Glucocorticoids are often used in the treatment of a variety of inflammatory, autoimmune and neoplastic diseases such as arthritis, asthma and inflammatory bowel diseases. The most common glucocorticoids consist of prednisone, methylprednisolone and dexamethasone. Although these medications have many benefits, they are the number one cause of secondary osteoporosis.[1] Recently, the International Osteoporosis Foundation released a study describing the connection between glucocorticoids and osteoporosis.
Osteoporosis is a condition that results in the thinning of bone tissue and loss of bone density over time. The International Osteoporosis Foundation warns that precautions must be taken to reduce the risk of osteoporosis for individuals on long-term oral glucocorticoid therapy. Glucocorticoids taken orally or intravenously are at a higher risk.
Debra Sietsema, Ph.D., R.N. at Orthopaedic Associates of Michigan states “taking steroids (glucocorticoids) is one of many risk factors for bone loss. Generally, those at risk take 3mg or greater of oral steroids for more than three consecutive months. The higher the dose and longer the treatment leads to a higher risk of broken bones.” Dr. Sietsema recommends that those at risk from taking steroids should ask their health care provider for:
- Bone health risk assessment, including a FRAX score
- Height measurements every year
- Bone density scan (DXA) with spine (vertebral) fracture assessment
- Review of needed calcium and vitamin D supplements
- Discuss other ways to improve bone health
It is important to speak with your doctor about the risks of long-term glucocorticoid use, and to weigh all options before determining a course of treatment, as each individual situation is different.
If you have concerns about osteoporosis or other medical effects of glucocorticoids and similar medication, please schedule an appointment with your OAM doc to discuss the best option for you. You can reach our office at 616-459-7101.
Sources:
[1] Cleveland Clinic Journal of Medicine
International Osteoporosis Foundation
