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 Male Osteoporosis – Overlooked and Overdue By Jared M. Skowron, ND Even as progress is made in improving life expectancy in our country, increased longevity has been accompanied by increased prevalence of chronic conditions. Osteoporosis, treated by most health professionals as an exclusively female condition, is exceedingly common in older men. More than 500,000 fractures occur in men every year, compared with a much lower 200,000 diagnosed with prostate cancer.1 Osteoporosis is continually ignored in men and this issue must be addressed, particularly considering the 30 percent mortality rate within the first year of hip fracture and the 50 percent of patients who do not regain their previous mobility and independence.
Osteoporosis becomes a medical issue once a bone breaks, and the risk of slips and falls increases with age. The Centers for Disease Control and Prevention (CDC) reports that more than 67 percent of Americans ages 20-74 are “overbese” – overweight or obese. Commonly, these people are less mobile and participate in less exercise than their normal-BMI peers. The common environmental risk factors to developing osteoporosis are low calcium intake, vitamin D deficiency, inadequate physical activity, smoking, and excessive alcohol and protein consumption.5 There are also many disease conditions associated with bone loss, and these are early signs for us as physicians to begin preventative treatment. Patients with autoimmune conditions, or others on high-dose steroids or glucocorticoids (≥ 15 mg/day), have a substantially increased risk for bone loss and fracture.6 Other inflammatory conditions, such as cardiovascular disease, have an inverse relationship with bone mineral density (BMD).7 Inflammatory bowel disease (IBD)8 and other conditions initiating from GI inflammation, such as juvenile arthritis,9 are associated with lower BMD. The emotional inflammation of depression associated with excess adrenergic activity also leads to impaired bone structure.10 While the complete physiologic mechanism is not completely understood, inflammatory conditions will lower bone density, and these patients are at higher risk for osteoporosis. Diet plays an obvious integral role in the creation of our bone matrix. Increased amounts of cola in one’s diet lowers bone density,11 and the more acidic our blood pH becomes, the more calcium is lost through our urine and removed from our bones.12 Treatment of osteoporosis and osteopenia, as well as preventing future bone loss, starts with our patients’ diets. Bone matrix builds over the first 30 years of life, and osteoporosis is now being looked at as a pediatric condition.13 Proper calcium intake, micromineral intake, exercise, alkaline diet and absence of cola drinks during the first three decades of life can prevent osteoporosis in the future. For those over the age of 30, appropriate nutrient intake is essential, including calcium, magnesium, vitamin K, boron, strontium and vitamin D.14-19 All of these nutrients improve bone mineral density and reduce risk of fractures. Strontium specifically is the only agent (including pharmaceuticals) to reduce vertebral and nonvertebral fractures in people over 80 years old. Many of these nutrients compete for absorption in the gut, and it is more important to give smaller nutrients of vitamin K, boron and strontium than to overload the body with more calcium/magnesium than it can handle. Also, those in southern latitudes who have access to more direct sunlight are still at risk to be deficient in vitamin D.20 Exercise is also essential to improve BMD. Bones strengthen when exposed to physical stress. However, flexibility and balance are equally important to prevent fractures from slips and falls, which then affect mortality and independence.21 For those patients who have difficulty with aerobic exercise, tai chi for 45 minutes, twice a week, improved balance by 81 percent to 84 percent, greatly reducing the risk of falls and fractures.22 Hormones also need to be monitored, even in males. Men with testosterone or estradiol deficiency have an increased likelihood to be osteoporotic.23 Therapies of phytoestrogen-rich herbs, such as Pueraria mirifica and Withania somnifera, improve bone density and prevent further bone loss.24,25 Osteoporosis and osteopenia are well-treated with naturopathic medicine. Recommending appropriate nutrients that build bone matrix and optimal GI and kidney health, and encouraging exercise in our patients, will increase bone mineral density. We need to be vigilant in our male patients to discover osteoporosis, which many overlook. Those with poor diet, inflammatory conditions, little exercise or steroid use are at high risk, but all men should be evaluated, so that we may improve the quality and duration of their lives. References
About the Author: Dr. Jared M. Skowron is in private practice in Hamden, Conn., where he specializes in pediatrics and successfully treating children on the autistic spectrum. A graduate of NCNM, he is the senior naturopathic physician with Metabolic Maintenance and has formulated a vitamin/mineral/amino supplement therapy for autism, currently undergoing clinical trials. Dr. Skowron also is an adjunct professor at the University of Bridgeport, teaching pediatrics, CPD and EENT. |
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All Rights Reserved, Naturopathy Digest, 2011.
Date Last Modified - Friday, 17-Oct-2008 12:11:05 PDT
The risk for men developing osteoporosis is between 13 percent and 22 percent.2 This translates into approximately one out of five male patients. Yet only 9 percent of the total referrals for DEXA scans are men, and 72 percent of those receive a diagnosis of osteoporosis or osteopenia.3 The technology for diagnosing is there; it is our duty as physicians to screen all male patients for bone loss. The therapies are equally as effective, but not used for men. Women are receiving the diagnosis later in life than men because of the knowledge and preventative therapies we can provide.4
