MARTIN NYDICK, MD: Yes, exactly. They may think that they have lactase deficiency, which is a very common thing where we can't absorb the lactose in milk, but they may actually have a low-grade form of sprue, which is an intestinal inflammation that can cause malabsorption of various nutrients. I see quite a few patients with that. So we're always looking for a secondary cause, just to be sure that we aren't missing something before we take it for granted that it's just postmenopausal.
LISA CLARK: Now one of the things that surprised me when I read it, one of the medications that might be a suspect are antacids that contain aluminum. Now, you see a lot of antacids marketed as calcium sources, but there's a specific type that may actually cause a calcium depletion?
MARTIN NYDICK, MD: Yes. Aluminum is actually a poison to the bones, particularly in people with renal disease. We used to see this when we used a lot of aluminum in the dialysis fluid. These people can get severe bone disease. In normal people who don't have renal disease, it probably isn't a factor unless they're taking very large amounts of aluminum-containing antacids.
LISA CLARK: Now are the secondary causes of osteoporosis more common in certain groups of people? Are there certain patients who will come in with possible osteoporosis and you would say they're suspects?
MARTIN NYDICK, MD: Because estrogen deficiency isn't a problem in men, in men we see more secondary causes of osteoporosis.
LISA CLARK: That's logical.
MARTIN NYDICK, MD: Perhaps 50 percent of the men who have osteoporosis tend to have a secondary cause, so we will always look much more deeply in those men.
LISA CLARK: Do you find male patients resistant to the notion that they might have osteoporosis because it's believed to be a disease that affects elderly women more often?
MARTIN NYDICK, MD: Absolutely, absolutely. Just the other day, I was seeing a woman with osteoporosis and she came in with her little husband, who was all bent over, and I said, "You should have a bone density," and he refused.
LISA CLARK: Very interesting. But it never hurts to talk to your doctor, no matter what your gender or your age?
MARTIN NYDICK, MD: That's right.
LISA CLARK: Thank you so much for being with us, Dr. Nydick. We appreciate your time.
MARTIN NYDICK, MD: Thanks for inviting me.