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The Hidden Dangers of Male Osteoporosis

January 2004

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The effect of boron intake was analyzed in a study involving 12 post-menopausal women not on estrogen replacement therapy.15 Patients were first given a boron-deficient diet for 119 days, followed by a 48-day period in which they received boron supplementation. Patients also were studied during periods of adequate magnesium intake versus magnesium deficiency. Deprivation of boron or magnesium caused changes similar to those seen in women with post-menopausal osteoporosis, including increased loss of urinary calcium. In women receiving boron supplements, however, urinary losses of both calcium and magnesium were significantly diminished, especially if dietary magnesium was low. Boron manifests similar integrative effects on bone metabolism in its actions relating to vitamin D, which enhances calcium absorption through the stomach and small intestine. This integrative effect of boron with vitamin D, as with boron’s interaction with magnesium, appears to be more profound in settings of vitamin D deficiency.

Men also are advised to increase their intake of vitamin K. Research has identified a link between vitamin K intake and the incidence of hip fracture. One study examined 900 elderly patients to determine whether vitamin K intake had any influence on hip fractures or low bone density.16 The researchers found that those with the highest vitamin K intake had the lowest level of hip fracture; no association was found between vitamin K intake and bone mineral density.

The study authors concluded that vitamin K helps keep bones healthy. (Those taking Coumadin® or other anticoagulant medication should not take vitamin K.)

Bone Mass: Lost in Space?

Space exploration has produced interesting insights into many subjects, including bone loss.

NASA research has found that during space flight, the body does not encounter the full force of gravity. This gravity-supplied stress on the bones is critically important. The cells that normally stimulate bone growth are not stimulated in a weightless environment, and as a result, astronauts lose around 1-2% of their bone mass a month. Upon returning to Earth, some space travelers have lost up to 20% of their bone strength during six-month stays at the International Space Station. This is of profound concern to NASA, as any long-duration space flight (for example, a trip to Mars) could result in severe weakening of the skeleton.

One interesting therapy NASA is examining involves placing astronauts on vibrating plates. The vibrations are barely detectable and astronauts strap themselves on to the plates while working on other tasks. The therapy appears to work, and scientists believe that the gentle vibrations help stimulate bone-forming cells.

Two recent studies reported in the journal Bone provide evidence that silicon plays a role in promoting bone formation. The first, a survey of 3,000 people, found that dietary silicon was associated with greater bone mineral density,17 except for postmenopausal women. The second study found that silicon has a stimulatory effect on collagen in the osteoblast cells that form bone.18 The study authors concluded that silicon is more important in forming bone that in preventing bone loss.

In men whose bone loss is the product of low testosterone levels, testosterone replacement therapy is vital. Testosterone works by improving bone thickness, especially in the small bones of the spine. Spinal fractures are much more common in men than in women. Moreover, men with low testosterone are twice as likely as women to suffer a hip fracture. After taking testosterone, men often report increased energy. (Men with prostate cancer, however, should not take testosterone.)

Testosterone therapy can take many forms. An injection can be given every two to three weeks. Patches are available that release the hormone at night, as is a cream form that can be applied to the skin. Additionally, a variety of natural supplements can be taken to increase testosterone levels.

As the population continues to age, more and more men will discover—unfortunately too late—that they are suffering the consequences of osteoporosis. Now is the time to be proactive with your physician and request a bone density test.

The two types of bone density tests are DEXA (dual x-ray absorptiometry) and QCT (quantitative computed tomography). DEXA is the most common bone mineral density test, but the QCT test is clearly superior. In a paper published by Smith, et al, investigators compared DEXA and QCT bone mineral density testing in the same patients. A significantly greater percentage of men were found to have osteoporosis using the QCT methodology than the DEXA approach. QCT technology picked up abnormalities in bone density in 95% of men compared to only 34% of the same men using DEXA.

Because most physicians are not readily familiar with QCT technology, it is important that patients and their partners share these new findings and seek out radiology facilities that have QCT equipment. Two references for sources of QCT testing are Mindways, Inc., and Image Analysis. To contact Mindways, call 1-877-646-3929 or log on to www.qct.com. To contact Image Analysis, call 1-800-548-4849, or log on to www.image-analysis.com. With proper supplementation, exercise, and lifestyle changes, you can avoid the crippling effects of this insidious disease.

References

1. Osteoporosis Prevention, Diagnosis, and Therapy. NIH Consensus Development Conference Statement 2000 March 27-29; 7(1):1-36.

2. Bilezikian JP, Kurland ES, Rosen CJ. Male skeletal health and osteoporosis. Trends Endocrinol Metab 1999 Aug;10(6):244-50.

3. Orwoll ES, Klein RF. Osteoporosis in men. Endocr Rev 1995 Feb;16(1), 87-116.

4. Gilansz V, Boechat MI, Roe TF, Loro ML, Sayre JW, Goodman WG. Gender differences in vertebral body sizes in children and adolescents. Radiology 1994 Mar;190(3):673-7.

5. Finkelstein JS, Klibanski A, Neer RM. A longitudi- nal evaluation of bone mineral density in adult men with histories of delayed puberty. J Clin Endocrinol Metab 1996 Mar;81(3):1152-5.

6. Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 1995 Mar 23;332(12):767-73.

7. Econs MJ, Speer MC. Genetic studies of complex diseases: let the reader beware. J Bone Miner Res 1996 Dec;11(12):1835-40.

8. Krall EA, Dawson-Hughes B. Heritable and life- style determinants of bone mineral density. J Bone Miner Res. 1993 Jan;8(1):1-9.

9. van den Beld AW, de Jong FH, Grobbee DE, Pols HA, Lamberts SW. Measures of bioavailable serum testosterone and estradiol and their relationships with muscle strength, bone density, and body com- position in elderly men. Clin Endocrinol Metab. 2000 Sep;85(9):3276-82.

10. Male hormone modulation therapy. Segala M, ed. Life Extension Disease Prevention and Treatment. 4th ed. Life Extension Media;2003:1043.

11. Snyder PJ, Peachey H, Hannoush P, et al. Effect of testosterone treatment on bone mineral density in men over 65 years of age. J Clin Endocrinol Metab. 1999 Jun;84(6):1966-72.

12. Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH. Undertreatment of osteo porosis in men with hip fracture. Arch Intern Med 2002 Oct 28;162(19):2217-22.

13. Strum S. Boron maintains bones, joints, neurons, and may reduce prostate cancer risk. Life Extension. Nov 2003:27-31.

14. Nielsen FH. Studies on the relationship between boron and magnesium which possibly affects the for mation and maintenance of bones. Magnes Trace Elem. 1990;9(2):61-9.

15. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testos- terone metabolism in postmenopausal women. FASEB J. 1987 Nov;1(5):394-7.

16. Booth SL, Broe KE, Gagnon DR, et al. Vitamin K intake and bone mineral density in women and men. Am J Clin Nutr. 2003 Feb;77(2):512-6.

17. Jugdaohsingh R, Tucker KL, Kiel DP, Qiao N, Powell JJ. Silicone intake is a major dietary determi- nant of bone mineral density in men and pre menopasual women of the Framingham offspring cohort. Bone. 2003 May;32(5)S192 (abstract only— presented at the 1st Joint Meeting of the International Bone and Mineral Society and the Japanese Society for Bone and Mineral Research; Osaka, Japan; 2003 June 3-7).

18. Reffitt DM, Ogston N, Jugdaohsingh R, et al. Orthosilicic acid stimulates collagen type 1 synthesis and osteoblastic differentiation in human osteoblast-like cells in vitro. Bone 2003 Feb;32(2):127-35.