Osteoporosis in men symptoms and treatment

The disease – osteoporosis, most people are not serious. This is especially true for men. Since for a long time the disease was considered “female”. However, statistics cite the following fact – approximately 20% of all patients suffering from the disease are men. The World Health Organization claims that osteoporosis in men and women takes the 4th place in danger, second only to cardiovascular, oncological ailments and diabetes.

Characteristics of the disease

What is osteoporosis? This is a disease in which the calcium content in the bones decreases. Bones become less dense, brittle. They are easy prone to fractures.

However, the main problem is not in the insufficient intake of calcium from food, as it might seem at first glance. The source of the problem lies in the poor absorption of the necessary element by bone tissue.

If the body functions “correctly”, then a constant balance is maintained in it. Osteoclasts (calcium-excreting cells) remove as much element from the body as osteoblasts (building cells) deliver to it.

Osteoporosis leads to a violation of this balance. Both an increase in destructive functions and poor construction performance can be observed.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Causes

Multiple factors can lead to osteoporosis. Most often, the disease is caused not by a single cause, but by a combination of several sources.

Doctors distinguish several main factors that provoke osteoporosis in men:

  1. Age-related changes. This is the main reason why bone mass is reduced. In extreme old age, it can drop to 45%. However, in men this process is slightly less pronounced than in women, since initially these tissues are stronger and thicker.
  2. Testosterone deficiency. It is believed that the hormone is converted to estrogen. It is the latter that is necessary for the formation of bones.
  3. Vitamin D and calcium deficiency. Bone mass tends to grow throughout all life. Old cells go away, and new ones grow and replace them. This process is called reconstruction. However, it needs a sufficient amount of vitamin D and calcium.
  4. Inactivity. Equally, like muscle tissue, bone should be in constant motion. Otherwise, it will atrophy. Numerous studies have shown that physical activity contributes to an increase in bone mass. However, only in those areas where the impact is made.
  5. Medicines Many drugs can cause bone loss, thereby provoking osteoporosis. Some corticosteroids needed to treat ulcers and asthma adversely affect the above tissues. These are the following drugs: Cortisone, Hydrocortisone, Prednisone. No less dangerous are the products intended for the treatment of prostate cancer. These are the so-called agonists. The next category of “adverse” drugs is anticonvulsants. Such drugs, taken for quite a long time and in large doses, can lead to bone loss.
  6. Diseases Unfortunately, a number of ailments can lead to osteoporosis. Most often, the disease develops against the background of diabetes mellitus, thyroid pathology (thyrotoxicosis), parathyroid disease, rheumatic ailments, liver or kidney failure.
  7. Smoking. Such a bad habit is completely incompatible with strong and strong bones. According to statistics, smokers have a 55% higher risk of fracture than a person who does not have such a bad habit.

Symptoms

The insidiousness of the disease lies in an almost asymptomatic course. Osteoporosis in men does not cause pain or discomfort. In this he is dangerous. After all, if osteoporosis manifests itself (in most cases, this is a fracture), it is too late to treat it. What signs may indicate the development of pathology?

The presence of osteoporosis can be characterized by the following symptoms:

  1. The occurrence of back pain. Discomfort is never sharp. Its canbut described as a “pain of fatigue,” which appears after a long walk or being in the same position. Such sensations disappear very quickly after rest.
  2. Decreased patient growth. This is one of the most important signs due to “subsidence” of the vertebrae, as well as a decrease in height. Just do not confuse, with osteochondrosis, such a pathology is observed in the intervertebral discs, and with osteoporosis in the vertebrae themselves.
  3. Poor posture, stoop. Deformations of the vertebrae lead to a characteristic “widow’s hump.” In this case, the patient’s stomach may sag and skin folds may form in the lower chest.
  4. Stratification and fragility of nails.
  5. Periodontal disease.
  6. Early gray hair.
  7. Cramps in the feet and calves at night.

A person who has some of the above symptoms in any combination should always consult a doctor and undergo an appropriate examination.

Diagnostics

Two methods of examination are used to detect osteoporosis. Consider them.

