Why does a 44yo man have osteoporosis? The doctors haven't figured it out yet, but I'm borderline between osteoporosis and osteopenia. I was diagnosed a few months ago, and it depends where they look. I'm not postmenopausal woman, so it's a bit strange.

It was first noticed in the spring from an x-ray, when I banged my toe on our furniture and Dolly insisted that I get it x-rayed, in case I broke it, not that anything could be done about a break. That x-ray showed low bone density in my right big toe (the same one I banged this week). Because of that observation by the radiologist, my doctor suggested having a heel scan done. A heel scan is an ultrasound, done as a first screening method for osteoporosis. After that, I had a bone density scan, which is a dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry, to get an assessment of bone mineral density (BMD). Both of those showed osteoporosis. Then came a bank of blood tests, which showed nothing out of the ordinary.

One theory is that I never developed the normal male bone density in my younger decades and, since BMD decreases with age, time is doing its thing and has caught up with me. When I was a child, my parents bought non-fat dry milk powder and we didn't drink too much of that.

The other theory, which may play into the first theory, is that the nasal corticosteroids that I have been using for many years have caused corticosteroid-induced osteoporosis. CIO normally only happens with people taking the oral version.

To check the first, my rheumatologist is supposed to have my x-rays reviewed and see if the bone density has decreased recently or if it has been an issue as far back as the record shows.

In the mean time, I'm supposed to get more blood and urine analysis work done. I'm home today because I have to do a 24-hour urine collection. I don't want to take the collection jug to work and put it in the refrigerator there.

Since the diagnosis, I have been eating much more dairy than before, because I'm supposed to get at least 1200mg of calcium a day. Cheese, yoghurt, cottage cheese, or milk with every meal, plus a calcium supplement. Then there's almonds, etc. One thing I didn't know is that it does no good to ingest more than 500mg of Ca at a time, because our bodies can't absorb more than that at once.

I have also shifted my exercise. I don't practice much yoga any more and should probably reduce the tai chi too, in favor of practicing more karate (i.e., Shorinji Kempo), which I took up after the diagnosis. I also dug out the dumbbells and have been doing some work with those. The rheumatologist was disappointed to hear I had stopped doing yoga because it has other benefits.

From the osteoporosis perspective there are three types of exercise: weight bearing, low-weight bearing and non-weight bearing. Weight bearing exercises are things like running, stair climbing, basketball, and tennis. Another type of weight-bearing includes lifting weights (including your body) or using elastic bands or weight machines. Low-weight bearing are elliptical-training machines, stair machines, and walking. Non-weight bearing are yoga, pilates, biking, swimming, etc. The latter are useful because they help with strengthening, balance, and posture, but they are not directly bone-strengthening exercises. Some of this info comes from the National Osteoporosis Foundation (https://www.nof.org).

I was surprised by yoga's classification because the standing poses work the legs and others (e.g., four-limbed staff pose) work the arms.

In a year or so, I'll be re-evaluated to see if there's any improvement.