Dear Dr. Garner,
I have been taking medication for osteoporosis for the past three years, after it was found that I had broken some bones in my back. My husband recently broke his wrist after a fall, and our doctor said he might have osteoporosis. I thought osteoporosis occurred in women because of hormone changes. Could you please advise me? We are both in our 70s.
Brittle Bones Broken in Bayside

Dear Brittle Bones,
Your question is a timely one. New studies show that many men are affected by osteoporosis. The studies also show that the diagnosis is often overlooked in men.

Guidelines now call for all men to be tested for osteoporosis from the age of 70 and those men at high risk from age 50.

The test for osteoporosis is a bone density test. This test shows just how strong the bones are and how they compare to people with normal bones at your age.

The score can then be used by your doctor to figure out how much at risk you are and what treatment should be instituted.

Osteoporosis is a disease that causes very weak bones that break easily. Women are more likely to get osteoporosis than men. There is no way to cure it, but there are things you can do to slow it down.

Causes and Risk Factors

The causes of osteoporosis include, poor diet in which there is not enough calcium and vitamin D, lack of exercise, hormone deficiencies, and genetic causes in which it is inherited from parents.

Those at highest risk of getting osteoporosis are:

1. Women.

2. People with thin, small frames.

3. People with an eating disorder.

4. People over age 50.

People who have used certain medicines for a long time, such as hormones, seizure medication and medication to treat asthma, arthritis or cancer.

Prevention  

There are measures that can be taken to reduce one’s chance for osteoporosis.

1. Get enough calcium — 1200 mg per day is the suggested amount.

2. Get enough vitamin D — 400 international units is what is recommended.

3. Get exercise every day.

4. Don’t smoke.

5. If you drink alcohol, don’t drink more than one glass per day.

Eat foods rich in calcium including low fat dairy products like milk and cheese, green leafy vegetables, tofu, canned fish, and orange juice.

Back to your main question about osteoporosis in men. Men definitely get osteoporosis. A man at age 60 has almost a 30 percent chance of developing osteoporosis before he dies.

Osteoporosis is known as a “silent” disease, meaning there is often no way to tell you have the disease, until there is a fracture.

I encourage everyone over the age of 50 to measure their height each year. If the height decreases in any 12-month period, there is strong suspicion for osteoporosis. The loss of height is due to the fractures of the backbone. This loss can be as much as two inches, and can result in a person being bent over.

The sad fact is that many people develop these deformities for no reason. There are medications given once a year by injection that can prevent many of these fractures.

At least 20 percent of men over 50 will suffer a fracture due to osteoporosis. This increases to over 30 percent past age 60.

About half of all hip fractures and back bone fractures can be prevented if osteoporosis is treated properly.

For women, 80 percent will suffer a fracture of their bones in their lifetime due to osteoporosis. The annual incidence rate of osteoporosis fractures in women is greater than the combined incidence rates of heart attack, stroke and breast cancer.

Right now, believe it or not, even after a fracture from osteoporosis, most women are not treated with medications.

Determine If You’re At Risk

There is a simple one-minute test available on the Internet to determine if you are at risk for osteoporosis. You can access it from Google, by typing in “The New IOF One-Minute Osteoporosis Risk Test.” Here are some of the key questions that if answered “yes” mean you are at increased risk for the disease.

1. Have either of your parents been diagnosed with osteoporosis?

2.  Have you ever broken a bone after a minor fall as an adult?

3.  Are you underweight?

4.  Do you regularly drink alcohol in excess of two drinks per day?

5. Do you, or have you ever smoked cigarettes?

6.  Have you ever been diagnosed with rheumatoid arthritis?

7.  Are you allergic to milk or dairy products?

8.  Have you lost more than one inch in height after the age of 40.

If you answered “yes” to any of the above, it does not mean you have osteoporosis, but it means you are definitely at risk, and must see your physician for an evaluation.

Brittle Bones, I urge that you bring your husband to your doctor, so your doctor can order a bone density test for him. There is no way to know how strong his bones are without this test.

Your doctor can discuss this with you further, but there is no reason why either of you should suffer from the consequences of this silent but treatable disease.

Thank you for you question. For further information, please tune into the Ask the Doctor Show, this Monday, March 11 at 8 p.m. on The Prayer Channel, when I will be discussing this matter further with the other physicians on the program. Thank you and be well.

Dr. Garner is affiliated with New York Methodist Hospital in Park Slope and is a Fidelis Care provider. He is host of the popular “Ask the Doctor” TV program on The Prayer Channel (Ch. 97 on Time Warner, or Ch. 30 on Cablevision).