ORTHOPEDICS/OSTEOPOROSIS
Corticosteroids are one kind of steroid medicine.
Occasionally the term “steroid” is used inter-inconsistently with “corticosteroid.”
Most people affected with inflammatory diseases are usually treated with corticosteroids.
Therapy for many inflammatory and autoimmune diseases (like Asthma, Rheumatoid Arthritis, Lupus and inflammatory bowel disease), uses eventually Steroids such as Prednisone.
Steroids are as well used to treat several allergic disorders.
Corticosteroids and Bone Rehab
While Corticosteroids affect calcium and bone metabolism, Steroids decrease the amount of calcium absorbed by the intestine.
Steroids increase calcium excretion through the foods as well.
These two causes conglomerate to produce a degeneration in the circulating ionized calcium concentration.
This action activates the parathyroid glands to increase the secretion of parathyroid hormone (PTH), a disorder known as secondary hyperparathyroidism resulting an increase in PTH levels that affect bone breakdown.
In addition that Corticosteroids may decrease the sex hormones levels as well, Estrogen (in women) and Testosterone (in men)
Furthermore, Corticosteroids cause muscle weakness that may conduct to inactivity and additional bone loss.
Another main Corticosteroids outcome is that they can affect bones directly (osteoblastic).
Bone Loss Shapes
There are two kinds of bone tissue: Cortical and Trabecular.
- The Cortical bone constitutes the outer shell of the bone and forms 80% of the skeleton
- The Trabecular bone (the remaining 20%) is found inside the bone
Each bone in the skeleton encloses both kinds of bone with variable proportions. Corticosteroids predominantly cause bone loss in those zones of the skeleton rich in trabecular bone, such as the spine for example.
Dose and Extent
Bone loss depends on both: dose and extent
Note that other risk factors for osteoporosis may affect bone loss, such as age, gender and principal disease (for example, elderly men on steroids may experience greater crack risk than middle-aged men).
Osteoporosis Controlling
Steroid-induced osteoporosis is both avoidable and remediable.
Usually, people on corticosteroids should perform a bone mineral density test. This test will provide a standard extent from which to monitor subsequent modifications in bone mass.
A daily intake of 1500 mg. calcium and 400-800 IU of vitamin D is recommended, because Calcium and vitamin D can help maintaining calcium balance and normal parathyroid hormone levels.
Osteoporosis Medicines
Osteoporosis medicines approved for corticosteroid-induced osteoporosis comprise:
- Actonel (Risedronate) for anticipation and therapy
- Fosamax (Alendronate) for therapy
Both mentioned drugs bring beneficial effects on spine and hip bone mineral density. Consequently they decrease risks of spinal cracks.
Regime Reforms
Quitting smoking and eliminating alcohol are two significant factors in decreasing the steroid-induced osteoporosis risk.
Sports activity and bodybuilding can help to maintain bones and muscles mass, in addition to increasing muscle strength and decreasing the falls risks.
Avoiding Slipping or falling is significant for elderly individuals and for those who have experienced steroid-induced muscle dimness.
Finally
Actions avoiding Osteoporosis should start early.
On the other hand, it is recommended using the lowest steroid dose for the shortest period possible.