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Osteoporosis overlooked in men

WASHINGTON – Osteoporosis is not just a disease for mom and grandma. Men can get it too.

“I think we underestimate the prevalence of osteoporosis in men,” says Dr. Assil Saleh with Foxhall Internists in D.C. “It is an overlooked problem and under-diagnosed. And it is actually becoming an important public health issue as our population is aging.”

While post-menopausal women still make up the bulk of patients with osteoporosis, the condition is becoming more and more common in men, particularly those older than 65.

An estimated two million American men have the disease and another 12 million are at risk, according to the National Osteoporosis Foundation.

Some have underlying health conditions, such as problems with joints or tendons, low testosterone, or conditions that require prolonged treatment with medications that can affect bone mass. But the lifestyle choices men make while they are young can have a big impact on bone health decades later.

The National Institutes of Health says alcohol abuse can affect bone density, as can smoking and a lack of exercise.

Saleh, who is both a rheumatologist and an internist, says the most important thing young men can do to prevent osteoporosis as they age “is to exercise and keep active throughout their adult life.”

She says getting enough vitamin D is also important.

The NIH recommends 600 IU (international units) a day before age 70, and 800 IU daily for men older than 70 — the same as for women. Calcium intake is also fairly similar — 1,000 mg a day for most adults, rising to 1,200 mg daily for women at 51 and for men at 70.

Screening is likely to be more intense for women, starting with a baseline bone scan similar to an X-ray at the onset of menopause. Men are less likely to get a bone scan until after they suffer a fracture.

That is what happened with Saleh’s own father, who was diagnosed with osteoporosis 10 years ago after he broke a bone.

“I was surprised because osteoporosis in men was not really on my radar screen at the time — even as a physician, even as a rheumatologist in training,” she says.

Saleh says her father’s diagnosis made her more aware of the problem and these days, she is vigilant when it comes to screening her patients for risk factors.

As for her dad, the proud daughter and physician says he is doing well. Like many elderly men with osteoporosis, he is taking a prescription medication originally developed just for women to prevent fractures and further bone loss.

Not all drugs for osteoporosis are cleared for use by both sexes. But the four that have been approved for men include some of the most popular brand name medications for the disease: Fossomax and Actonel.

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Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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