise. But we probably should focus as well on bone-strengthening activities. Webmd suggests these weight-bearing activities:

I do various weight-bearing and strength-training sessions for most days of the week, aiming for 30 to 40 minutes.

Three young children of color, wearing traditional scarves, look at the camera.
Photo by Muhammadtaha Ibrahim Ma’aji on Unsplash

But strength training is more than these formal activities. We build bone and muscle when we do activities such as lifting bags of groceries or small children.

Some benefit from lifting weights, but I find bodyweight movements more appealing as I age. I prefer pushups to bench presses and have recently begun using elastic resistance bands.

Vitamin D and calcium

Vitamin D and calcium promote bone density. We can generally absorb the calcium we need from our diet with vitamin D. Consider some sun — to make reasonable vitamin D levels, we need to get some sun on most days of the week. Of course, remember the recommendations for sun exposure and skin cancer risk reduction.

While you won’t get a lot of vitamin D from food, some options in the dietary realm include liver (a hard pass for this writer), fatty fish such as salmon or mackerel, eggs, or foods fortified with vitamin D.

Can we get enough vitamin D through food? Ask a knowledgeable health care provider if you might benefit from vitamin D supplements.

According to WebMD folks, most adults should get about 1,000 milligrams of calcium daily. But if you’re a male over 70 or a female over 50, you should aim for 1,200 milligrams.

Good sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products, such as tofu
  • Calcium-fortified cereals and orange juice

If you take supplements, please be careful — too much can lead to kidney stones, poor muscle tone, constipation, and other problems.

The National Academies of Sciences, Engineering, and Medicine recommends that total calcium intake from supplements and diet combined be no more than 2,000 milligrams daily for people older than 50.

Other osteoporosis avoidance strategies include avoiding smoking, drinking alcohol in moderation (if at all), and dodging excess caffeine.

That’s it for today. Thank you for joining me. I hope you have a joy-filled day. As for me, there is little vitamin D coming from that orb in the sky on this cloudy Seattle day.

[The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.]

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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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