Do Men Need Bone Scans?

Question: How often should a male osteoporosis patient have a bone density scan? I fractured a hip six months ago at the age of 62, and now take Fosamax, calcium, and vitamin D. Is there anything else I should be doing?

Dr. Hibberd's Answer:

Osteoporosis in men is much less common than in women. Treatment is specific to severity. A dexa scan is the most reliable way to assess for osteoporosis, and a repeat scan is considered after 12 months of treatment. The portable units used to measure peripheral bone density are fine for screening, but they are not as reliable as dexa scanning.

Though your medications seem appropriate, an individual recommendation based on your disease activity and underlying conditions is advisable. We now have a wide variety of oral and injectable medications for osteoporosis treatment. Some injections are given only once a year.

Your medical professional will be your best resource for your available prescription and nonprescription options. Also, be sure to work with your other consultants, pharmacist, and dietitian when setting up osteoporosis plans for either prevention, or treatment, or both.

Osteoporosis management techniques involve increasing your dietary calcium intake in conjunction with daily sunlight exposure so your body can produce adequate vitamin D to absorb and utilize this calcium. Remember that dietary calcium is far better utilized than supplemental calcium.

Vitamin D supplementation may be necessary if you have insufficient sunlight exposure.

Low-fat dairy products are probably the best sources of bioavailable calcium as well as selected fruits and green leafy vegetables. Hormones are rarely used for osteoporotic management in men.

Most importantly, regular exercise and physical activity are very strongly associated with improvement in patients with osteoporosis. Sometimes we take medications, such as steroids like prednisone, immune suppressants, anti-metabolites, chemotherapy, and anti-seizure medications, that may induce or worsen osteoporosis. Be sure to review all your pills and supplements with your doctor. I often see patients taking the right supplements but in incorrect ratios or incorrect doses.

I hope this helps you to prevent fractures in the future and serves as a warning to other men that they, indeed, may also be at risk for fractures with osteoporosis.