...less medical jargon in a 'Quick Glance' format!
Corticosteroid-Induced Osteoporosis: Many people with joint or muscle pain, breathing or intestinal ailments use corticosteroids (e.g., Prednisonemethylprednisolone). However, long-term use of these drugs can cause loss of bone density and fractures.
Symptoms:
Because corticosteroid-induced osteoporosis can start quickly after a patient begins taking the drugs, it is better to measure bone density levels and monitor them regularly than wait until the patient starts having frequent fractures.
Causes:
The body's ability to produce strong, dense bones is a juggling act between natural processes that build up bone and ones that break it down. Corticosteroids tend to both reduce the body's ability to absorb calcium and increase how fast bone is broken down. The more of these drugs you take and the longer you take them, the greater your risk of developing crticosteroid-induced osteoporosis.
Treatment:
Persons with low bone mass, postmenopausal women who are not taking estrogen and others at high risk for osteoporosis should be identified before being given corticosteroid drugs. To lessen the risk of this condition, a patient should use the lowest possible dose for the shortest possible time or switch to a non-corticosteroid drug, if medically advised. The same treatments used for osteoporosis should be applied in the case of corticosteroid-induced osteoporosis.
Hormone replacement therapy (HRT) is often used to prevent osteoporosis in women. HRT does have side effects, including an increased risk of blood clots and gallbladder and heart diseases. Taking HRT as a combination therapy - estrogen with medroxyprogesterone acetate (such as Prempro) - for several years or more may increase your risk of breast cancer. All combination HRT regimens can cause patchy vaginal bleeding, particularly during the first year of use. More study is needed to learn if estrogen-only therapy increases the risk of breast cancer. The long-term benefits of HRT are, therefore, under intense study.
If HRT isn't for you, other prescription drugs can help slow bone loss and may even increase bone density over time. They include:
Bisphosphonates
. These can reduce bone breakdown, preserve bone mass and even increase bone density in the spine and hip. The best known of these drugs is alendronate (Fosamax). Studies show it may cut the risk of hip and spine fractures in half. Etidronate (Didronel) is also sometimes given to help prevent bone loss.
Raloxifene
. This imitates estrogen's good effects on bone density, without some of the increased cancer risks. Hot flashes are a common side effect. You shouldn't use this drug if you have a history of blood clots.
Calcitonin
. Produced by the thyroid gland, calcitonin may slow bone loss and prevent spine fractures, but not hip fractures. It's given as a nasal spray, and about 12% of those who use it develop nasal irritation. It is usually given to those who are at high risk of fracture but cannot take estrogen or bisphosphonates.
Tamoxifen
, a synthetic hormone used to treat breast cancer. Although it blocks estrogen's effect on breast tissue, it has an estrogen-like effect on other cells, including bone cells. It may have serious side effects.
Statins
. Ordinarily this class of drugs is used to lower cholesterol levels, but some studies have shown that women who take statin drugs for at least a year may also lower their risk of bone fractures. Because research is ongoing, the drugs are not routinely given for osteoporosis. Side effects include potential reversible liver damage and, rarely, muscle inflammation.
