All men with osteoporosis should be given lifestyle advice on how to decrease bone loss. This advice should include adequate caloric intake and calcium and vitamin D, 30 minutes of appropriate daily weight-bearing exercise, stopping smoking and reducing alcohol intake. If there is a history of falls, attempts should be made to identify why the person has been falling and ensure any trip hazards in their home are taken away.
A pair of walking shoes should be worn inside the house to give maximum support, as many slippers give no support. Open back slippers or sandals are not recommended along with walking in bare feet or in socks in your home.
All treatments should be prescribed on an individual basis. Any underlying cause/s of osteoporosis should be investigated and addressed; NOT assumed.
Extensive blood tests should be done before starting any Osteoporosis treatment. The following tests we consider to be essential; Testosterone levels, PTH, Vitamin D, calcium, Kidney function, Cortisol and bone turnover markers. If there is a marked reduction in the level of male hormone in a young patient, then treatment with replacement male hormone testosterone may be appropriate.
Note: Patients on steroids or on certain immuno-suppressant therapy for cancer or aromatase inhibitors, should have a DXA scan and they should be treated proactively to prevent fractures occurring. They need to be taking calcium, Vitamin D3 and protein, preferably from food. Depending on their DXA scan results, causes of bone loss and medical history, will depend on which Osteoporosis medication is the most appropriate for them. Appropriate weight-bearing exercise is essential, and they should be monitored by repeat DXA scans, minimum every two years.