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It is unlikely that anyone visiting this website has never heard of
osteoporosis, but to many it is something linked to elderly ladies rather than
healthy young boys. However the condition is of particular importance to
boys & men with KS, although there is no need for it to be a problem. But
ALL of us are vulnerable to the condition, and there is huge gain in adopting a
WHOLE FAMILY approach to avoiding the condition through a healthy diet & good
exercise. It is predicted that 12000 men each year will need hip
replacements due to osteoporosis, whilst 40% of women over the age of 50 will
suffer osteoporosis triggered fractures.
How does it happen?
The most vulnerable bones are the long, porous bones with the "honeycomb"
centres, as these have the largest surface area, though almost all bones are
susceptible. Bone density is managed
by two types of cells:
- Osteoblasts: fill in the gaps and make bone more dense.
- Osteoclasts: break down & reabsorb old bone, creating cavities.
Osteoblasts are most active and dominant in our youth, and are responsive to
hormonal, and other chemical, balances in our bodies. It is during this
time that we can make the best investment in our future health, by laying down
strong bone material and giving every advantage by ensuring our diet, exercise
and medication promote bone formation.
Bone mass generally reaches a peak between the ages of 25 - 35 years, and
then gradually declines. The worrying part is that bones can deteriorate
to a very serious state before any symptoms are felt.
Why is it important in KS?
Testosterone is vital for the production of strong bones in men.
Of course, although KS boys often produce very little testosterone of their own,
with supplementation this can largely be negated, so it is VITAL that we follow
the course of treatment outlined by our endocrinologists. However there are other
key factors, such as the low activity levels in some boys, that puts them at
risk. Check your family against the list below.
Risk Factor
|
What to look out for
|
| Genetics |
Do you have a family history of fractures due
to osteoporosis? |
| Hormones |
Starting testosterone supplements late,
regularly missing doses, inappropriate dose. |
| Diseases |
Many diseases, particularly some forms of
cancer, can lead to the destruction of bone structure. Unfortunately
many treatments are as bad in themselves |
| Steroids |
Check with your doctor, if you are on regular
medication, whether any of the drugs you are taking regularly contain
steroids. Few drugs are as effective at leaching away bones. Be
warned, though, you may not be able to take the drugs that counteract this. |
| Diet |
A good, healthy diet as a child can have an
AMAZING effect upon keeping osteoporosis at bay. This is the most
reliable way for the whole family to protect itself, as well as feeling so
much better, too. |
| Smoking |
Smoking is known to depress hormone levels and
suppress the activity of osteoblasts |
| Alcohol |
Alcohol (in above moderate amounts) works in
two ways. Firstly it suppresses the development of bone tissue - of
importance to the younger student who likes to keep up with
his rugby-playing mates in the SU bar! Also, for those of us who look backwards to
being 40, alcohol can lead to very much grater risk of a fall & a fracture |
| Lethargy |
Every time a bone is stressed, the osteoblasts
are encouraged to lay down more material (hence tennis players having
heavier racquet arms). The best time to put this exercise in is now.
In children it can lead to strong bones, in adults it leads to healthier
muscles and fewer falls. |
| Severe dieting |
Minerals & vitamins must be taken in gradually
over time. Long periods of poor supply cannot be compensated by high
levels later on. Most diets are fine as long as they are balanced -
ask your doctor or dietician if in doubt. |
Protecting yourself
Consider the following treatments:
- Healthy Diet: The key is a healthy,
balanced DAILY intake of vitamins and minerals. Calcium is present in
most dairy products and vegetables. A pint of skimmed milk will give
around 75% of your daily need. The Osteoporosis Society has a diet sheet
available over the web - rather than plagiarise this it makes sense for us to
link
to it! If you don't have MS Word installed,
let us know & we'll see if they will put it up as PDF, or we will write
our own
- Outdoor life: moderate amounts
of sunlight promote the formation of vitamin D3. Deficiency can lead to
rapid bone loss. Consider a diet that is rich in vitamin D3, e.g. Fatty
fish, cod-liver oil. Strong bones require BOTH forms of vitamin D
- Weight bearing exercise: a
moderate healthy exercise program, e.g. walking briskly for ½ hour per
day, climbing several flights of stairs instead of using the lift. Avoid
extreme exercise without medical advice as this can store up more worrying
bone problems.
- Calcium Supplements: these will not
reverse osteoporosis but can be significant in its prevention and delay. There are
literally hundreds available, many of which are of little value, check with
your pharmacist. Note - these are NOT an alternative to a good diet.
Absorption is increased in formulations that are acidified, e.g. contain betain hydrochloride. Calcium sources that simply reduce stomach acidity
are next to useless.
- Testosterone: Don't skip your
injections or reduce your dose below the doctor's recommendation. Bone
scans will give a good indication of dose rates. Remember an injection
hurts a lot less than a broken bone, and a future of injections is more
inviting that a future with severe osteoporosis.
- Drugs prescribed by your doctor: A
relatively new group of drugs, the Bisphosphonates are particularly effective
at treating osteoporosis. Another drug, Calcitonin, is currently being
investigated as a nasal spray.
Testing for Osteoporosis
- X-ray densitometry yielding a valuable t-score
- Ultrasound densitometry - a newer alternative to x-ray
- Biochemical urine tests - these are generally a lot of trouble, but a new
test NTx promises to be extremely valuable and quick as well as giving a good
indication of the aggression of the bone loss.
- REGULAR checks are the only way to monitor bone density management and if
performed every 2-5 years would give an excellent measure of the
effectiveness of treatments. However, check the
advice of our medical advisers as this may not be necessary for all.
Further Reading
Compston J (1998) Understanding Osteoporosis BMA Family Doctor Series
(usually available in your local chemist shop/pharmacy)
Note: This is an excellent booklet and should be read by all
families
Webb M, Walker M, (2000), New insights into ageing bones, Biologist,
47 (1), Institute of Biology
Visit the National
Osteoporosis Society website at www.nos.org.uk/
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