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.