Older and postmenopausal women are the two most frequent groups in osteoporosis clinics. After around age 30, bone mass will gradually decrease with age; before and after menopause, due to the sudden drop in hormones, the rate of bone loss in women also increase, will accelerate. However, many people are unaware that patients with autoimmune diseases are also at high risk for osteoporosis: their constitution and long-term use of steroids further worsen their bone condition!
Chronic inflammation and steroids generate early warning warnings
Doctor Li Xinxing, director of the department of allergology, immunology and rheumatology at Zhenxing hospital, said that in addition to treating autoimmune diseases, he will also open an osteoporosis clinic, mainly because he often meets patients with osteoporosis or even fractures before of menopause. In patients with autoimmune diseases, the body is in a state of chronic inflammation, resulting in increased osteoclast activity and accelerated bone loss. To control inflammation, most patients will take steroids called “American elixir” but the price is There are many side effects, osteoporosis is one of them. “Steroids not only inhibit osteoblast activity, but also activate osteoclasts. Just take 1 pill per day, more than 2.5mg1, About 3 months, can cause osteoporosis. She pointed out that the impact of steroids on bones is beyond everyone’s imagination and most patients with autoimmune diseases are women and don’t have to wait until menopause to have low bone density.
The condition of osteoporosis in patients with autoimmune diseases will be proportional to the severity of their disease and the dosage of steroids. Some elderly patients suffer from osteoporosis even at the age of 3 or 40. Dr. Li Xinxing said a 40-year-old patient with rheumatoid arthritis had to go to the hospital to drop steroids frequently due to the uncontrollable condition and constant pain in the joints. Spinal compression fractures due to osteoporosis.
It is more difficult to seek medical treatment for osteoporosis when a fracture occurs
“Just like patients with high blood pressure or diabetes, they will not wait until they have a stroke or kidney dialysis to receive treatment. People at high risk for osteoporosis also need to be prevented early. If they wait for the fracture to occur, the difficulty will increase. ! ” Dr. Li Xinxing It is especially recommended for patients with autoimmune diseases to undergo a bone mineral density test before the age of 50. If you find that your bone condition is really unsatisfactory, you can discuss with your doctor whether to use osteoporosis medications for preventive treatment first, as this will reduce the risk of bone loss. Risk of future fractures.
“There are many types of drugs to treat osteoporosis. Some inhibit osteoclast activity and others stimulate osteoblasts. Regardless of the drug used by the patient, as long as treatment begins, osteoporosis will not continue to deteriorate.” Xinxing The doctor pointed out that the treatment of osteoporosis in patients with autoimmune diseases is no different from that of ordinary people.Although drug treatment may not be effective immediately, as long as it continues, the results can definitely be seen after a period of time. ; at the same time, chronic autoimmune diseases are controlled. Inflammation is also very important and patients can discuss with their doctors to consider lower doses of steroids or alternatives such as biologics.
Additionally, more exercise, more calcium supplementation, and more sunlight should be used to help the body synthesize vitamin D. If lupus erythematosus patients are concerned about their condition deteriorating due to ultraviolet exposure, they can switch to additional vitamin D supplementation. Due to joint inflammation and pain, some patients have less activity than the average person and their bones will be more fragile.At this time, they should also pay attention to their calcium and vitamin D intake and do their best to protect the own skin. bones I believe that in With multiple efforts, the bone will gradually recover.
Discontinuing treatment accelerates bone loss and increases the risk of fractures
Regardless of autoimmune diseases or osteoporosis, long-term follow-up and care are needed; however, as the outbreak fluctuates, it also affects patients’ willingness to seek medical attention. Many patients are afraid to go to hospital for fear of contracting the disease. Dr. Li Xinxing recalled that once osteoporosis treatment is stopped, bone density will permanently decrease and the likelihood of fracture will increase. In fact, the hospital’s protective measures are very comprehensive: as long as people wear masks, wash their hands often, and disinfect themselves with alcohol, they can protect themselves and others.
Although osteoporosis is neither painful nor itchy, in the unfortunate case of a fracture it can be fatal. Dr. Li Xinxing stressed that we shouldn’t take it lightly because there are no symptoms. We must return to the clinic regularly for treatment and maintain confidentiality and avoid falls to feel truly comfortable.
1. Reference: Osvaldo D Messina et al. Aging Clin Exp Res. 2021; 33 (4): 793-804.
For more information on osteoporosis, see A good doctor for osteoporosis in Taiwan。
This health education article is provided with assistance from Amgen Taiwan
TW-03410-PRO-2022-August
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