This image will clearly show the deformation of the vertebrae. In addition, osteoporotic bone tissue even looks a little different. They are transparent in the center and clearly defined at the edges.

X-ray examination has its advantages and disadvantages. The main plus is the availability of such a study in almost any medical institution.

The disadvantages include the ability to diagnose osteoporosis only if about 20-30% of bone mass is lost. Otherwise, osteoporosis will not be noticeable on the x-ray.

We must not forget that the correct diagnosis depends on the interpretation of the image, therefore, on the qualification of the attending physician. This is another minus of x-rays.

Densitometry

This study is more objective. It is produced using a special apparatus called a densitometer. Such a study measures bone density with an accuracy of 95-99%.

In addition, a big plus of densitometry is the ability to diagnose osteoporosis in the early stages. Thanks to this method, the doctor can control the dynamics of osteoporosis.

Therapies

When diagnosed with osteoporosis, the doctor will recommend special methods to combat pathology. Conventionally, they are divided into 2 groups, mutually complementing each other:

  • drug treatment;
  • the right way of life.

The latter implies the necessary physical activity, massage, exposure to the sun.

Medication

A common mistake of many patients trying to treat osteoporosis on their own is taking pure calcium. This is completely useless, since in most cases it provokes the emergence of a new pathology – the formation of kidney stones.

The treatment prescribed by the doctor for osteoporosis will initially be aimed at stimulating the body to absorb calcium.

The following groups of drugs are included in drug therapy:

  1. Medicines containing Vitamin D. These are drugs: Natekal D3, Calcium D3 Forte, Alpha D3 TEVA, Osteomag, Oksidevit. These drugs stimulate the absorption of calcium from the intestines. Due to this, its content in the blood increases. These funds should be taken only as directed by a doctor. Since for those patients whose blood calcium is elevated, such medicines are completely unsuitable.
  2. Calcitonins. This category includes: “Alostin”, “Calcitrin”, “Myakaltsik”. These are effective drugs that stimulate bone formation and help eliminate pain. They reduce the loss of calcium by the body by suppressing osteoclasts. At the same time, they increase the activity of osteoblasts. With a low calcium content, these drugs are completely unsuitable.
  3. Resorption inhibitors. Medicines: Bonviva, Fosamax. Drugs that suppress the activity of osteoclasts. Thus, they lead to a decrease in bone resorption.

Healthy lifestyle

In addition to drug therapy, patients who are diagnosed with osteoporosis must necessarily lead a correct lifestyle.

Physical exercise

About their feasibility says statistics. Doing gymnastics 3-4 times a week, 30-40 minutes, in the first months you can increase bone mass by 3-5%. The main thing is not to forget that the complex of exercises should be selected by the appropriate specialist, based on the individual pathological characteristics of the disease.

Massage

The procedure greatly enhances the effectiveness of gymnastics. Massage with osteoporosis should be carried out extremely carefully so as not to injure fragile bones.

Sunbathing

As you know, under the sun, the body begins to more actively synthesize vitamin D. However, do not forget that this procedure is not suitable for all patients. It is especially not recommended to sunbathe in the elderly. Therefore, before you get out into the sun, be sure to consult a dermatologist. And only in the absence of unpleasant formations on the skin, feel free to go to sunbathe.

Osteoporosis in men: treatment and prevention

Osteoporosis, a condition of thinning of bones that was once considered a disease that affects only women, is now found in men. Men over 50 are at a greater risk of osteoporosis-related fracture than prostate cancer.

Bone fragility

The threat of osteoporosis is ignored in men for several reasons. Men usually have larger and stronger bones than women, and by the time they are 30, peak bone density has been reached. In addition, men do not experience rapid thinning of bones, like women after menopause.

But, like in women, the bones of men begin to gradually become thin and lose strength after 30 years. And bone density depends on heredity, diet, sex hormones, lifestyle choices, physical activity, and the use of certain medications. So, although men have an advantage over women in terms of maximum bone density, they can still get into trouble if the conditions and lifestyle are wrong.

Who is at risk?

