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Corticosteroid Associated Osteoporosis

Aka: Corticosteroid Associated Osteoporosis, Osteoporosis Secondary to Corticosteroid Use

See Also
1. Systemic Corticosteroid
2. Osteoporosis
Risk of Osteoporosis on long-term Corticosteroids
1. Prednisone 1-5 mg: Relative risk 1.9x
2. Prednisone 5-10 mg: Relative risk 4.5x
3. Prednisone >10 mg: Relative risk 32x
Evaluation: Obtain Bone Mineral Density
1. Check BMD at baseline prior to therapy
2. Check BMD every 6-12 months during first 2 years
Prevention of Osteoporosis from long-term steroids
1. Use lowest dose of a short-acting glucocorticoid
2. Maintain a well-balanced, low sodium diet (2-3 gram)
3. Weight bearing Exercise and Isometric Exercise
4. Calcium Supplementation 1500 mg/day
5. Vitamin D Supplementation 400-800 IU/day
6. Control Hypercalciuria with Thiazide Diuretics
7. Treat Hypogonadism
  1. Menopause: Hormone Replacement Therapy
  2. Men with low testosterone: Testosterone Replacement
8. Treat bone loss if it occurs with Corticosteroid use
References
1. Dubois (2002) Chest 121:1456-63
2. Lane (1998) Endocrinol Metab Clin North Am 27:465-83

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 5/14/2013.

This is one of 5887 pages in the Family Practice Notebook