Real men get osteoporosis

By Osteoporosis Canada

Even in his forties, Larry had broken bones in his back, arms, ribs and shoulder blades doing simple things like walking or going down stairs. No one thought there could be an underlying cause or that he was constantly at risk of breaking another bone.

“Everybody thought I was a klutz. I’d fall and break something and it was ‘there goes Larry with another cast.’”

Diagnosed at 48 years old

“I was shocked when I was told I had osteoporosis. Like many others, I didn’t think that osteoporosis affected men. It wasn’t until an eighth fracture occurred that my doctor sent me for a bone mineral density test. My history with broken bones suddenly made sense. However, while there was plenty of information available about women and osteoporosis there was disappointingly little for men. I discovered several local osteoporosis support groups, but became dismayed when I was often the only man to show up at meetings.

What is osteoporosis?

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue, which can lead to increased risk of fracture. Known as the “silent thief”, bone deterioration can occur over a number of years without any symptoms. Unfortunately, by the time affected bones break or fracture, the disease is already fairly advanced and less treatable. The most common fractures associated with osteoporosis are in the hip, spine, wrist, and shoulder.

Not just a woman’s disease

Osteoporosis is not just a woman’s disease. During their lifetime, at least 1 in 3 women and 1 in 5 men will suffer a broken bone caused by osteoporosis. Approximately 30,000 hip fractures occur in Canada each year and over one quarter of these occur in men. Proportionately more men than women die as a result of a hip fracture — 37% of men who suffer a hip fracture will die within the year following that fractured hip. Men are also more likely than women to require care in a long-term care facility after a hip fracture. Yet, despite the fact that hip fractures can be more devastating for men than for women, men are less likely to be assessed for osteoporosis or to receive treatment for it.

Research shows that after age 50, the risk of breaking a bone increases with age for both men and women. A fragility fracture, (a broken bone from a minor injury), is often the first sign that a person has osteoporosis. Fragility fractures are usually the result of a trip, slip, stumble, or minor fall. They can even occur while someone is performing a simple task such as reaching,
coughing or sneezing. They can affect the hip, spine, wrist and shoulder as well as other bones.

Bone Mineral Density (BMD) Test

A risk factor assessment is an important first step in alerting you to your risk for osteoporosis, but bone density tests are more accurate. Assessments aren’t scientific and many people who develop osteoporosis have few of the risk factors — a fact we are trying to understand through research into the causes of osteoporosis.

This is why medical testing is so important. The tests are known as Bone Mineral Density (BMD) tests and the technology that they use is known as bone densitometry. BMD tests are safe, painless and accurately measure the density of your bones. They can tell you whether or not you have osteoporosis and how likely you are to develop it in the future, and can help you to make decisions that may prevent fractures or further bone loss.

Who should have a BMD Test?

All women and men 65 years or older. Post menopausal women and men 50–64 with risk factors for fracture including:

  • Fragility fracture after age 40
  • Vertebral fracture or low bone mass identified on x-ray
  • Parental hip fracture
  • High alcohol intake
  • Current smoking
  • Low body weight, i.e. less than 132 lbs or 60 kg
  • Weight loss since age 25 greater than 10%
  • High risk medication use: prolonged glucocorticoid use, aromatase inhibitors for breast cancer, androgen deprivation therapy for prostate cancer
  • Rheumatoid arthritis
  • Other disorders that may contribute to bone loss

 

Younger men or women (under 50) with a disease or condition associated with low bone mass or bone loss:

  • Fragility fractures
  • High-risk medication use (steroid use, aromatase inhibitors, androgen deprivation therapy)
  • Rheumatoid arthritis
  • Other chronic inflammatory conditions
  • Cushing’s disease
  • Malabsorption syndrome
  • Uncontrolled hyperthyroidism
  • Primary hyperparathyroidism
  • Hypogonadism; Early menopause (< 45)

 

Other disorders associated with rapid bone loss/fractures

At the time Larry found out he had osteoporosis, he felt embarrassed and isolated because he felt as if he had a “fragile woman’s disease.” He kept his diagnosis from all but his family and closest friends. Over time, he met other men with osteoporosis and started raising awareness. In the almost 20 years since his diagnosis, Larry has been diligently getting treatment and taking steps to protect his bones. “Osteoporosis and the fact that you could break a bone, it guides all the decisions you make—what you’re going to eat, drink and I’m careful these days.”

Make bone health a priority. Take the Know Your Risk quiz osteoporosis.ca/risk.

The importance of nutrition and exercise for strong and healthy bones

All men (those with and without osteoporosis) need to follow the same lifestyle choices recommended to everyone for optimal bone health.

Nutrition, especially calcium, plays an important role in preventing osteoporosis. In people who have healthy bones, adequate calcium intake on a daily basis is necessary to maintain bone health. For older adults, studies have shown that adequate calcium intake can slow bone loss and lower the risk of fracture. Protein is another important nutrient for building and repairing body tissues, including bones.

Exercise is an important step towards protecting your bones, as it helps protect your spine, slows the rate of bone loss, and builds muscle strength, which can prevent falls.

Exercise is recommended for all people with osteoporosis, even people who have had a spine or hip fracture. If you are  new to exercise, talk to your doctor before starting any type of program. Consider speaking to a physical therapist or kinesiologist to get advice on the type of exercise that is right for you.

Vitamin D, the “sunshine vitamin,” is produced when the sun’s rays interact with our skin. It helps build stronger bones by increasing the absorption of calcium. It also improves the function of muscles, which can improve your balance and decrease the likelihood of falling and suffering a fracture.

In Canada, we don’t get as much sun as we need to produce adequate vitamin D. Further, the skin’s ability to make vitamin D decreases as we age. There are also very few food sources of vitamin D, therefore Osteoporosis Canada recommends routine vitamin D supplementation for Canadian adults year-round.

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