XXY: Osteoporosis

I've written quite a bit about osteoporosis... but I'll go over it again here, this is a cross post from another site. Invariably people have questions about this, and there is so little written on the topic specifically applying to Klinefelter's Syndrome. It galls me that doctors are the source of most of the mis-information concerning osteoporosis. Know the facts before meeting a doctor, you might just save your own life.

The mechanism in biology that is called osteopenia and osteoporosis consists of losing bone faster than it is replaced. To understand whats happening you have to understand how you gain bone in the first place. The body takes calcium, vitamin D, trace minerals like manganese, and using progesterone does a series of chemical conversions to create osteoblasts (new bone structure), which is then attached to existing bone. The second part of this mechanism we have to understand that bone structure does not last forever, and the body has a process to break down old bone structure, this process works faster in the absence of estradiol (higher the estradiol the more bone retained). We can say that at no point in the process of building new bone or removing old bone does the body require testosterone, ie.. testosterone is not required at all. For some reason this common misunderstanding that high testosterone is required to stop osteoporosis continues, probably because it is easier than to tell males that if they have enough testosterone then their body will naturally convert some into estradiol.

The basics of osteoporosis and hormones:
You need progresterone to make new bone.
You need estradiol to prevent the wasting away of bone.
Testosterone has nothing at all to do with bone.

Vitamins and Minerals needed for bone health:
Calcium 1400 mg daily.
Vitamin D 1000 UI daily.
Manganese (take a multi-vitamin, you need an incredibly small amount).

So about Vitamin D... the experts really don't have a clue how much you need. Until 2007 they assumed that 400 UI was enough because 60 years of studies showed it was enough to eliminate rickets. But gasp in 2007 the new target became 1000 UI. I personally take 2000 UI, and thats probably closer to the target. I would not be surprised if in 10 years from now, circa 2020 the new target for Vitamin D is closer to 10,000 UI daily. For all the concern about UV caused cancer, we need sunlight exposure or some form of UVB replacement. A white skinned person gains 10,000 UI of vitamin D in about 10 minutes of full body exposure to sunlight near the topics.

Estrogen Blockers:
Be very careful with these, since blocking your estradiol is perhaps one of the most dangerous things you can do. The lack of estradiol causes bone wasting, ie.. osteoporosis.

What you can do:
1. Get your hormones balanced. I don't care if you choose male, female, neither, both, or whatever.
2. Do weight bearing exercise for at least 3 hours every week.
3. Get a balanced diet of foods, and take vitamins.
4. Avoid smoking.
5. Get a normal level of 5 hours per week of basic stamina building exercise, like walking 3.5 miles in an hour.

So what does Klinefelter's Syndrome have to do with Osteoporosis...
If you are XXY, and lead a sedentary life you will get osteoporosis, if you lead an active life and have a bad diet you will get osteoporosis. Be aware of this, and get healthy. Unlike the average population we are at risk for osteoporosis from childhood if we are sedentary.

Testing for osteoporosis:
Dexa Scan will determine the level of relative bone structure that exists.
Low progesterone is an indicator of many problems.
Low estradiol is an indicator of bone loss.

If after a dexa scan that is positive for osteopenia or osteoporosis your doctor does not test you for progesterone and estradiol then you have a problem and need a better doctor. Unfortunately most doctors are ill-equipped to provide treatment for people with Klinefelter's Syndrome, so you have to protect yourself.

XXY: Maintaining Good Health through Walking

From personal experience jogging is too harsh on the body, especially the out of shape or overweight body, and lifting weights alone doesn't lose weight. Cardio exercise is what helps people to lose weight, and most serious fitness people include an element of cardio in their workouts for this reason. There is a misconception, mostly among men, that working out to lose weight means going to a gym and lifting weights. While it is true that increasing muscle will help the body to burn more fat, the benefit pales next to the action of doing a cardio workout. If you are just starting out to lose weight, start with the cardio and work forwards.

Cardio (weight loss):
I recommend simply walking at a hastened pace for as long as you can and gradually work that up to 1 hour. Your target speed is 3.5 miles per hour, and about 5 kilometers. If you're using a jogging machine, skip all of the uphill/downhill/fancy options and set a hastened pace and walk. Make sure you drink plenty of water.

A second option is swimming laps. Hop in a pool setup for lap swimming, do a front crawl (nothing fancy..) and swim as far as you can at a slightly hastened pace. Your target is to develop the ability to swim for 1 hour at a hastened pace.

Second requirement for losing weight:
Eat healthy. That means Mediterranean diet and no fast food. A Mediterranean diet consists of 2/3rds vegetables, few or very minimal sauces, some fruits and nuts, and very small amounts of meats, breads, or pasta's. No sugars or oils. And limited amounts of dairy products. If you cannot tolerate, like some people cannot eat/drink dairy then find a normal substitute. Avoid manufactured foods.

Lastly drink lots of water....People have suggested its possible to drink too much, and yes technically it is possible but its extremely unlikely that anyone who isn't running marathons will ever reach the point of too much water. It is really hard to force yourself to drink too much water, without first forcing your endurance far beyond the limits. By the time you have worked a physical regimen to the point where you have achieved sufficient physical fitness to push to the limits (this isn't possible at the start) then you will understand this better. For now, don't worry about it.

Here's the fun part of cardio for an hour at a hastened pace. When you're done, right after finishing, you should immediately drink a beverage that will restore electrolytes. My personal favorite is about a pint sized portion of chocolate milk (about 6 oz or less). A small energy drink is also acceptable, provided it is not loaded with caffeine. This should have some sugar, salts, and potassium. This burst of sugar is your reward for success, and the electrolytes will help your body recover from the stress of exercising. When it is available I like to make a blue berry and vanilla yogurt sundae, as my treat (again, limited to 6 oz or less).