Thyroid hormones can speed up the bone turnover rate if they are at abnormally high levels which make the incidence of osteoporosis more likely although it is relatively simple to medically treat the person to maintain normal thyroid hormone levels. Men with osteoporosis who are given to high levels of alcohol consumption are about 5 percent of all male osteoporosis sufferers and their chance of developing a hip fracture is three times that of someone who does not consume alcohol. Alcohol suppresses the activity of cells which produce bone substance and also inhibits the absorption of calcium and other nutrients, all fitting together with the tendency to be unsteady to add up to significant bone loss plus a risk of falling over.
The risk of suffering osteoporosis is increased by operations on the stomach and by diseases of the gastrointestinal tract but exactly why this occurs is not apparent. Intolerance to gluten, called coeliac disease, causes the intestine lining to become inflamed, reducing absorption of minerals and vitamins. Even when following the correct diet, half of patients with coeliac disease were diagnosed with lowered bone density in one study.
If the risk to an individual of developing osteoporosis is higher than a certain level then a measurement of bone density may be requested. Bone density has to drop by 30% at least before the results show up on an x-ray so this is not a good way of estimating bone loss or monitoring it over time. DEXA scanning (Dual Energy X-ray Absorptiometry) is a much more reliable and sensitive method of calculating bone loss and following the changes which might occur with treatment. The level of bone density on DEXA scanning correlates well with the risk of fracturing and it is a very easy, safe and convenient technique due to the low radiation levels used and lack of undressing.
If the scan shows lowered bone density, there has been a fracture from a trivial event or specific risk factors then a rheumatological specialist or a general practitioner might prescribe treatment. When a scan is performed the outcome falls within one of three main areas, normal, osteoporotic or osteopoenic (a reduced level of bone density above osteoporosis). Male bone density can be reduced by many medical conditions and these will be investigated and managed initially as this can improve bone density. Hormone replacement of testosterone can be given as implants, patches, injections or tablets, with medical discussion important about risks.
Bisphosphonates are a class of drugs which slow down the actions of the osteoclasts, the bone cells which break down bone, allowing the bone building cells (osteoblasts) to work with less opposition and so increase the density of the bone. Examples of these drugs are risedronate, alendronate and etidronate. Calcitonin also interferes with the bone breakdown cells and is particularly used to relieve the acute pain of recent spinal fractures. Anabolic steroids can be used in some cases, especially where their muscle building effect is required. It is not clear exactly what role calcium and vitamin D supplements have in managing osteoporosis in men, but a good diet and some sunlight exposure outside are useful for this.
A healthy bone density can be at least partly maintained by keeping a healthy lifestyle which includes exercise and appropriate diet. Our behaviour can modify the bone density level we are given by our genetic profile. The four food groups of fish, meat, nuts and eggs, cereals and breads, dairy products including milk and vegetables and fruits can supply us with a well balanced choice of minerals and vitamins. A sufficient calcium intake is important with dairy products having high levels of this mineral.
As our bones are a living and dynamic tissue, if we do not use them then they will lose strength as they are not being used. Regular impact activities in weight bearing exercise stimulate bone to become denser to resist the stresses. Useful exercise types are running, fast walking, aerobics, tennis, weight training and skipping, all activities with impacts. There is much less or no impact in cycling and swimming and so they are less therapeutic. Three times a week exercise for a continuous twenty minute period is a common recommendation. Exercise and drug therapies are continually being innovated. - 14130
The risk of suffering osteoporosis is increased by operations on the stomach and by diseases of the gastrointestinal tract but exactly why this occurs is not apparent. Intolerance to gluten, called coeliac disease, causes the intestine lining to become inflamed, reducing absorption of minerals and vitamins. Even when following the correct diet, half of patients with coeliac disease were diagnosed with lowered bone density in one study.
If the risk to an individual of developing osteoporosis is higher than a certain level then a measurement of bone density may be requested. Bone density has to drop by 30% at least before the results show up on an x-ray so this is not a good way of estimating bone loss or monitoring it over time. DEXA scanning (Dual Energy X-ray Absorptiometry) is a much more reliable and sensitive method of calculating bone loss and following the changes which might occur with treatment. The level of bone density on DEXA scanning correlates well with the risk of fracturing and it is a very easy, safe and convenient technique due to the low radiation levels used and lack of undressing.
If the scan shows lowered bone density, there has been a fracture from a trivial event or specific risk factors then a rheumatological specialist or a general practitioner might prescribe treatment. When a scan is performed the outcome falls within one of three main areas, normal, osteoporotic or osteopoenic (a reduced level of bone density above osteoporosis). Male bone density can be reduced by many medical conditions and these will be investigated and managed initially as this can improve bone density. Hormone replacement of testosterone can be given as implants, patches, injections or tablets, with medical discussion important about risks.
Bisphosphonates are a class of drugs which slow down the actions of the osteoclasts, the bone cells which break down bone, allowing the bone building cells (osteoblasts) to work with less opposition and so increase the density of the bone. Examples of these drugs are risedronate, alendronate and etidronate. Calcitonin also interferes with the bone breakdown cells and is particularly used to relieve the acute pain of recent spinal fractures. Anabolic steroids can be used in some cases, especially where their muscle building effect is required. It is not clear exactly what role calcium and vitamin D supplements have in managing osteoporosis in men, but a good diet and some sunlight exposure outside are useful for this.
A healthy bone density can be at least partly maintained by keeping a healthy lifestyle which includes exercise and appropriate diet. Our behaviour can modify the bone density level we are given by our genetic profile. The four food groups of fish, meat, nuts and eggs, cereals and breads, dairy products including milk and vegetables and fruits can supply us with a well balanced choice of minerals and vitamins. A sufficient calcium intake is important with dairy products having high levels of this mineral.
As our bones are a living and dynamic tissue, if we do not use them then they will lose strength as they are not being used. Regular impact activities in weight bearing exercise stimulate bone to become denser to resist the stresses. Useful exercise types are running, fast walking, aerobics, tennis, weight training and skipping, all activities with impacts. There is much less or no impact in cycling and swimming and so they are less therapeutic. Three times a week exercise for a continuous twenty minute period is a common recommendation. Exercise and drug therapies are continually being innovated. - 14130
About the Author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapists, physiotherapy, physiotherapists in Harpenden, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.
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