Risk factors for osteoporosis in men include:

  • Parent with osteoporosis;
  • Bad habits (smoking, alcohol) with an unbalanced diet;
  • Lack of exercise and obesity;
  • Chronic inflammation of the joints, lungs and the presence of autoimmune diseases;
  • Long-term use of stero >

Men who have one or more of these risk factors should talk with their doctor about the health of their bones. In addition, men who develop: sudden back pain, loss of growth, or a change in posture should also consult a doctor and be examined.

Treatment of osteoporosis in men

Although the treatment of osteoporosis in men is not well understood, several treatment options for this pathology are available. Alendronate (Fosamax) has been approved for the treatment of osteoporosis in men. Risedronate (Actonel) and calcitonin (Miacalcin, Calcimar) can also be prescribed at the discretion of the doctor.

Estrogen and estrogen-like drugs are used to treat osteoporosis in women, they are not used in men. As more information becomes known about the mechanisms of osteoporosis in men, additional treatment options should be available.

Prevention

Prevention of osteoporosis in men is as follows:

Essential Calcium (about 1500 mg / day)

Calcium is needed for bones and muscles. Typical sources of calcium are milk and dairy products.

Vitamin D Stock

Without vitamin D, calcium cannot be absorbed in the body and, therefore, is not included in the bone. A balanced diet and plenty of sunlight allow the body to produce vitamin D on its own. But vitamin D can also be supplied through diet (adult dose of about 200 IU). Typical vitamin D-containing foods are fish, dairy products, and mushrooms.

Testosterone

Testosterone and its metabolites are important for bone metabolism. Testosterone deficiency can lead to osteoporosis. If you suspect a testosterone deficiency, you must visit a specialist doctor and consider what measures to increase testosterone levels can be taken.

Salt not only negatively affects blood pressure, but also helps in the elimination of calcium by the kidneys.

Do not take too many stimulants

High levels of alcohol and coffee lead to the elimination of calcium by the kidneys and in the decreased formation of body vitamin D. It is safe to consume no more than 2-3 cups of coffee per day.

Physical exercise

Calcium is absorbed by bone only when there is physical activity. This means that with a high content of calcium and vitamin D, their consumption does not matter in the diet, as long as the person remains physically inactive.

Causes of osteoporosis in men, the main symptoms of the disease and methods of its treatment

The bone structure in the human body is constantly updated. Two types of cells are involved in the renewal process – osteoclasts remove old bone tissue, and osteoblasts create a new one. If there are no violations, then the destructive processes should be fully compensated by the restorative ones. However, imbalances can occur in the functioning of these cellular systems, resulting in increased bone fragility and increased risk of fracture. Such a disease is defined by specialists as osteoporosis.

If we talk about the prevalence of osteoporosis, depending on gender, it can be stated that men are less prone to osteoporosis than women. The latter are diagnosed with this disease 2-3 times more often.

Despite this, according to statistics obtained on the basis of densitometry, in Russia, almost a quarter of men over the age of fifty have a lower bone mineral density.

The initial stage of osteoporosis is almost asymptomatic. Only 13% of men from this age group had one or more fractures.

The number of cases of this disease is growing everywhere, and Russia is no exception. Urban residents are particularly susceptible to osteoporosis, and recently, experts have been paying attention to the increased incidence in older men.

Why does osteoporosis occur?

Osteoporosis is a systemic disease. Outwardly manifesting in fractures of the femur, vertebral bones, or bones of the forearm, this disease gradually destroys all skeletal bones without exception.

The main cause of osteoporosis is the leaching of mineral salts from hard bone tissue. Due to the lack of these salts, the bones become so fragile that the slightest mechanical effect can provoke a fracture. With this diagnosis, a person can break a leg or arm from falling from a height of his height or abruptly turning a joint.

Bones in the presence of osteoporosis do not lose mineral density in more than one day. The process lasts for years: from the moment when the disease appeared to the first fracture caused by it, ten or even fifteen years can pass.

