Osteoporosis Risk to Men, Experts Warn

When Tom Carskadon sprained an ankle rummaging through his attic two years ago, he expected to get it wrapped at his doctor’s office and be on his way.

That’s what 47-year-old men are supposed to do: Stop for quick repairs and get back in action.

But Carskadon’s X-ray showed an unusual lack of bone density, and eventually he was found to have osteoporosis, the bone-weakening disease that affects about 20 million American women over 50.

“I was flabbergasted,” said Carskadon, a psychology professor at Mississippi State University in Starkville. “I found out that I had it, but it was later that I found out how bad, and that just blew me away.”

Carskadon says his back is so bad that he is able to pick up his 5-year-old son, but not his 8-year-old. He worries every day that he’ll break a bone in his back or legs.

“Here I am, a 49-year-old man, and I have the bones of a 120-year-old man, if you can find one,” Carskadon said.

Carskadon is one of the about 1.5 million men who have osteoporosis. Studies show that another 3.5 million have a high risk of developing the disease.

An alarming number of those men, and their physicians, aren’t getting enough information about what is perceived as a women’s disease, according to a recent national survey. One disturbing fact turned up by the poll was that older men who are most susceptible to the disease are the least informed about it.

“Many of us have fallen down on the job at alerting men to the dangers of this disease,” said Dr. Eric Orwoll, one of the nation’s leading authorities on osteoporosis in men. Orwoll is chief of endocrinology and metabolism at the Veterans Administration Medical Center in Portland.

Orwoll helped prepare the survey, conducted by Gallup and funded by the Washington-based National Osteoporosis Foundation. The poll, released June 11, shows how little most men know about the disease and its devastating impact.

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More than 70% of the men polled said a woman is at least somewhat likely to develop osteoporosis, while fewer than half thought it was somewhat likely for a man to develop the disease. Fourteen percent knew osteoporosis can cause curvature of the spine, while even fewer knew about the loss of mobility (8%) and height (3%).

“In direct contrast to the opinions men expressed in this poll, they are not immune to osteoporosis,” Orwoll said.

Slightly more than 1,000 men aged 45-75 were surveyed by telephone for the poll, which was conducted nationwide between Feb. 8 and March 27, according to foundation officials. The poll has a margin of error of 3 percentage points in either direction.

“It’s very clear that men perceive it as a women’s disease,” said Dr. Robert Lindsay, chairman of the department of medicine at Helen Hayes Hospital in West Haverstraw, N.Y., and professor of clinical medicine at Columbia University. “I’m not the least bit surprised by these findings.”

Osteoporosis makes bones weak and brittle and can lead to fractures in the back, hips and legs. About 20% of women who suffer broken hips related to the disease die within a year. That figure is about 30% among men, Orwoll said.

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Orwoll said it isn’t uncommon for the disease to show up in men who haven’t yet reached their 40s.

“The young men who have this are absolutely devastated,” he said. “They’re cut down in the primes of their lives, and they can’t understand why.”

Doctors often fail to educate their male patients about the risks of osteoporosis, Orwoll said.

Preventive measures, such as exercise and calcium supplements, can reduce the risk of osteoporosis, Orwoll said. The recommended daily calcium intake is 800 milligrams, but for older men and post-menopausal women, the dosage should be about 1,500 milligrams, Lindsay said.

Smoking, drinking, poor diet and steroid use can make men more vulnerable to the disease, Lindsay added.

Various prescription drugs are available to help combat the symptoms of the disease once it is diagnosed. One is the non-hormone alendronate, which was approved by the Food and Drug Administration in November. But no one knows conclusively how well these drugs work on men.

“There’s never been a study,” Orwoll said. “There’s been a concern that [drugs] may not work as well in men as with women. We just don’t know.”

Carskadon said he wouldn’t have known the extent of the disease in his body if he hadn’t undergone a $200 X-ray called a DEXA (dual energy X-ray absorptiometry) scan.

Carskadon uses alendronate regularly and said his symptoms haven’t worsened. But he knows the disease is irreversible and says one broken bone will effectively end his career.

“I’m living proof, glad to be living proof, that it can hit a man and hit a man hard,” he said.