Men are at risk for osteoporosis too. What you need to know to keep your spine healthy as you age.
Our image of osteoporosis is that of a little old lady, stooped over, at risk for a fractured hip. The overwhelming emphasis on preventing osteoporosis has been focused on women. They are at greater risk in general due to a thinner bone mass than men as well as the postmenopausal drop in bone density. In addition, since women tend to live longer than men, the incidence of hip fractures and other osteoporotic injuries are much greater in women than in men.
However, this disease does not discriminate based on gender. Being a man is no guaranteed protection against the devastating consequence of thin bones. This article will describe some of the risk factors that make you more likely to suffer from osteoporosis at some point in your life. I will also talk about measures you can pursue to guarantee a sturdy skeletal system throughout your entire life.
Our skeletal system is dynamic, living tissue. We are constantly destroying old bone and replacing it with new healthy bone. Properly maintained, our skeletal system should not “wear down” but should be perpetually replenished. As with other aspects of our health, healthy bones start with healthy living. Proper nutrition is essential. We are now discovering that the amounts of vitamin D ideal to optimize health is much greater than once believed. Recent research has led physicians to increase the recommended amount of vitamin D for people to take in their diets. Current recommendations target blood level of 80 mg/mL. In all my years of doing blood levels for vitamin D, I have not seen any patients in my practice at this level without vigorous use of supplements.
A rough estimate of the amount of vitamin D that you need is 1000 - 5000 units daily. While it is possible to take too much vitamin D, reported cases of toxicity are rare. Remember to take this vitamin with your largest meal, fat helps the vitamin to be better absorbed.
What about calcium? It turns out that calcium supplementation does not appear to be very valuable for men when it comes to bone density preservation. In some cases, extra calcium can increase calcium deposition into soft tissue such as arteries, causing increased heart disease and hardening of the arteries. If you’re predisposed toward kidney stones, it is especially important to avoid supplemental calcium.
I make it my practice not to advise men to take supplemental calcium unless there is a specific need.
There’s also growing awareness that Vitamin K–2 has significant value in both enhancing bone density and preventing hardening of the arteries. This vitamin helps to direct calcium to be deposited into the bone rather than soft tissue. K–2 should be considered in all men taking vitamin D supplementation.
The role of strength training: That which grows muscle also grows bone. Power training of any sort will help to stimulate the bones to become thicker and stronger. The more intense the power training, the greater the bone response. I do not consider walking to be adequate. This is far too gentle an activity to maximally stimulate bone.
The best time to build bone is when you’re young. Prior to the age of 40 you retain your greatest ability to strengthen your bone structure. Too often I see young men in the rush of life–sprinting from job to home, raising children, paying bills, acting as if they will be young forever. Meanwhile, their skeleton is slowly weakening. All it really takes at this stage is once, ideally twice a week to do some vigorous power training for the lower body and upper body to keep yourself vertical and strong.
If you happen to be reading this from the vantage point of an advanced age, rest assured that proper nutrition and strength training can stimulate bone at any point in your life journey. Not only will you protect yourself from fractures, but you will preserve your height as well. There’s absolutely no need for vertebrae to gradually collapse and shrink in their height, other than a lack of understanding and attention to the elements required to maintain a youthful skeleton.
What role do hormones play? As with women, sex hormones play a central role in maintaining bone density in men. Maintaining healthy, youthful levels of testosterone when accompanied by proper nutrition and exercise can do more to stimulate bone density preservation than diet and exercise alone.
In certain high-risk cases, I will use low-dose progesterone in men. While thought of as a female hormone, this agent is a powerful stimulus for bone formation. Over the years, I have moved away from prescription drugs for bone density preservation. Agents such as Fosamax and other drugs in the ”bisphosphonate” class have questionable merit with regard to the quality of bone that they form and also have been connected with potentially serious side effects.
With the good news that men are living longer than ever, there comes the need to be prepared for the hundred-year lifespan. I suppose one way to avoid osteoporotic fractures is to simply die young–this approach is not widely recommended. For my part, I’m going to hit the weight room, continue my vitamin D, and keep my hormone levels at a youthful level.
Strong and vertical is the manly way to march through your golden years.
Dr. Stephen Petteruti is a board-certified family physician specializing in functional medicine. His practice Intellectual Medicine 120 is in Warwick, Rhode Island.