The main factors contributing to the onset of osteoporosis are genetic predisposition and adverse environmental conditions. The hereditary origin of this disease is determined by the presence of fractures in blood relatives after the age of fifty to sixty years. The more such cases were and the closer the relationship, the greater the risks of osteoporosis.

More susceptible to osteoporosis are men who:

  • are 65 years old or older;
  • physically inactive;
  • lack of calcium and vitamin D;
  • for several months they take drugs from the group of glucocorticoids;
  • have a reduced body weight;
  • suffer from hypogonadism – a disease in which androgens show low indicators;
  • have bad habits: smoke, often drink alcohol.

If there are several factors from the above list at once, the risks of osteoporosis significantly increase.

Signs of osteoporosis in men

In the early stages, osteoporosis is almost impossible to recognize by external signs. If this disease is suspected, the doctor prescribes densitometry – an examination designed to track changes in the bone structure.

The following symptoms may be alarming signs in this regard:

  1. Human growth is reduced by several centimeters per year.
  2. Thoracic kyphosis appears – a person gradually becomes stooped.
  3. A fracture of the spine was recorded with minimal mechanical impact.

Indirect signs of osteoporosis can be:

  1. Pain in the back of a aching character.
  2. The changed gait.
  3. Decreased stamina.
  4. Stiffness in the shoulder or hip joint.

Despite the fact that this disease, although not easy, is amenable to early diagnosis, osteoporosis in men is most often detected precisely after a fracture. The localization of fractures is typical – as a rule, the femurs or radial bones break, but we can also talk about the thoracic or lumbar spine.

Since osteoporosis makes bones extremely fragile, the bone sometimes breaks due to a completely harmless movement, for example, with a sharp change in body position.

Methods of treatment of osteoporosis and its prevention in men

Preventive measures to prevent the onset of this disease should be undertaken as early as childhood. A balanced diet and properly selected physical activity reduce the risks of its occurrence in adulthood and have a positive effect on the course of osteoporosis if bone structure disorders still occur.

To minimize the risk of fractures in young people, doctors strongly recommend:

  1. Refuse bad habits, especially smoking.
  2. From a very young age, form the right eating habits that ensure a daily intake of at least 1000 mg of calcium.
  3. As much as possible to be in the sun.
  4. Introduce moderate exercise.

Diet is of great importance both for the treatment of osteoporosis and for its prevention. Aimed at strengthening bones, it should include as many high calcium foods as possible (hard cheeses, cottage cheese, fermented milk products). However, do not forget about the balance of fats, due to which the absorption of calcium occurs. Nutrition should be balanced and varied, nutritionists recommend eating at least four times a day.

If by densitometry it is established that the bones already have a fairly low mineral density (5% of the norm or more), doctors advise men to start treatment with strength training and aerobic exercise. A set of exercises for osteoporosis should be performed in a standing position, the emphasis is on walking. Any physical activity should correspond to the age of the patient, it is developed based on the degree of development of concomitant disorders, if any.

Drug therapy of osteoporosis, depending on the stage of its development, may consist in the use of:

  • bisphosphonates;
  • calcitonins;
  • parathyroid hormones;
  • fluorine and strontium salts;
  • active metabolites of vitamin D;
  • anabolic steroids.

Specialists always include a daily intake of calcium from 1000 to 1500 mg and vitamin D from 200 to 800 IU in the treatment plan for osteoporosis. For people over the age of 65, a scheme is considered more effective in which this vitamin is replaced by active metabolites.

As a first-line drug, doctors mainly prescribe bisphosphonates containing nitrogen – alendronate or zoledronic acid, as well as strontium ranelate. The low effectiveness of such drug treatment or its poor tolerance is a reason for reviewing therapeutic tactics. In this case, calcitonin may be recommended for use, especially effective for pain that a person experiences as a result of a vertebral injury.

Correction of the prescribed treatment plan for osteoporosis should be based on data on its effectiveness. The assessment of the patient’s condition is given by the attending physician, guided by the indicators of bone mineral density in dynamics, as well as tracking new cases of fractures and their severity.

