Bone loss not just a female problem

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Until fairly recently not much attention has been paid to osteoporosis in men.

In large part this is because it is considerably more common in women. It is now known that men have fractures due to osteoporosis about 10 years later in life than women.

More troubling findings are that men are more likely to die from hip fractures. And if they survive their fracture it is more common for them to lose their independence.

About a third of hip fractures are in men. They can also get fractures in their backbones. Some of these fractures are what we call spontaneous. That is they don't have to be associated with a fall or injury but the bones just get too thin to bear the body's weight. The same is true with women.

The bottom line for this information is that older men need to be more concerned about this possibility than they are now.

The question has arisen whether all men over a certain age should have a bone density test since this is the only way to be sure if the bones are getting thin. The test is not painful. The consensus at this time is that this doesn't need to be done.

However, men do need to know the risk factors. The following list is taken from a Medicare website:

  • Age 50 or older.
  • Family history of broken bones.
  • Personal history of broken bones.
  • White or Asian.
  • Small-boned and/or have low body weight (less than about 127 pounds).
  • Smoke or drink a lot.
  • Have a low-calcium diet.

Other risk factors are a low vitamin D level or men with prostate cancer who have had their testicles removed or been given certain medications tor suppress their sex hormones.

The appropriate thing for a man to do, if he has any of the above factors, is at some time discuss his concern with his primary care provider. He/she should be able to advise whether a bone density test or a vitamin D level should be done.

The bone density test could reveal osteopenia, which means thin bones but is not as severe as osteoporosis.

Most private insurance companies will pay for this test if your provider has ordered it. Medicare will pay for it on the following basis providing it has been ordered: Medicare Part B covers bone mass measurements to determine whether or not you are at risk for a fracture (broken bone). This test is covered once every 24 months, or more often if your doctor deems it necessary.

If a patient has been found to have osteopenia or osteoporosis there are several medications that can be taken to help build up bones.

There is a also an injection called teraparitide or Forteo that can be quite effective but is usually used for more advanced osteoporosis. There may be some lifestyle things that would need to be done.

The most important thing an older man can do is discuss the issue with his medical care provider.

The journal Current Osteoporosis Reports 2011 was largely the source for this article.

Dr. Don Casebolt of College Place is a retired physician who is passionate about preventive medicine. He spent four years as a medical officer in the U.S. Navy, the last 21/2 years as a flight surgeon. He also worked on the Navajo Reservation for 22 years.

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