Steroids are the leading cause of secondary osteoporosis – meaning something produces the disease osteoporosis. The term steroids used here refers to “glucocorticoids.” Natural glucocorticoids are hormones made in the outside portion of the adrenal gland that sits on top of your kidneys. Cortisol is the major natural glucocorticoid. Medicines classified as glucocorticoid are equivalent hormones that are given for treatment of a variety of ailments including some respiratory, skin, inflammatory, or autoimmune diseases.
Prednisone
The most common steroid prescribed is prednisone. Bone loss appears to be dose-related. Higher doses are correlate with greater the risk of bone loss and fracture. Although any dose may promote bone loss, guidelines for protective therapy start with doses of 5 to 7.5 milligram or more depending on your age and for women, child-bearing status.
Accelerates Bone Loss
Regular use of steroids accelerates bone loss and puts you at risk for glucocorticoid-induced osteoporosis or “GIOP.” In contrast to bone loss with menopause, steroids effect the bone building cells more than bone breakdown cell causing a marked decrease in bone formation. As a result, you are at higher risk for breaking a bone with low bone density.
Prevention and Treatment
Steroids also have a direct effect on muscle that increases your risk of falls. Fall prevention along with the basic bone health measures of lifestyle, calcium, and vitamin D are part of overall prevention and treatment. The FDA-approved medicines for individuals on steroids include Actonel, Forteo, Fosamax and generic alendronate, and Reclast. Guidelines published by the American College of Rheumatology in 2010 are helpful starting point for anyone who is starting or taking steroid therapy to discuss with their doctor.