Question

Why are corticosteroids contraindiacted in osteoporosis?

Answer 1

Explanation:

Steroid medications have major effects on the metabolism of calcium, vitamin D and bone. This can lead to bone loss, osteoporosis, and broken bones. When steroid medications are used in high doses, bone loss can happen rapidly. It is important to know that not all people who take steroid medications lose bone. There are different rates of bone loss among individuals taking steroid medications. The exact reasons for these differences are not known but probably include differences in steroid dose, the effect of certain underlying diseases on bone loss, and perhaps some people are genetically more susceptible to the effects of steroid medications. For example, postmenopausal women who take steroid medications for longer than six months have the greatest risk of bone loss.

Bone loss occurs most rapidly in the first 6 months after starting oral steroid medication. After 12 months of chronic steroid use, there is a slower loss of bone. Some people are concerned about the eects of inhaled steroids. Inhaled steroids are less likely to cause bone loss than steroids taken by mouth. However, in higher doses, inhaled steroids may also cause bone loss. Steroid medications used for only a few days or applied to the skin are not associated with bone loss. The major impact of steroid medications on bone is fractures (broken bones) that occur most commonly in the spine and ribs. Steroid medications (taken by mouth) equal to or more than 5mg of prednisone daily, taken for more than 3 months, is considered a risk for fracture. Fracture risk increases as the daily doses of steroid medications increase. Almost 1 in 3 postmenopausal women who routinely take steroid medications will have a spine fracture. A person on steroids is more than twice as likely to have a spine fracture compared to a person not taking steroids. Your health care provider determines when you should stop taking your steroid medication. Once the medication is stopped, it is expected that your fracture risk will lessen. You should never change the way you take your medication until you speak to your health care provider.

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