Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Osteoporosis Caused by Prednisone

Prednisone and Osteoporosis

Prednisone is a corticosteroid used in rheumatoid arthritis and other inflammatory conditions. Prednisone is a steroid hormone that has detrimental effects on bone density. Consequently, taking this medicine over a long period of time increases the chances of developing bone diseases such as osteoporosis, as it weakens the bone structure. Early symptoms of osteoporosis are the fractures which often occur and can be life threatening. Many people who have suffered hip or leg fractures have not regained their previous level of activity.

Steroid-induced osteoporosis is one of the many side effects of taking corticosteroids in the long term. Bone thinning may be prevented by taking mineral supplements like calcium and vitamin D, increasing your exercise levels, and avoiding alcohol and smoking during treatment. Osteoporosis is associated with older people, especially women after the menopause[1]. There are many studies that have investigated whether long term Prednisone use leads to osteoporosis. The objective of these studies was to establish the proportion of affected patients using medical records from people between 21-89 years old. The results showed that more than half of affected individuals developed osteoporosis due to secondary causes.

The most common secondary cause of osteoporosis in men is alcoholism and hypogonadism. Male hypogonadism is a pathological condition which leads to reduced testosterone secretion, a hormone that has a major role in male growth. Low levels of testosterone lead to the loss of muscle and bone mass, lack of body hair and underdeveloped genitals, along with infertility. For women, the most common secondary causes of osteoporosis are hyperthyroidism and hypoestrogenemia[2]. Hyperthyroidism is a condition in which the thyroid gland overproduces certain hormones. The symptoms include irregular heartbeat, tremblings, sweating and increased appetite. Hypoestrogenemia is the lack of estrogens in the blood. Estrogen is the main female hormone and its deficiency leads to headaches, reduced bone density and lowered genital arousal.

Low bone mineral density is one of the most common side effects of long-term Prednisone use. In Europe, more than half of patients taking steroids have developed osteoporosis after having treatment for longer than 6 months. In the first 3 months of therapy, up to 20 percent of bone loss occurs, and significant amounts may be lost due to high dosing[3]. In order to reduce the amount of bone loss, you can use an alternate-day dosing method or use lower doses. Alternate-day therapy is a method of corticosteroid dosing in which once in two days the patient takes twice his usual dose of medicine in order to get the required long-term dose with less undesirable effects such as adrenal suppression or growth suppression.

References:

  1. Staa T., Leufkens H., Cooper C., Osteoporos Int. Ed, The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis, 2002
  2. Grossman J., Gordon R., Ranganath V., Arthritis Care Res, American College of Rheumatology recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis, 2010
  3. Reid D., Nicoll J., Sniter M., Clin Red Ed., Corticosteroids and bone mass in asthma: comparison with rheumatoid arthritis and polymyalgia rheumatica, 1986

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