By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Men are doers. They build. They fix. They defend, compete, achieve, and provide. Action is the name of their game.
But see a doctor when something doesn’t feel right? Not so much.
Men’s Health Problems
That observation is not just mine. Men have a well-known reputation for procrastinating when it comes to health, and an unfortunate tendency to not seek help until their symptoms are significant.
Rick Kellerman, M.D., a former president of the American Academy of Family Physicians, said it best following the organization’s 2007 survey on men’s health: “One of the biggest obstacles to improving the health of men is men themselves.”
Whether due to busy schedules, denial, fear, or cultural expectations to “tough it out,” men’s reluctance to be proactive about their health does them no favors. More than 34 percent of men over age 20 are obese, and 32 percent have high blood pressure. At least 12 percent of men 18 and older are considered to be in fair to poor overall health, according to the U.S. Centers for Disease Control.
Health Checks for Men
To all men, I say this: It’s far easier to prevent health problems (or to address them when they’re small) than it is to deal with the consequences of letting them go—an ordeal that may well involve a trip to the emergency room or a hospital stay.
Make time on a regular basis to get yourself checked out, especially if you’re over 50. Here are the five areas to focus on.
Essential Medical Tests for Men Over 50
Test #1: Metabolic Syndrome
While awareness of metabolic syndrome is growing, many men remain in the dark about their risk—namely because none of the physiological, biochemical, and metabolic conditions that comprise metabolic syndrome will make them feel like something is wrong. Yet the problem exists at epidemic levels and significantly increases the likelihood of developing diabetes and cardiovascular disease, making it one of the top men’s health problems.
To identify metabolic syndrome, doctors look at several co-occurring factors:
- Weight and waist circumference. Men who are overweight and have a belt size of 40 inches or more, may have metabolic syndrome.
- Blood glucose. When measuring blood sugar (glucose), doctors look at two numbers. The first is the fasting blood glucose—a measure of how much glucose is in the blood at the time of the blood draw. The other is glycohemoglobin, or as it’s more commonly known, HbA1c. The HbA1c is an effective indicator of the average glucose level over several months. A normal HbA1c level is below 5.7 percent; pre-diabetes below 6.4; and diabetes 6.5 and above.
- Blood lipids, specifically HDL cholesterol and triglycerides. In men with metabolic syndrome, levels of HDL cholesterol tend to be low, and levels of triglycerides high. Both of these factors contribute to systemic inflammation and together are one reason why metabolic syndrome raises cardiovascular risk so dramatically. Ideally, your ratio of triglycerides to HDL should be no more than two-to-one. For example, if your triglycerides are 100 and your HDL is 50, the ratio between the two is a healthy 2:1. On the other hand, if your triglycerides are 200 and your HDL is only 40, the ratio is 5:1—a red flag.
- Blood pressure. Known as a “silent killer,” high blood pressure has no symptoms. In fact, most people never realize they have a problem until a reading at a routine doctor visit is elevated. For best health, blood pressure should be no higher than 120/80. Readings higher than 120/80 contribute to metabolic syndrome. If you have higher numbers, you can usually lower them by practicing healthy lifestyle habits.
To quickly summarize, that extra weight around the middle may be a sign of more than middle age – especially when accompanied by higher blood sugar, blood pressure, and triglycerides, and lower HDL cholesterol. Get checked for metabolic syndrome to make sure you’re not unknowingly putting your health at risk.
How often to monitor: Annually, as part of a routine physical.
Test #2: Prostate Exam
If you want to single out one reason why many men avoid the doctor, the prostate exam may be it. Uncomfortable though it may be, it’s a necessary part of managing health as men grow older. Again, a prostate health screening involves looking at a couple different things:
The digital rectal exam helps doctors find lumps or abnormalities, and to determine the size of the prostate. Prostate enlargement and inflammation of the prostate are common in older men and can cause difficulty urinating and/or the need to urinate more frequently. Always report any changes you notice to your doctor.
A second prostate-related test that every many should have is the prostate-specific antigen, or PSA, test. This test—which is a simple and noninvasive blood test—screens for cancer. When cancer begins forming in the prostate, the gland produces a protein called, appropriately, PSA. Elevated PSA levels may indicate an active tumor.
