Bone Health and Corticosteroids

by Jim Sliney, Jr.

What you can do to keep your bones healthy when you have to use them

Asthma, lupus, skin rashes, arthritis. These are just some medical conditions that use CORTICOSTEROIDS as a treatment.

Corticosteroid drugs such as prednisone, cortisone, and hydrocortisone do 2 major things:

  • Reduce inflammation by reducing a swollen rash or lung inflammation like in asthma or joint inflammation like in arthritis
  • Suppress the Immune System which is important for someone experiencing an AUTO-IMMUNE response in which the immune system mistakenly attacks the body; like in cases of severe allergic reaction, Addison’s disease, lupus, type 1 diabetes, and celiac disease just to name a few

Corticosteroids are used to treat the primary side effects of these conditions of inflammation and auto-immunity. While effective, corticosteroid use has several SIDE EFFECTS associated with it. They include

  • Glaucoma – increased pressure in the eye
  • Cataracts – clouding of the lens of the eye
  • Edema – fluid retention (think swelling in the lower legs)
  • Increased blood pressure
  • Increased blood sugar levels – this can complicate diabetes
  • Increased risk of infection
  • Mood swings
  • Weight gain
  • Adrenal gland suppression – this could lead to lower levels of some of the adrenal glands hormones like
    • Aldosterone – maintains salt and water levels in the body
    • DHEA – mild sex hormones
    • Cortisol – stress response and metabolic regulator
  • Skin bruising and slower wound healing
  • Osteopenia/osteoporosis

Bone health and corticosteroids

Corticosteroids also interfere with normal bone turnover. It does this by essentially creating a flaw in the osteoclasts cells in the bone. This is why people who use corticosteroids, especially over a long time, begin to experience losses in bone density which can lead to osteopenia, which can then lead to osteoporosis. Most people who use corticosteroids do so because the immediate benefits of the drug would seem to outweigh possible health issues the future.


What do I do if I have to use corticosteroids despite the risks to my bones?

You will have to work out what is best with your doctor, but some things you can do to counter the bone suppressing feature of corticosteroids could include

  • Getting adequate calcium and vitamin D – the most consistent way of doing so is by //">taking a supplement
  • Weight bearing exercise – fight gravity a lot!
  • Reduce or eliminate smoking and alcohol consumption
  • Get a bone density test – this can tell you where you are in relation to osteopenia or osteoporosis

So if you are using corticosteroids you will need to figure out what you can and should do to protect your bone health.

//">Glucocorticoids suppress bone formation via the osteoclast

//">Autoimmune Disorders

//">Prednisone and other corticosteroids

//">Adrenal glands

//">Living with osteoporosis

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