EPISODE 83: From Prevention to Treatment: Advancing Men’s Bone
Osteoporosis is often associated with women, but men are also at risk for bone loss and fractures as they age. On this episode of Bone Talk, BHOF Vice President of Science & Education Ami Patel talks with Annette Gantz, a board-certified family nurse practitioner specializing in osteoporosis and metabolic bone disease, about why men need to pay attention to their bone health and what they can do to protect it.
Osteoporosis Can Affect Men Too
Because osteoporosis is more common in women, men and even their healthcare providers may overlook the risk. Annette explains that osteoporosis is a silent disease, meaning a fracture may be the first sign that something is wrong.
Men may feel healthy and physically strong but still have weakened bones. A fracture from a fall at standing height or even from lifting something heavy can be an indication of osteoporosis.
Bone Health Starts Early
Strong bones aren't something to think about only later in life. Bone development begins in childhood and continues through the first few decades of life.
For men, bone health may remain relatively stable for years, but risk can increase as they age and testosterone levels decline. Certain medical conditions, medications and lifestyle factors can increase risk much earlier.
Important risk factors include:
Family history of osteoporosis or fractures
Previous fractures
Long-term steroid use
Low body weight
Smoking
Excessive alcohol consumption
Certain seizure medications and other medications associated with bone loss
Gastrointestinal or absorption problems such as celiac disease
Low testosterone
Prostate cancer treatments that reduce testosterone
Men with these risk factors should talk with their healthcare provider about whether earlier bone density testing is appropriate.
Bone Density Is Only Part of the Picture
A DXA bone density scan can help evaluate bone health and fracture risk, but Annette stresses that it's only one tool.
Healthcare providers also consider previous fractures, family history, medications, hormone levels, body size and other medical conditions. A person can even have a bone density result that appears normal and still have osteoporosis if they've experienced a fragility fracture. The goal is to evaluate the whole patient rather than relying on a single number.
Everyday Habits Can Help Protect Your Bones
Nutrition and exercise are two important parts of maintaining strong bones.
Men should focus on a balanced diet with adequate protein, vitamins and minerals, including calcium. Annette explains that a normal blood calcium level doesn't necessarily mean someone is consuming enough calcium. When the body doesn't receive enough through the diet, it can take calcium from the bones to maintain the amount needed in the bloodstream.
Resistance exercise is also important because it helps maintain muscle and bone strength. Balance and vision matter too, since preventing falls is an important part of preventing fractures.
Avoiding smoking and excessive alcohol consumption can further help reduce osteoporosis risk.
When Medication Becomes Necessary
Lifestyle changes are important, but they may not be enough when someone has a high risk of fracture.
Osteoporosis medications generally work by either helping preserve existing bone or helping build new bone. The appropriate treatment depends on a person's bone density, fracture history and overall fracture risk.
Annette emphasizes that osteoporosis is a chronic condition, but it's treatable. The goal of treatment isn't simply to keep someone on medication. It's to reduce fracture risk, preserve strength and eventually move toward an appropriate maintenance plan when possible.
Ongoing Monitoring Matters
Treatment doesn't end after a prescription is written. Follow-up bone density scans and laboratory testing can help healthcare providers determine how well treatment is working and make adjustments when necessary.
Monitoring calcium, vitamin D, phosphorus, parathyroid hormone and other markers of bone health can help ensure treatment remains balanced and appropriate over time.
Protecting Independence as You Age
One of the most important reasons for protecting bone health is maintaining independence.
Fractures, particularly hip and spinal fractures, can have lasting consequences. Annette encourages men to think about how they want to be living 10 years from now. Taking action before a fracture occurs can help protect mobility, quality of life and the ability to remain independent.
For men who've never thought much about osteoporosis, the first step is understanding their personal risk factors and discussing them with a healthcare provider. For men who've already been diagnosed, the message is equally important: osteoporosis can be managed, and there are steps you can take to protect your bones and reduce your risk of future fractures.
