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Many commonly prescribed medications are a double-edged sword for everyone, male or female. On one hand, they cure or help control serious health problems; on the other hand, the medications themselves can cause serious health problems.
Several commonly prescribed medications can increase your chance of developing osteoporosis. Educating yourself about your medication's side effects is a positive move to protect your body — and your peace of mind. You can take certain precautions, with your doctor and pharmacist's help, to decrease your risk of medication-related osteoporosis.
Why corticosteroids can thin bones
People commonly take corticosteroids, such as prednisone, to decrease inflammation in the body, from their eyes to their intestines. If you have serious asthma, an autoimmune disease, severe allergies, or arthritis, you may be taking corticosteroids every day. Corticosteroids help many people live normal lives.
But corticosteroids are very potent medications with the following serious side effects:
- They increase calcium loss through your urine.
- They decrease calcium absorption through your intestinal tract.
- They inhibit growth of new bone.
- They lower estrogen and testosterone hormone levels.
Corticosteroids come in many different forms and under different brand names. No matter how people take corticosteroids, all routes lead to bone loss. (Some people inhale them for asthma and other lung diseases, some inject them, some take them by mouth, and others apply them as creams.)
 | The higher the dose of corticosteroid and the longer the time you take it, the more likely you are to develop osteoporosis. One quarter of all people who take corticosteroids for five to ten years will suffer a fracture. Some studies have shown that you may lose up to 30 percent of bone mass after taking corticosteroids for a relatively short time. |
If you absolutely must take corticosteroids of any type long term, doing the following is important:
- Be on the lowest dose possible.
- Reduce your dose slowly. Stopping or reducing your dose too quickly can be dangerous.
- Have your bone density tested every other year, or more frequently if suggested by your doctor.
- For men, check your testosterone levels.
- Check your urine calcium.
- Discuss your concern about osteoporosis with your doctor. Most doctors will place you on calcium and vitamin D supplements if you're on chronic corticosteroids. Your doctor may also recommend taking them every other day.
 | People on long-term moderate or high doses of corticosteroids may gain weight, develop hypertension or elevated blood sugars, and become prone to easy bruising. This condition is referred to as iatrogenic (a disease caused by medical treatment) Cushing's syndrome. These people are at most risk for bone loss. |
Avoiding excess thyroid medication
Your thyroid is an important part of your body because it helps control your metabolism. Thyroid problems come in two varieties: hypothyroid (sometimes called Hashimoto's disease), or too little thyroid hormone being manufactured, and hyperthyroid (sometimes called Grave's disease), which is too much thyroid hormone.
If your thyroid is underactive, you may gain weight, be tired all the time, feel cold, or have hair loss. If you have an overactive thyroid, you may lose weight, feel like your mind is racing, have difficulty sleeping, be jittery, and perspire more than usual.
Hyperthyroid hormone levels can increase your risk of developing osteoporosis. Hyperthyroid can result when your thyroid produces too much thyroid hormone or when you take more thyroid medication than you need to correct hypothyroidism.
A simple blood test ordered by your doctor can tell you whether or not the amount of medication you're taking is too much — or just enough.
 | Calcium may interfere with absorption of your thyroid medication if the two are taken too close together. Your doctor may recommend taking your thyroid medicine in the morning and your calcium 12 hours later. You also need to avoid drinking calcium-fortified juices close to the time you take your thyroid medicine. |
Taking medications to prevent seizures
Approximately one in ten people will have at least one seizure in their lifetime by age 75. There are different types of seizures caused by the malfunctioning of different parts of your brain; some seizure medications work better on one type of seizure than another. Some anti-epileptic drugs (AEDs) are more sedating than others, and many have been implicated in causing bone loss by interfering with your body's absorption of vitamin D.
Seizure medications may also interfere with female hormone levels such as estrogen and progesterone. Some AEDs suppress ovulation, which keeps estrogen levels from rising during the menstrual cycle. Lower estrogen levels means a greater chance of developing osteoporosis.
| If you're on AEDs, make sure to have a bone density test done each year, and take at least 200 to 400 IU of vitamin D a day, along with at least 1,000 to 1,400 mg of calcium. Also be aware of a major risk of poorly controlled seizures: falling! |
Other drugs associated with developing osteoporosis
A large number of drugs in addition to the ones mentioned here are associated with bone loss. Be aware that you may be at extra risk for osteoporosis if you're taking any of the following:
- Vitamin A (in excess of 3,000 micrograms per day): Excess vitamin A may cause too much bone to be reabsorbed.
- Heparin, a blood thinner: Researchers and doctors don't completely understand the connection between osteoporosis and heparin, but long-term therapy (more than four or five months) and doses of 15,000 U or more increase the risk of osteoporosis. Heparin may increase the number of osteoclasts in bone.
- Drugs that lower estrogen and testosterone: Any drug that lowers your estrogen level increases your risk of developing osteoporosis because bone loss increases when estrogen levels are low. For example, Lupron (leuprolide acetate) is an anti-estrogen medicine that is used for women with endometriosis and also for certain cancers in men, such as prostate cancer. This drug lowers your estrogen level.
- Medications that attack the virus that causes AIDS: Anti-HIV drugs may increase your chance of osteoporosis by raising cholesterol levels and interfering with the way the body manufactures and uses fat.
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