Doctors at the University of Arkansas are publishing fascinating new insights into how low hormone levels in maturing men affect their bones. Here are the highlights of their research.
- Aging men and women are subject to two distinct types of bone loss mechanisms low estrogen and stress.
- Bone loss in both sexes are caused by increased osteoclastogenesis caused by estrogen deficiency. What this means is that bone cells responsible for breaking down bone so it can be replaced by new bone – is breaking down more bone than can be replaced.
- The second cause of bone loss is independent of estrogen deficiency. It is caused by oxidative stress.1
Add to this a third independent cause – the Gut Microbiota
Scientists at Emory University and Georgia State University reported that hormone deficiency increases gut permeability (the ability of harmful lipids and other cells to pass through the gut wall into the rest of the body) and the production of osteoclastogenic cytokines (cells that send messages to increase bone destruction through inflammation.)
So in recap – hormone deficiency increases gut inflammation which sends inflammatory messages to the bone marrow to break down bone.
How is this for a summary of this research:
- “treatment with probiotics prevents the increase in gut permeability, the production of intestinal and bone marrow cytokines, and the bone loss induced by sex steroid (hormone) depletion.2
More on this subject Probiotics and potassium salts may prevent bone loss and disease.
Bone loss and osteoporosis
In treating bone loss and osteoporosis at the Magaziner Center for Wellness, we look closely at each patient’s diet and lifestyle and work with her/him to make any necessary modifications.
For instance, if we see that a patient is consuming too much red meat and or sugar, we help her/him move toward a plant-based eating plan; if we see excessive smoking and alcohol use, we work to identify healthy strategies for stress relief, including physical activity that emphasizes weight-bearing and resistance exercises, both of which can reduce the likelihood of bone fractures in people with osteoporosis. We also consider the patient’s use of antacids, as chronic use can increase the levels of acidity in the body. When there is too much acid in the body, it draws the calcium needed to neutralize that acid from the bones, thereby preventing the bones from being adequately strengthened.
We have found that many with osteoporosis have insulin resistance. As a result, we do a thorough evaluation regarding lipid balance, and insulin and glucose metabolism and treat these areas accordingly.
Additionally, we assess for appropriate digestion and assimilation to be sure that a patient can properly break down and utilize the nutrients in their food.
Where necessary, we use nutritional supplements, namely vitamin D and calcium, to ensure that patients are getting the vitamins and, especially, the minerals, needed to keep bones healthy and strong, longer. These include zinc, copper. silica, manganese and magnesium.
Estrogen, progesterone and testosterone – a focus on the men
We assess levels of estrogen, progesterone and testosterone and, if necessary, we replace these hormones using bio-identical hormones – hormones that have a chemical structure identical to the hormones that the human body naturally produces.
Doctors have suggested a connection between testosterone and estrogen and bone health in aging men. Writing in the journal Bone and Mineral Research, doctors say that estrogen is the dominant regulator of bone metabolism in men and that a legitimate argument can be made that testosterone is largely a prohormone (a building block precursor) for the male skeleton, with its effects on bone mediated principally via aromatization (synthesis) to estrogen.3
What does all that mean? It is another example that the balance of hormones in men is equally as challenging to that in women. In the example above the challenges of balancing estrogen and providing enough testosterone in men to help build and maintain bone is highlighted.
Male osteoporosis is a health problem which deserves more attention as nearly 30% of osteoporotic fractures happen in men aged 50 years and above.
- Observations from epidemiological studies indicate that elderly men with higher testosterone can preserve their Bone Mass Density better and thus are less prone to fracture.
- Observations on men with estrogen resistance or aromatase deficiency indicate that estrogen is equally important in the maintenance of bone health status.
This had been validated in several epidemiological studies which found that the relationships between estrogen and bone health indices are significant and sometimes stronger than testosterone.
Doctors writing in the International Journal of Endocrinology wrote “both testosterone and estrogen are important in the maintenance of bone health in men.”4
Many men who consult us as patients are surprised to find that we want to talk to them about their estrogen levels.after all, isn’t estrogen a “female” hormone? Listen to what the medical literature has to say about estrogen, the aging man, and bone health.
- Seijiro Mori of Tokyo Metropolitan Geriatric Hospital published research in support saying: “it has been proved that estrogen plays an important role in maintaining bone mass in men.” 5
- Doctors at the University of Gothenburg wrote,”Even though estradiol has been considered the ‘female hormone’, levels of serum estradiol in elderly men are higher than those in postmenopausal women. Estradiol levels are more strongly associated with bone mass density, bone turnover and bone loss than testosterone levels are in adult men…” 6
- Doctors at the US Veterans Affairs Medical Center also confirmed that older men with total testosterone or estradiol deficiency were more likely to be osteoporotic. 7
So Estrogen plays an important role in preventing bone weakening and osteoporosis in men, especially in men over 70.
For more on this subject see our article on hormone replacement therapy helping patients avoid joint replacement revision surgery due to bone loss.
Do you have questions about bone loss?
Call US 856-424-8222 OR email us at: info@DrMagaziner.com
1 Ucer S, Iyer S, Kim HN, et al. The Effects of Aging and Sex Steroid Deficiency on the Murine Skeleton Are Independent and Mechanistically Distinct. J Bone Miner Res. 2016 Oct 7. doi: 10.1002/jbmr.3014.
2 Li J-Y, Chassaing B, Tyagi AM, et al. Sex steroid deficiency–associated bone loss is microbiota dependent and prevented by probiotics. The Journal of Clinical Investigation. 2016;126(6):2049-2063. doi:10.1172/JCI86062.
3. Khosla S.Commentary: New Insights Into Androgen and Estrogen Receptor Regulation of the Male Skeleton. J Bone Miner Res. 2015 Apr 9. doi: 10.1002/jbmr.2529.
4. Chin KY, Ima-Nirwana S. Sex steroids and bone health status in men. Int J Endocrinol. 2012;2012:208719. doi: 10.1155/2012/208719. Epub 2012 Oct 24.
5. Mori S. [Bone and Men’s Health. Male osteoporosis]. Clin Calcium. 2010 Feb;20(2):182-8.
6. Vandenput L, Ohlsson C. Estrogens as regulators of bone health in men. Nat Rev Endocrinol. 2009 Aug;5(8):437-43. Epub 2009 Jun 16.
7. Fink HA, Ewing SK, Ensrud KE, Barrett-Connor E, Taylor BC, Cauley JA, Orwoll ES. Association of Testosterone and Estradiol Deficiency with Osteoporosis and Rapid Bone Loss in Older Men. J Clin Endocrinol Metab. 2006 Jul 18