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Testosterone and Osteoporosis

A very common illness that comes with age, osteoporosis is the weakening of the bones. Specifically, it is when the honeycomb structure of the bone (trabecular bone) becomes more sparse, and there is literally less mass in each bone. This is a serious issue because it limits mobility and severely increases the risk of breaking bones due to their increased fragility. This decrease of bone mass is caused by one of two reasons (or possibly both): bone is being destroyed, or not enough bone is being made. To better understand how this works, there are two cells that need to be explained: osteoblasts and osteoclasts. Osteoblasts are involved in bone formation, while osteoclasts destroy bone tissue. 

Over half of people aged 50 and above either have osteoporosis or below average bone mass and density. Thus, if you are over 50 and have broken a bone, or are noticing stooped posture and back pain, it is important to get your bone density checked. While age is a major risk factor in developing osteoarthritis, there are others to take note of. Certain diseases, such as celiac disease, cancer, and rheumatoid arthritis, may increase one’s risk of developing osteoporosis. Gender, body frame, hormone imbalances, diet, and lifestyle are all factors that affect the risk of osteoporosis (eg. females are more likely, low calcium and sedentary lifestyle increases risk). 

Most people know testosterone as the ‘male hormone’, as opposed to estrogen for females. However, it has been shown to have a significant effect on the body’s bone density. As mentioned before, hormone imbalance is a significant risk factor for osteoporosis. Specifically, the decline in testosterone with age has been linked with bone loss. Osteoblasts, osteoclasts, and osteocytes all have androgen receptors, meaning that testosterone has an important role in the control of bone metabolism. Further, blocking these receptors has shown a significant decrease in bone quality and increased fracture risk. 

After establishing that testosterone is linked to better bones, how can this be used in a treatment? Testosterone replacement therapy for those suffering from hypogonadism can be practiced in multiple ways, the most popular being injections and skin patches. There are testosterone pills but these have been noted to impact liver function in some cases. Testosterone therapy has some possible risks, such as cardiac or hepatic dysfunction, and increased risk of prostate cancer. In general, it’s important to get checked up regularly while on therapy to make sure that no issues develop. You should notify your physician about any underlying conditions before starting testosterone therapy.

If you have any questions about this treatment, or want to schedule an appointment, call our office at (609) 587-9944 or e-mail us at info@sleep-wellness.org.

Tirtho Banerjee 

Tirtho Banerjee is a Johns Hopkins undergraduate studying to become a doctor. He believes medicine should be available to everyone and hopes that educating the public is the first step to realizing that.

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