Part 1: Understanding Osteoporosis

According to the National Institutes of Health, the long-term use of steroids can lead to a loss of bone density and ultimately, fractures. Steroids are a group of hormones normally produced by the adrenal glands that have an important role in the regulation of blood sugar levels, retention of salt and water, and in metabolism and growth.

However, their long-term medicinal use for the diseases listed on the previous page can interfere with the bone remodeling process and calcium regulation by decreasing the amount of calcium absorbed from food and also by increasing the loss of calcium in the urine. This will lead to overproduction of parathyroid hormone, which works to maintain levels of calcium found in the blood by removing calcium from the bone. Steroids can also stimulate osteoclasts (break down bone) and inhibit osteoblasts (build bone). Additionally, the production of estrogen by females and testosterone by males can be reduced by steroids - another contributing factor to bone loss.

If taken in high doses, this classification of drugs can cause fractures in less than a year. The bones most susceptible to the effects of steroids are the ribs, wrist and bones present in the spine. The long-term use of these drugs via the oral route is the most likely manner to cause the most bone loss, although excessive use either as a topical, inhalant, or I.V. injection can also damage bone.

The bone loss that occurs is increased by the dose and duration of the drug treatment. However, adverse effects of the use of steroids on bones can occur even with intermittent use. Consequently, physician consultation is imperative to receive the lowest dose possible.