How to Protect Your Bones (Low Testosterone)

How to Protect Your Bones (Low Testosterone)

When testosterone levels drop, your bones can pay the price. While it’s often associated with women, osteoporosis — a condition characterized by weakened bones and an increased risk for fractures — affects up to 2 million men in the United States, according to the American Academy of Family Physicians. “Testosterone deficiency has been shown to be a cause of osteoporosis in men,” says Aaron C. Lentz, MD, an assistant professor of surgery at the Duke University School of Medicine and a urologist in Raleigh, N.C. In addition, as you age, the risk of fracture increases. “In our lifetime, our bones are constantly changing,” says Aram Mouzeyan, MD, an endocrinologist with Kaiser Permanente in Southern California. New bone growth replaces old bones as you age, but low testosterone affects the rebuilding process. “The lower the level of testosterone, the lower the rebuilding of the bones, which may lead to low bone density and osteoporosis,” he says.

To protect yourself, brush up on bone health and follow these tips to be strong inside and out:

Hit the gym. Exercise not only gives you strong muscles; it can also contribute to strong bones. Focus on weight-bearing exercises — activities done standing — because they strengthen your bones as you work out. So, at least three days a week, go for a hike, walk, or jog; play basketball or racquet sports; or lift weights. Shoot for more than 30 minutes a day for optimal bone health. A study published in the Journal of the American Geriatric Society in 2013 found that men with fewer than 33 minutes a day of moderate activity were 70 percent more likely to break a bone in a fall than those who exercised more.

Follow a bone-healthy diet.
Focus on a calcium-rich diet for better bone health. The National Institutes of Health (NIH) state that men over age 50 need 1000 milligrams of calcium every day. “The best way to meet your calcium and vitamin D needs is through your food,” Dr. Mouzeyan says. Focus on dairy products, green vegetables (especially broccoli, collard greens, and kale), canned sardines with bones, and calcium-fortified foods such as oatmeal, breads, and cereals to get needed calcium. Mouzeyan also suggests limiting salt and caffeine as they can negatively affect bone health.

Get more vitamin D.
Also known as “the sunshine vitamin,” vitamin D helps your body absorb calcium and build stronger bone, and sunlight is one of the best sources. “Sun exposure of 10 to 15 minutes a day is a good way to allow the body to make its own vitamin D,” Mouzeyan says.  You can also get some vitamin D by eating fatty, wild-caught fish such as tuna, salmon, and mackerel. Choose vitamin D-fortified foods such as milk, orange juice, and some cereals. The National Osteoporosis Foundation recommends a daily intake of about 400 international units — if that's not possible from sunlight and food, consider a supplement.

Avoid too much alcohol.
Though it’s not exactly understood how alcohol affects bone health, the NIH notes that heavy alcohol consumption appears to impact the formation of bone cells. Additionally, “alcohol intake is associated with malnutrition, which further deteriorates bone health,” says Monti Khatod, MD, an orthopedic surgeon with Kaiser Permanente in Southern California. “Limiting alcohol and maintaining a healthy diet can improve bone health.” Men should have no more than two alcoholic beverages a day, the NIH recommends.

Snuff out smoking.
Better bone health is yet another reason to quit smoking if you're still lighting up. “The ingredients in tobacco cigarettes are toxic to bone health and the cells that help bone turn-over,” Dr. Khatod explains. “Smoking will increase the natural loss of activity of these cells that occurs with age.” If you smoke, talk to your doctor about smoking cessation resources to help improve your odds of quitting for good.

Watch your weight.
A healthy body weight means lower risk for many chronic health conditions. What’s more, a review of research published in Clinical Cases in Mineral and Bone Metabolism in 2014 cited several studies that found that obesity increased the risk for fracture. The relationship between body weight and osteoporosis risk is less established, but there’s no question that being at a healthy weight is better for your overall health. If you’re overweight, talk to your doctor about how to make diet and exercise changes that will help you protect your health.

Talk to your doctor about testosterone replacement therapy.
For some men with low testosterone, testosterone replacement therapy may help protect bone health. “Testosterone replacement has been demonstrated to increase bone mass density in men with low testosterone, but whether it can protect against fractures has not been documented,” Dr. Lentz says. However, testosterone replacement therapy is not right for everyone with low testosterone, so talk to your doctor about whether treatment is appropriate for you.

Commit to your treatment plan.
If you have low testosterone and know that you’re at risk for osteoporosis, work closely with your doctor to protect your bone health. That means regular bone density screenings and taking medications as directed, possibly including those that help prevent osteoporosis. “Patients with osteoporosis may be treated by a variety of drugs that are shown to reduce the risk of fractures,” Khatod says.

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