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Risk factors increase chances of osteoporosis

Copyright 2002 President Fellows Harvard College behalf HMS MediServices Phoby LizGreen HMS MediServices Anthony Leader Komaroff MD Harvard Health Publications

Copyright 2002 President and Fellows of Harvard College on behalf of HMS Media Services, Photo by Liza Green, HMS Media Services, Anthony Leader Komaroff, MD, Harvard Health Publications

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Updated: November 24, 2012 6:09AM

Dear Doctor K: Do men need to worry about osteoporosis? Doesn’t it affect mostly women?

Dear Reader: Osteoporosis is a disease that weakens bones and makes them more susceptible to breaks. You’re correct that women are more likely than men to develop osteoporosis, but that doesn’t mean men don’t have to worry about it. In fact, about 2 million men in the United States have osteoporosis.

When men under age 75 develop osteoporosis, it’s often because of treatment with certain drugs or an underlying condition. This is called secondary osteoporosis.

Medications: Glucocorticoid use is one of the most common causes of secondary osteoporosis. Glucocorticoids are steroids used to reduce inflammation caused by asthma, arthritis and a variety of other conditions. Anticonvulsants and certain cancer treatments also increase risk.

Medical conditions: Disorders that can damage bone health include Type 1 diabetes, epilepsy, hyperthyroidism, multiple sclerosis and many others.

Other risk factors that are particularly relevant to men include:

Low sex hormones. Men produce both estrogen and testosterone. Levels of both of these hormones decline as men age, and this can cause bone loss.

Heavy alcohol use. Heavy drinking can damage bone health by reducing bone mass.

Smoking. Many years of smoking encourage the thinning of bones.

Inactivity. Our bones respond to being challenged by becoming denser and stronger. The bones of the legs, hips and spine are strengthened by weight-bearing activities, and by exercises like walking or running.

Gastrectomy. This operation, in which part or all of the stomach is removed, can reduce the amount of calcium the body absorbs. That, in turn, causes some thinning of the bones.

Heredity also plays a role. Also, compared to people of African background, people of Caucasian or Asian ethnicity are at higher risk.

The National Osteoporosis Foundation recommends bone mineral density testing for men starting at age 70.

In the meantime, do the following to protect your bones:

Engage in regular weight-bearing exercise.

Get adequate amounts of calcium and vitamin D.

Don’t smoke.

Avoid excessive alcohol use.

Write to Dr. Komaroff at

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