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What Is the Relationship between Corticosteroids and Osteoporosis?

By Lee Johnson
Updated May 17, 2024
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The relationship between corticosteroids and osteoporosis is that long-term use can cause the condition. Corticosteroids affect the amount of calcium used by the body. Studies have confirmed the link between corticosteroids and osteoporosis, and as a result doctors measure bone density in patients likely to be taking corticosteroids for any extended period of time. Increased dosages of corticosteroids such as prednisone, cortisone, and prednisolone have also been shown to increase the likelihood of osteoporosis.

Studies have shown that there is a link between corticosteroids and osteoporosis. Between 30 and 50 percent of patients frequently taking any corticosteroid medicine will develop the condition. Doctors therefore take measurements of patients’ bone density before and during treatment with corticosteroids. Researchers state that if the patient is taking 7.5 milligrams or more of prednisone for over two months, there is cause for concern. The loss of bone density occurs most quickly during the initial stages of corticosteroid therapy.

The link between corticosteroids and osteoporosis is related to the physiological effects of the drug. Corticosteroids prevent the absorption of the normal levels of calcium by the intestines and cause more calcium to be excreted through the kidneys. This causes the parathyroid glands to release a hormone named parathyroid hormone, which attempts to correct the levels of calcium within the blood by removing it from the bones. Calcium is vital for the strength of bones, so its absence causes osteoporosis.

Several treatment options are available for patients suffering from corticosteroid-induced osteoporosis. The simplest one is the use of calcium supplements, which aim to increase levels of calcium and thereby strengthen bones. This can be effective but is in no way reliable for effective treatment of the condition. Prescription drugs ending in “-dronate” are often effective at treating osteoporosis caused by corticosteroids. These drugs include alendronate, zoledronate and risedronate, which are often combined with calcium and vitamin D supplements for maximum effectiveness.

Osteoporosis affects the density of the bones, and can literally cause the bones to become porous, like a sponge. The most noticeable effect of this condition is increased likelihood of bone fractures and breakages. These require bed-rest, and may result in decreased quality of life, lost work days, and constant pain. The increased amount of time patients spend in bed recovering from osteoporosis-related breaks and fractures can cause blood clots and pneumonia. These potentially serious consequences explain why doctors take the link between corticosteroids and osteoporosis so seriously.

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