DR. HOOK- Bone up: Men can get osteoporosis too

"Sticks and stones might break my bones, but names will make me want to hurt you." Do I sound like Paula Abdul? She said in her reality TV show Hey Paula, "They're trying to break me down, but I'm a warrior." 

She's a warrior? Oh, please! If she's a warrior, I'm Conan the Barbarian. I'm guilty of watching her show because it's too juicy not to. I sat in both horror and delight wondering what other odd thing she would do or say. For the first time, I feel sorry for Simon Cowell. No wonder he's so cranky. 

When Paula had to fly on the airplane wearing jeans instead of sweats because her assistants didn't pack correctly, she acted like she'd contracted Ebola virus from her work with Idol Gives Back. Boy, I wish finding my limousine was my biggest problem.

Now, I admit I have thin skin (though I do have some calluses in the right places, so watch out!). I've always been told to get a thick skin, but no one has ever told me to get thick bones. We think osteoporosis affects only women, not men, but that's not true. What happens to men with thin bones?

Osteoporosis means that both the bone mass density and quality decrease. It's like peanuts turning into peanut brittle, like butter turning into Butterfingers, like rice turning into Rice Crispies– okay, you get the point.

Boys are made of "snips, and snails, and puppy dog tails" but also stronger bones through adolescence and puberty compared to girls. It's thought the high androgen level in boys makes bones stronger. Despite stronger bones, boys and young men have a lot more fractures than girls and young women, probably because of the all the crazy Johnny Knoxville stunts. After age 50, men start to have more fractures again– though lagging 10 years behind the rate of women. Possibly one in seven men after age 50 will have a "fragile" fracture, i.e. due to osteoporosis. 

Still, women have it worse. Men are 50 percent less likely to have a vertebral fracture or a hip fracture. Interestingly, unlike women, two thirds of men don't have pain or any symptoms from a vertebral fracture.

On the flip side, male senior citizens who experience a hip or vertebral fracture have a higher mortality rate than women. There could be many reasons to explain this fact, but there's no solid answer. Men have a nine times increased risk of death within six months. That is an 800 percent increase in the risk– it's huge! "Sticks and stones might break my bones and actually kill me."

Speaking of bad boys, half the cases of male osteoporosis result from taking steroids, from alcohol abuse, and lack of testosterone (the last not necessarily due to behavior, though being obese and out of shape can lower a man's testosterone levels). Other causes of male osteoporosis include lack of vitamin D and calcium, high thyroid, high parathyroid, and smoking. (By the way, can you believe US Open golf champion Angel Cabrera kept lighting up on the links? How can you consider golf to be a sport when you can drink beer and smoke while putting around?)

It can be fun to crack a joke, but to crack a bone is not fun. Just realize, gentlemen, osteoporosis of the spine, hip, or arm is not humerus. 

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your question.

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