Proactive Bone Health with Steroid Use

Over the past week I have been getting through an exhausting and achy cold. This cold has worn me down longer than other colds in the past. It’s likely the result of my autoimmune medication, which by design, impacts the immune system.

After several days of still feeling exhausted, I went to Urgent Care. One of the first questions that the nurse asked me was about my weight.  This led to me making a comment about my weight being higher than it has ever been. I told her that it was probably because of my prescription medication which despite its benefits, led me into unusual health issues over the past several months.

The nurse said that she doubted that it was because of my medication (a medication she wasn’t familiar with), but concluded that it was probably because of the steroids.

The nurse’s next comment was that I should ask to have my bones observed in the future to look out for any bone damage in the future resulting from the steroids. I had heard remotely somewhere in the past about osteoporosis and steroid use. But I was previously not  too concerned because I used steroids infrequently, like a 2-3 times a year.

But this conversation with the urgent care nurse left me feeling concerned, and with more questions then I began with. Why do doctors find it unimportant to talk about protecting our bones? Our conversation here today sounded more like a suggestion to wait around for bones to show damage before taking action.

Prednisone. Methylprednisolone or Solu Medrol.  Do these sound familiar? When you have an autoimmune condition, these names get passed around from physician/nurse/pharmacist conversations, to the label on your prescription medication, to the clear pouch of liquid that the nurses are placing by IV into your arm at the infusion center. We learn that they can cause weight gain, insomnia, and I was also warned of the urge to clean the house at strange hours of the day.

But after leaving urgent care, I decided that I wasn’t going to wait for signs of bone damage to come along.  Thanks to the internet, I would not have to be alone with this lack of knowledge. I began to explore information on how to protect my bones from steroid use. Thankfully, articles exist out there to tell us what we didn’t know or were too afraid to ask about bone health and steroid use.


During my search, I found an interesting term, bone protection therapy. I hadn’t heard of such a thing before. (I always thought that bone health was a concern of the elderly. At least the nurse’s comment woke me up the fact that with regular steroid use, that it was time to be proactive about my bones.)  I felt that it was my responsibility to find out more about what this means. In a web post from the UK, on Guidelines in Practice, I found this information:

“A key recommendation of the guidelines is that all patients taking steroids, whether or not on bone-protective therapy, should be advised about adequate dietary calcium, taking exercise, and avoiding smoking and overindulging in alcohol. We often underestimate the contribution that lifestyle factors can make to the development of osteoporosis and fail to counsel our patients accordingly.”

Based on this information, I’ve begun taking calcium (my nails needed it anyway to stop bending and breaking), I take regular Vitamin D, and I’ve made more efforts to do weight bearing exercise (lightweight dumbbells and an exercise video can work wonders).  

Hopefully these will be the protective actions that I needed to protect my bone health for decades to come.

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