Osteoporosis Management Strategies
Strategies for the prevention and treatment of osteoporosis in people with lupus are not significantly different from the strategies for those who do not have the disease.
Nutrition:
A diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include:
- low-fat dairy products
- dark green leafy vegetables
- calcium-fortified foods and beverages
Calcium supplements can also help ensure that the calcium requirement is met each day.
Vitamin D plays an important role in calcium absorption and bone health. It is synthesized in the skin through exposure to sunlight. While many people are able to obtain enough vitamin D naturally, excessive sun exposure can trigger flares in some people with lupus. These individuals may require vitamin D supplements in order to ensure an adequate daily intake.
Exercise:
Like muscle, bone is living tissue that responds to exercise by becoming stronger. The best exercise for your bones is weight-bearing exercise that forces you to work against gravity. Some examples include:
- walking
- climbing stairs
- weight lifting
- dancing
Exercising can be challenging for people with lupus who are affected by joint pain and inflammation, muscle pain, and fatigue. However, regular arthritis-friendly exercises such as walking can help prevent bone loss and provide many other health benefits.
Healthy lifestyle:
Smoking is bad for bones as well as the heart and lungs. Women who smoke tend to go through menopause earlier, triggering earlier bone loss. In addition, smokers may absorb less calcium from their diets.
Alcohol can also negatively affect bone health. Those who drink heavily are more prone to bone loss and fracture, both because of poor nutrition and an increased risk of falling.
Bone density tests:
Specialized tests known as bone mineral density (BMD) tests measure bone density at various sites of the body. These tests can detect osteoporosis before a fracture occurs and predict one’s chances of fracturing in the future. Lupus patients, particularly those receiving glucocorticoid therapy for 2 months or more, should talk to their doctors about whether they might be candidates for a bone density test.
Medications:
Like lupus, there is no cure for osteoporosis. However, there are medications available for the prevention and treatment of osteoporosis. Several medications and drug options are approved by the Food and Drug Administration (FDA) for the prevention and/or treatment of osteoporosis in post-menopausal women these include:
- Fosamax (alendronate)
- Actonel (risedronate)
- Boniva (ibandronate)
- Didronel (etidronate)
- Evista (raloxifene)
- Miacalcin (calcitonin)
- Forteo (teriparatide)
- estrogen/hormone therapy
Alendronate is also approved for use in men. For lupus patients on corticosteroid (glucocortiocoid) drugs such as prednisone, alendronate (for treatment) and risedronate (for prevention and treatment) are approved for glucocorticoid-induced osteoporosis.
Related Resources
Source: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center, What People With Lupus Need to Know About Osteoporosis, Rev Date: 6/2005
