Bone health for men

 

The risk of bone fracture is increased with aging, but many other factors are associated as well. Osteoporosis is common in men, especially in patients who receive treatments that suppress their testosterone production.

Men with prostate cancer often require treatment with Lupron, Flutamide, Casodex, or other hormonal manipulations. Lupron suppresses testosterone (androgen) made in testicles. Flutamide and Casodex block testosterone from working inside cells. However, testosterone is important for men to maintain bone health and its deficiency can cause major impact on a patient’s risk of bone fracture. 

Other factors such as smoking, history of rheumatoid arthritis, taking steroid, consuming alcohol more than 3 units a day can also increase the risk of osteoporosis. A unit of alcohol is approximately 8-10 grams of alcohol, equivalent to a standard glass of beer (285 millileters), a single measure of spirits (30 millileters), a medium-sized glass of wine (120 millileters), or 1 measure of an aperitif (60 millileters) (see also notes on risk factors).

You may use this website tool developed by WHO (World Health Organization) to calculate your risk of osteoporosis and risk of bone fracture.

 

Treatment:

Calcium:
It is recommended that adult older than 50 take calcium 1,200 milligrams a day in divided doses (two to threes a day).

Adult younger than 50 years old may take calcium 1,000 milligrams a day in divided doses (two to threes a day).

  • Calcium carbonate needs to be taken with food.
  • Calcium citrate may be taken without food.
  • One serving of dairy contains 300 milligrams calcium.

Vitamin D intake:
The Institute of Medicine recommends that:

  • Children and adults up to age of 50 receive 200 international units of vitamin D daily.
  • Adults older than 50 is 400 to 600 units daily.
  • However, many experts feel these recommended dosages too low.
    • The American Academy of Pediatrics now recommends children and adolescents get 400 units a day.

There are many different over-the-counter brands of vitamin D and calcium tablets. Most of them contain 400 to 600 milligram of calcium and 400 to 500 units of vitamin D.

For patients with a low vitamin D level, a higher dose of vitamin D may be required.  Your doctor can prescribe high-dose vitamin D to maintain an adequate blood level.

 

Patients with osteoporosis may consider Alendronate (Fosamax) or a similar drug of this class, in addition to taking calcium and vitamin D supplements.

 

Bone health for women

 


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