The treatment process for osteoporosis, as well as the development of this type of disease, is quite lengthy. Its average duration is from three to five years, during which the patient must strictly adhere to the recommendations of the attending physician in order to achieve relief of symptoms and prevent a further increase in bone fragility.

Osteoporosis in men: the main causes, methods of therapy, prevention

Bone resorption is a systemic pathology that covers all parts of the musculoskeletal system. Osteoporosis in men is a common problem in old age. This is due to hormonal changes and some other reasons leading to increased bone fragility.

The main therapy is the intake of calcium, vitamin D and an individually selected complex of physiotherapy exercises. An important role is played by the timely treatment of any diseases of the skeletal system, proper nutrition, and a healthy lifestyle.

Features of the development of osteoporosis in men

The main cause of the disease is considered a low level of testosterone production, which contributes to the formation and strengthening of bone tissue. A decrease in testosterone synthesis is observed in men older than 50 years. This is manifested by a decrease in potency, body weight, the development of depression, chronic fatigue syndrome. The most dangerous at this age is the development of osteoporosis, which has its own characteristics.

So, bone resorption in men is diagnosed less often than in women. This is due to the following reasons:

  • higher bone mass density;
  • pathology develops more slowly;
  • massive tubular bones;
  • there is no sharp decrease in the synthesis of sex hormones, even in old age.

In addition, the male part of the population is more likely to experience physical stresses that contribute to the strengthening of skeleton elements. The disease usually occurs in old age, to which men often do not survive.

Negative factors in the occurrence of osteoporosis can be smoking and excessive consumption of alcohol against the background of inactivity and malnutrition.

According to medical statistics, smoking doubles the risk of fractures, alcohol negatively affects all endocrine glands.

Men in old age often turn to traumatologists for fractures resulting from minor household injuries. This is especially true of the femoral neck, femur and vertebral bodies. Radiological diagnosis reveals signs of osteoporosis.

Disability and mortality after fractures are higher than in women. Perhaps this is due to the development of the disease in more advanced years, when the general state of health is poor and complications after injuries occur more often.

The following points increase the risk of fractures:

  • age over 65-70 years;
  • history of injuries;
  • long-term use of corticosteroid hormones;
  • hereditary predisposition.

Often injured are urban residents suffering from arthritis, malignant diseases, pathologies of the stomach and intestines.

Signs of pathology

The initial stages of osteoporosis are asymptomatic. Then some clinical manifestations arise: the gait becomes insecure, lameness often appears, posture changes – growth decreases due to curvature of the spine, potency is impaired. Sometimes there may be a decrease in the size of the testicles.

Subsequently, patients complain of the following symptoms:

  • discomfort in the interscapular region;
  • fatigue;
  • decrease in the volume of active and passive movements in the shoulder and hip joints;
  • aches in the lumbosacral spine, in the knee and ankle joints after physical exertion.

Men often do not pay attention to signs of osteoporosis, attributing malaise to physical overwork.

The pain syndrome occurs later, at the stage of significant demineralization, threatening fractures of the femur or spine.

Pain is provoked by fatigue, often disturbing at night, disturbing sleep. Gradually, they become chronic, significantly worsening the quality of human life.

The principles of therapeutic tactics

At the same time, two processes occur in the human body of any age: osteosynthesis and bone destruction. The goal of therapy is to slow down demineralization and improve the formation of new bone cells for the prevention of fractures.

To assign adequate therapy, it is important to establish the cause of the pathology. Treatment of osteoporosis in men should solve the following problems:

  • making up for testosterone deficiency;
  • normalization of the concentration of thyroid hormones in the blood;
  • monitoring the correct intake of corticosteroid hormones, antitumor and antiepileptic drugs.

It is necessary to treat the disease with calcium preparations, which forms the basis of the bone framework. To assimilate this element successfully, add vitamin D at a dose of at least 400 IU every day. With laboratory-confirmed osteoporosis, 1-1,2 g of calcium, which is part of drugs and foods, should be taken daily. According to the indications, the doses may be increased.

