Osteoporosis - something for men to worry about ?

Strengthening bones, particularly spine, pelvis and leg bones, is one of the motivating factors in wanting to keep running as deep into life as possible.

My father had a pronounced hump in his back in his forties and it is possible that he had osteoporosis issues. He was a coal miner and in winter rarely saw the sun. Sufficient Vitamin D plays an important role in building bone mineral density and hence warding off osteoporosis, it is possible that his issues came from that particular direction. Nevertheless I worry. The picture to the left is a knee showing weakened bones due to osteoporosis - luckily not my knee.

Men have osteoporosis issues as well but nothing like the extent that osteoporosis affects women.

Men can check their osteoporosis risk at Check up on your bones.

Amgen have gathered a lot of attention after releasing data from a clinical trial with the drug DENOSUMAB. This drug is taken twice a year by injection. The headline number from the clinical trial is that denosumab reduces the risk of spinal fracture in women with osteoporosis by 68% and the risk of hip fracture reduces by 40%.



At an earlier stage in the research the New England Journal of Medicine carried an extensive article on denosumab as it treats women. These three pictures illustrate a typical weakening of the spine due to osteoporosis and the resultant forward lean.


The July-September 2008 issue of ACSM's Certified News (only available on-line if you are an ACSM member - as I am) focuses on Men's Health Issues. One article talks about The Male Athlete Triad but I was left unconvinced that this is a big issue. There is also an extensive article on Osteoporosis in Men. It is estimated that 2 million men in the USA are at risk of osteoporosis.

That said men do have multiple advantages compared to women when in comes to osteoporosis risk. In particular:

• men achieve a higher bone mineral density than women
• men have a lower rate of bone loss
• men do not experience hormonal reduction mid-life
• men have a shorter life expectancy
• men have a greater formation of periosteal bone with a related increased cross-section in the bone leading to greater strength.

There seem to be many reasons why a man is at risk of osteoporosis:

# glucocorticoid medications
# other immunosuppressive drugs
# hypogonadism (low testosterone levels)
# excessive alcohol consumption
# smoking
# chronic obstructive pulmonary disease and asthma
# cystic fibrosis
# gastrointestinal disease
# hypercalciuria
# anticonvulsant medications
# thyrotoxicosis
# hyperparathyroidism
# immobilization
# osteogenesis imperfecta
# homocystinuria
# neoplastic disease
# ankylosing spondylitis and rheumatoid arthritis
# systemic mastocytosis

Here's the easy explanation.

I'm hoping that running by putting stress through the spine, pelvis and feet will help keep osteoporosis at bay.