Could the Medication I Take Contribute to Bone Loss?

Many people are unaware they have osteoporosis – weak and brittle bones -- in the first place. And most don’t know that there are different types of osteoporosis– primary and secondary -- each with different causes.

Primary osteoporosis is strongly connected to aging and is the type you are probably most likely to have heard about. For women, this means menopause brings a loss of estrogen and progesterone. With less estrogen, the body is less able to produce new, healthy bone tissue. Women are typically at a higher risk for primary osteoporosis 10-15 years after menopause, which also means a higher risk of fractures of the spine and wrist.

Outside of hormonal changes, some people are diagnosed with primary osteoporosis because of a long-term calcium deficiency. This type of primary osteoporosis is twice as common in women and is more likely to result in hip fractures, which can have a huge impact on quality of life and even survival. Unfortunately, up to 25% of patients who have a hip fracture don’t live beyond a year, 40% can’t walk without help, and 80% have difficulty with at least one daily activity.

Secondary osteoporosis can develop when an underlying medical condition or certain medications interrupt new bone tissue from forming. It is common in patients with diabetes, lupus, celiac disease, chronic kidney disease, liver disease, multiple myeloma, multiple sclerosis and anorexia nervosa, among others. Hormonal imbalances caused by hyperthyroidism or hyperparathyroidism may also lead to secondary osteoporosis. Medications that could impact bone tissue include:

• Long-term use of oral corticosteroids -- cortisone, hydrocortisone and prednisone (often used as part of the treatment for diseases like severe allergies or skin problems, irritable bowel disease, asthma or arthritis)
• Heparin
• Methotrexate
• Proton pump inhibitors
• Anticonvulsants
• Lasix
• Thyroid hormone

To determine if you have osteoporosis, your doctor may recommend simple screening procedures like a blood test and/or a DEXA bone density scan. A DEXA scan can detect even small changes in bone loss and can help determine your risk of fractures. If you’re 65 or older, you should get one, but you should consider one even earlier if you have certain risk factors or any concerns about your bone health.

For those diagnosed with primary osteoporosis, the treatment typically includes bone-building medication and lifestyle changes like diet and exercise to help prevent further bone loss.

The treatment for secondary osteoporosis typically means identifying and treating the underlying cause, such as an undiagnosed or unmanaged medical condition or reducing the dosages of any medications that may be causing or contributing to bone loss.

After a bone density scan, treatment recommendations are often based on an estimate of your risk of breaking a bone in the next 10 years. If you have a family history, you’re more at risk, especially if there is a history of bone fractures on your mother’s side. If your risk isn’t high, treatment might not include medication and might focus instead on modifying risk factors for bone loss and falls.

Take our Bone Health Center quiz to determine if you are at risk for osteoporosis.

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Angela Roy, PA-C
Bone Health
Baton Rouge General Physicians - Bone Health Center
(225) 237-1810