When it comes to taking care of our bones and preventing osteoporosis, there are many things we can do: lead an active lifestyle, eat plenty of foods high in calcium and vitamin D, and avoid tobacco and excess alcohol. Despite our best efforts, though, healthy bones can sometimes be jeopardized by the medications we take to treat other health conditions.

Here are five commonly prescribed medications that can cause problems for bones, and helpful steps to take if they’re prescribed for you.

  • Steroid Medications. These are among the most frequently prescribed drugs, typically given to treat allergies, asthma, and autoimmune or inflammatory conditions including arthritis. Steroids have four major effects on bones: They decrease the body’s ability to absorb calcium from the intestines, increase calcium loss from the kidneys, prevent healthy bone from being formed, and decrease estrogen levels. All of these effects increase the risk for osteoporosis and fractures. And the risk is greater when steroids are given in high doses and for long periods of time.
  • Thyroid Hormone. Many women have underactive thyroid glands and take daily thyroid medications throughout their later years. Taking too much thyroid hormone can cause increased bone loss. Regular monitoring of thyroid blood levels to ensure the correct dose can avoid this.
  • Aromatase Inhibitors. These drugs are used to treat breast cancer, but can also increase the risk of bone loss by decreasing estrogen levels.
  • Seizure Medications. Some seizure medications, such as Phenobarbital and Dilantin, are also associated with bone loss. The mechanism for this is unclear, but researchers theorize that the medications could affect the body’s ability to metabolize vitamin D or absorb calcium.
  • Antidepressants. Co mmonly prescribed antidepressants (SSRIs) such as Lexapro, Zoloft, and Prozac are also associated with an increased rate of bone loss. The same is true for some acid reflux medications, including Nexium and Prevacid. (Technically, that makes six on the list, not five. But these medications are too important, and too commonly used, to leave out.)

What To Do:

Step One: Talk with your doctor. If you have to take steroids or any of the other types of medications listed here, it’s important to discuss calcium and vitamin D supplementation and to set an appropriate amount. It’s also important to consider a bone density scan before starting these medications, so that you and your doctor know how strong your bones are to begin with.

Once you begin taking these medications, bone density scans should be performed every two years, and more frequently in certain situations. Before starting treatment, the risks and benefits of medications should always be fully discussed with your doctor. Medications should also not be stopped without consulting your doctor.

Naina Sinha, M. D., is Assistant Professor of Medicine, Endocrinology, Diabetes & Metabolism, New York Presbyterian Hospital and Weill Medical College of Cornell University. She is a member of the WVFC Medical Advisory Board.

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