Most often prescribed medications from the following drug groups:

  • bisphosphonates – Bonviva, Alendronate, Zometa, slowing down the process of bone destruction (can not be taken simultaneously with calcium preparations);
  • sex hormones as replacement therapy;
  • Miacalcic is a medicinal analogue of the thyroid hormone involved in mineral metabolism.

Mineral and vitamin supplements containing phosphorus, magnesium, selenium are useful. Physiotherapy is used – massage to improve blood supply to muscles and bones, mud therapy.

We need timely and competent treatment of concomitant diseases. This is especially true of endocrine pathology, including diabetes mellitus, adrenal gland diseases. Attention should be paid to diseases of the gastrointestinal tract.

Additional recommendations

Of great importance is the implementation of the following measures:

  1. Dosed, agreed with a specialist, physical activity to strengthen muscles and bones.
  2. The correct diet is high in calcium – dairy and dairy products, cabbage, beets, nuts, greens. Fractional nutrition, greens, fruits and vegetables, it is important to use raw.
  3. Rejection of bad habits.
  4. Long walks in sunny weather.

Testosterone deficiency can be partially replenished by consuming certain foods containing zinc and other trace elements. These include the following food:

  • oily sea fish;
  • olive oil;
  • oysters;
  • beans, peas, lentils;
  • almonds (very useful to eat 9-10 nuts a day);
  • onion and garlic.

The use of folk remedies

Alternative methods of combating osteoporosis are used only as an auxiliary component. The goal is to improve mineral metabolism. At home, the following agents have a positive effect:

  1. Mummy. The amount of substance in the size of a match head is diluted in 100 ml of water. Take 2 times a day 30 minutes before meals.
  2. Parsley and dill. Take 200 g of herbs and pour 1 liter of boiling water for 3 hours. Use 100 g of infusion 3 times a day between meals.
  3. Lemon juice and honey. In a glass of warm water add 1 tbsp. a spoonful of juice and as much honey. Drink the solution before meals at least 3 times a day for a long time.
  4. Hypericum herb. Brew in a glass of boiling water 1 tbsp. a spoonful of plant material for 40 minutes. Consume 1 tbsp. spoon 3 times a day, regardless of food.

Answers to questions

At what age should osteoporosis be prevented?

You need to take care of bone strength from early childhood. The body must accumulate a sufficient amount of calcium and other minerals, which will make the elements of the skeleton strong. But for young people, after the formation of the bone skeleton is completed, the prophylactic intake of vitamin-mineral complexes is important, especially during the transitional periods of the year.

In adulthood, the prevention of osteoporosis in men is concern for maintaining sexual activity. This will help maintain testosterone synthesis at the level necessary to maintain male health and bone strength. It is better to spend certain efforts, time and money on the prevention of pathology than on its treatment.

Which foods contain the most calcium?

A good complement to treatment is to consume foods that are high in calcium. These include:

  • milk and dairy products, hard cheeses;
  • vegetables and greens – young nettle, basil, parsley, broccoli, rose hips;
  • nuts and seeds – sesame, poppy, almonds;
  • cereals – beans, soybeans;
  • sea ​​fish – sardines, salmon, cod;
  • egg yolks.

What sports are suitable for patients with osteoporosis?

Strength exercises, including simulator exercises, have a good effect. But they can be carried out only after medical consultation. Useful walking at a comfortable pace, jogging, swimming. Daily exercise should take about 30 minutes, but not cause fatigue and irritation.

To avoid falls and fractures, exercises are needed to coordinate movements and develop a sense of balance. They should be performed at a slow pace. Doctors also recommend dancing and yoga classes.

Weightlifting, boxing, game and extreme sports are contraindicated. Forbidden jumping, sharp bending of the spine in the lumbar.

Which doctor to contact?

If there is pain in the bones, you need to contact the local therapist, who, if necessary, refers to a traumatologist or orthopedist. Specialists will conduct the necessary examinations. Consultation with a rheumatologist and endocrinologist may be required.

Conclusion

The course of osteoporosis in men has its own characteristics. This disease can turn into life-threatening problems, leading to disability. It is important to know the first symptoms of the pathology in order to receive timely and competent medical care, normalize nutrition and lifestyle.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

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