It's one of the great health myths - osteoporosis is a disease suffered exclusively by older women. Elaine Edwards reports
Many people are shocked to learn that osteoporosis strikes men, women and children of all ages.
One in three women will suffer from the bone-thinning condition, while one in 12 men over the age of 50 are likely to have an osteoporosis-related fracture. The figure for older men is as high as one in eight. More than 40,000 Irishmen could be affected by the condition.
And despite the fact that up to 20 per cent of spinal fractures and 30 per cent of hip fractures caused by osteoporosis occur in men, most receive no treatment to prevent further fractures, according to the Irish Osteoporosis Society.
It also estimates that within one year of a hip fracture, the mortality rate for men is 2.9 times higher than for women.
Osteoporosis in men is complicated by the fact that in nearly half of all cases, its cause is unknown. Those with a family history of the condition may have a lower than normal bone mineral density. Other causes include long-term use of corticosteroid tablets (such as asthma medication) and low levels of testosterone, a problem for those who have had treatment for a testicular tumour.
Heavy smoking, a low intake of calcium and low levels of physical activity and weight-bearing exercise can also contribute to a loss of bone density in both sexes. Excessive alcohol and caffeine intake can also prevent proper absorption of calcium, the mineral most vital to healthy bones. People with eating disorders such as anorexia and those who exercise excessively are also at risk.
Prof Moira O'Brien, professor of anatomy at Trinity College and president of the Irish Osteoporosis Society, says trauma fractures suffered from a relatively small knock to the bone also need to be checked out in case there is an underlying tendency to the condition. "The commonest cause is low levels of hormones and anyone who has a minimal-trauma fracture should also be investigated for osteoporosis."
Osteoporosis, if caught in its early stages and in younger sufferers, can be very successfully treated through diet, exercise and, if necessary, hormone replacement or medication.
Nicholas Flood (38), from Dublin, is a professional silhouette shooter and a world champion in the field. So-called DEXA scans used to measure bone density revealed depletion of his spine around four years ago. He had just returned from a world championship event in Australia. "I had a lot of pain in my lower spine and I was quite worried about it. I went to Prof O'Brien in Trinity College and I found out I had osteoporosis in my lower spine. I had a previous examination that showed I had a slight tendency to it so I wasn't really surprised. The sport involves standing off-hand and upright using the rifle. It's a particularly hard position for the body and there's a lot of pressure on your spine. Some of the training regimen is quite stiff.
There were some deficiencies and deficits in his nutrition from the excessive amounts of training he was doing. "I thought it was going to be a career-ending injury, because I was looking at a possible collapse of my discs and an operation to have the discs fused. I was advised to change my training regimen and to drop out some exercises and adjust my nutrition regimes. Within a year, it had subsided substantially. It made a huge difference."
Flood says he doesn't know other men suffering from osteoporosis, but knows a lot of people with back problems. "So I encourage people to get checked out, because your body tells you things and you have to listen to it."
Some 10,000 osteoporosis sufferers are taking part in trials and receiving treatment at Prof O'Brien's unit at TCD. "We are trying to identify the men at risk but we are also trying to make people realise osteoporosis is not just a disease of older people, that it affects men, women and children. That's the crucial thing."
Prof O'Brien says research into osteoporosis needs further funding and that the DEXA scans for bone density need to be standardised. Some of the private concerns who offer expensive DEXA scans don't include a lifestyle survey as part of the test, which is vital to any assessment of osteoporosis risk, she says.
The Irish Osteoporosis Society has published a leaflet which includes a questionnaire to help men identify if they might be at risk of osteoporosis.
Prof O'Brien says: "If you are over 60 and have recently broken a bone, it could be because you have osteoporosis. The good news is that osteoporosis may be treated effectively. All men need to be aware that they are at risk of osteoporosis and should not wait until they have broken their hip to discover they have it."
www.nicholasflood.com
www.irishosteoporosis.ie