• Equal-opportunity osteoporosis

    Known as a 'women's disease,' bone density problem strikes men, too
  • Osteoporosis, a disease that causes bones to weaken and sometimes break, is often thought of as a "women's disease," but it poses a significant threat to more than 2 million men in the United States, according to the National Institutes of Health.
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    Osteoporosis in men "is an area, you could say, that's forgotten almost," said Bob Schmaltz, radiology assistant with Altru Health System in Grand Forks, N.D.
    Schmaltz performs Dexa scans, dual-energy X-ray absorptiometry, a technology that measures bone mineral density, or BMD.
    Osteoporosis is considered to be a "silent disease," Schmaltz said. "You don't know you have osteoporosis until you're well into the disease."
    "Men at age 70 should be scanned," Schmaltz said. "I don't see that happening in our practice. We're not seeing a glut of males" coming in for a scan.
    On average, he scans 10 patients a day, he said. "I have not seen a male in about two months."
    Several reasons explain why men have a lower risk of osteoporosis.
    Because women live longer, they are more likely to get the disease, Schmaltz said. "There are four times as many women who have osteoporosis than men."
    Lifestyle may also be a factor in protecting men from osteoporosis.
    "Generally — and I'm speaking generally now — men are more physically active during their lives," he said. "They're engaging in heavier work."
    "Smokers have a higher rate of fractures," Schmaltz said. "They have a 55 percent higher risk for hip fractures compared to nonsmokers."
    People who use nicotine and caffeine excessively and "couch potatoes" tend to have lower bone mass than those who don't, he said.
    "A lot of times, someone who's taking medications for prostate cancer or metastatic disease elects not to have surgery," he said. "We get a baseline (Dexa scan) to start with."
    If later scans reveal that medications are causing major bone loss, a change in treatment may be considered, he said. Doctors "don't want to create another problem."
    Conditions such as rheumatoid arthritis, digestive and blood disorders, and cystic fibrosis play a role in developing osteoporosis, Schmaltz said. They can impair the body's ability to absorb needed nutrients.
    "Bones, if they're healthy, are very, very strong," Schmaltz said.
    "Bone continually monitors what stress we put on it," he said. "With bone mass, it's a 'use-it-or-lose-it' proposition, much like muscle."
    "In the 25 to 64 age range, only about 35 percent of men are meeting the minimum exercise prescription of what they should be doing," he said.
    "To make new bone the body needs, it takes plenty of calcium," Schmaltz said. "In the age range of 19 to 50, it's recommended that a person get 1,000 milligrams a day. If you're older than 50, the recommendation is 1,200 milligrams a day."
    To help the body properly use calcium, vitamin D is recommended, he said. "The recommendation used to be 400 to 800 (international) units a day; now it's 800 units a day. Some take 1,200."
    Some health professionals are including the Dexa scan in their male patients' annual physical exam, Schmaltz said. "They'll tell the patient, 'We'll check your BMD along with your hemogloblin and cholesterol.'
    "It's better to be proactive than waiting for something to happen."
    Distributed by MCT Information Services
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