Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Osteoporosis (or porous bone) is a disease in which bones become weak and are more likely to break. Without prevention or treatment, osteoporosis can progress without pain or symptoms until a bone breaks (fractures). Fractures commonly occur in the hip, spine, and wrist. Osteoporosis is the underlying cause of more than 1.5 million fractures annually (300,000 hip fractures, approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures in other areas). The estimated national cost (hospitals and nursing homes) for osteoporosis and related injuries is $14 billion each year in the United States.
Although women are more likely to get osteoporosis, it is not just a disease of elderly women. Osteoporosis is more common in white or Asian women older than 50 years
of age, but osteoporosis can occur in almost any person at any age. In fact, more than 2 million American men have osteoporosis and 12 million are at risk. Many people who have osteoporosis and risk factors for osteoporosis often do not know they have thin or weak bones. This is because most patients with osteoporosis have no
symptoms and are not aware of their weak bones until they have an unexpected fracture. For example, a simple everyday movement such as picking up a grocery bag causes a broken bone or a slip and fall in a parking lot causes a broken hip, and that is their first "symptom of osteoporosis."
Osteoporosis is often not recognized in men. There are many reasons for underdiagnosis in men. Identifying risk factors is important because osteoporosis and fractures can be prevented and treated. Also, men have a higher mortality rate due to hip, vertebral, and other major fractures.
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A man's average bone mineral density (BMD) is higher than a woman's, and men have a lower risk for osteoporosis. All men, though, naturally lose bone mass as they age, and some men do develop osteoporosis, which can be devastating to an older man's health. Men who fracture a bone in their spine have a much greater risk of getting other fractures and losing their mobility.
Most men develop osteoporosis as a result of:
Smoking, which increases the rate of bone loss.
Not getting enough weight-bearing exercise.
Taking certain medicines, such as corticosteroids (for example, prednisone).
Having low levels of the male hormone testosterone.