PSA tests have saved many lives; however, I recommend caution in responding to the results because these tests also have been known to produce false results, both positive and negative. The greatest value of a PSA test, in my opinion, is in monitoring results over several years. (Another reason for regular checkups!) A gradual upward trend in results often reflects nothing more than normal aging. A sudden spike, on the other hand, may warrant more aggressive diagnostic testing.
How often to monitor: If you’ve never had a PSA test, get one to establish your “baseline.” Then monitor annually for changes.
Test #3: Eye Exam
When you think about medical tests, an eye exam may not spring to mind—but good sight is an important and overlooked (pun intended) aspect of health. Environmental toxins, increasing amounts of “screen time,” and normal age-related eye problems earn routine eye exams a place on this list.
How often to monitor: If you don’t have medical conditions affecting your eyes, such as glaucoma or macular degeneration, seeing an optometrist every couple years is adequate. If you have more serious vision concerns—or a family history of vision loss—follow the recommendations of your ophthalmologist (eye specialist), as early detection and treatment can make a big difference in preserving sight.
Test #4: Dental Exam
Some recent reviews may be trying to walk back the long-time belief that periodontal disease increases risk for heart attack and stroke, but I’m sticking to my guns. The inflammation and bacteria associated with gum disease may be concentrated in the mouth, but I believe they can have a more systemic impact—particularly given the condition’s chronic inflammatory nature.
Half of American adults have some degree of periodontal disease. See your dentist regularly; this is one heart risk factor that is easily avoidable. Plus, the cosmetic benefits can help keep you looking young and vibrant.
How often to monitor: One or two yearly cleanings, with additional care as recommended by your dentist.
While this is not an absolute must-have test in my book, I put it on the list because colorectal cancer remains a leading cause of death in the United States for both men and women.
In 2015, Canadian researchers found that colonoscopies may not be the fail-safe that we once believed they were, but they still can be useful in identifying and removing abnormal growths before they become dangerous. Regular screening may also help find colorectal cancer at an early stage, when treatment is most effective.
How often to monitor: If your first procedure shows no abnormalities and you have no unique risk factors such as family history, have this procedure every 10 years and follow these eight recommendations to reduce colon cancer risk. If you are at increased risk for colorectal cancer or your initial colonoscopy discovers problems, follow the advice of your doctor.
What To Do About Symptoms Your Doctor Can’t Solve
As you begin paying closer attention to how you feel day to day, you may notice symptoms that your conventional doctors can’t explain. For such issues I suggest consulting with a naturopath, chiropractor, or a physician trained in environmental medicine. These alternative practitioners have the diagnostic skills that often lead them to find the root causes of illness that other doctors cannot.
- American Academy of Family Physicians, 2007 Men’s Health Study, published online at http://www.aafp.org/dam/AAFP/documents/media_center/men-prevention/final_executive_summary_061307.pdf
- Centers for Disease Control and Prevention (CDC): Men’s Health, CDC.org, accessed June 1, 2018.
- Centers for Disease Control and Prevention (CDC): Half of American Adults Have Periodontal Disease, 2014, American Academy of Periodontology, published online at http://www.perio.org/consumer/cdc-study.htm
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention: Fast Stats, Men’s Health. (2014). http://www.cdc.gov/nchs/fastats/mens-health.htm. Accessed May 24, 2016.
- National Institutes of Health, National Cancer Institute: SEER Stat Fact Sheets: Colon and Rectum Cancer. http://seer.cancer.gov/statfacts/html/colorect.html Accessed May 24, 2016.
- N.N. Baxter, M.A. Goldwasser, L.F. Paszat, R. Saskin, D.R. Urbach, and L. Rabeneck. “Association of Colonoscopy and Death From Colorectal Cancer.” Ann Intern Med. 2009 Jan 6;150(1):1-8. Epub 2008 Dec 15.
- S.T. Sinatra. “8 Ways to Avoid Colorectal Cancer.” http://www.drsinatra.com/8-ways-to-avoid-colorectal-cancer-1/ Accessed May 24, 2016
- U.S. Department of Health and Human Services, U.S. Centers for Disease Control and Prevention, and National Center for Health Statistics: Health, United States, 2015. (2016). http://www.cdc.gov/nchs/data/hus/hus15.pdf Accessed May 24, 2016.
- U.S. Department of Health and Human Services, U.S. Centers for Disease Control and Prevention, and National Center for Health Statistics: Summary Health Statistics: National Health Interview Survey, 2014. (2015). http://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2014_SHS_Table_A-11.pdf Accessed May 24, 2016.
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