Graceful Health: Bone density testing — not just for women

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The latest news to come out regarding osteoporosis is that testing for men tends to fall through the cracks.

While women's bone health is often followed closely by their primary care and ob-gyn providers, men aren't as likely to get regular check-ups or to be referred for bone density testing when it is needed.

On May 12, researcher Dr. Mary Ruppe, a Houston Methodist Hospital endocrinologist, announced this finding and remarked that, "Women have a screening safety net. Between their primary care physician and ob-gyn, women will begin bone density screenings at the appropriate age. Men are less likely to have routine primary care checkups and don't receive preventative care similar to what is provided for women."

Statistics do show that women are more susceptible to osteoporosis, a condition that makes bones brittle and thus prone to breakage. But men are not immune to the disease. The May 12 press release cited a study that found an estimated 1.5 million American men older than 65 have osteoporosis, and another 3.5 million men are at risk.

The best way to determine whether you are at risk for osteoporosis it to have a bone mineral density (BMD) test, which measures the amount of calcium and other minerals that are present in a section of bone. It does this by taking a picture of the bone that shows how dense it is. The more density, the stronger the bone. If the test determines that density is low, the condition can be treated, but it all starts with the test.

Most often, a scan is performed on the lower spine and one hip. On rare occasions, the whole body is scanned. The test generally lasts about 20 minutes. The patient lies on a padded platform and the scanner's metal arm passes over him or her, casting a thin ray of low-dose radiation over the bone being tested. The patient is fully clothed in either street clothes or a hospital gown and does not feel any effect from the test.

Osteoporosis risk increases with age. Our bodies are constantly breaking down old bones and replacing bone mass throughout our lives. For most people, the rate of build-up exceeds break-down until approximately age 30 to 35. Until that point, the body is making new bone faster than it is breaking down old bone, so bone mass increases. As we age, the rate of replacement slows down, while the rate of break-down increases. The higher one's peak bone mass in youth, the more bone the body has to sustain it through old age.

A combination of strength training and weight-bearing exercises can help to mitigate the decline, as can getting enough calcium and Vitamin D. Calcium in one of the principle components of bone, and Vitamin D help us to absorb calcium. Low-fat dairy products, dark green leafy vegetables, canned sardines with bones, canned salmon, and soy products are also good, natural sources of calcium.

The National Osteoporosis Foundation recommends a bone density test for all women over age 65, and for any woman who has broken a bone after age 50. Women who are post-menopausal in their 40s may need the test sooner even if they haven't had a bone fracture.

The American College of Physicians recommends that, by the age of 50, men should be screened yearly for risk factors associated with osteoporosis, and the National Osteoporosis Foundation recommends that all men begin routine bone density screenings by the age of 70.

The biggest risk factor for osteoporosis among men is a family history of the condition. Other risk factors that could increase a man's chances of developing acute bone loss include prescription steroid use, gastrointestinal disease, use of prostate cancer drugs, and overuse of alcohol. Patients with thyroid conditions, those who have had a transplant, who smoke, or who are especially tall or thin should also discuss the need for this test with their medical providers.

According to Dr. Ruppe, "Each year, approximately 80,000 men will suffer a hip fracture, and studies have shown they have a higher mortality rate after a hip fracture than women of the same age." Such data underscores the importance of routine osteoporosis screening for men as well as for women.

Grace Cottage accepts bone density test orders from all providers. The Grace Cottage Diagnostic Imaging Department is open Monday through Friday, 7 a.m. to 6:30 p.m. For more information, call 802-365-3639.

Angie Clark joined the Grace Cottage staff as Director of Diagnostic Imaging in 2011. She holds a Bachelor of Science degree in Business from Granite State College and an Associates of Radiologic Science from the NH Technical Institute. She also serves as the hospital's Director of Clinical Informatics, overseeing training and data collection for Grace Cottage's Electronic Medical Records system.


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