Is There a Link Between Asthma Medications, Osteoporosis, and Bone Health?
Because of their effectiveness in controlling asthma with the fewest side effects, inhaled corticosteroid medication is preferred to oral forms. Oral corticosteroids, which can cause significant bone loss over time, may be necessary for some people with asthma. Asthma patients who are treated with 40 to 60 mg per day of oral corticosteroids for long periods of time are most likely to experience bone loss. Even those patients who take 10 mg per day are likely to experience some bone loss over time.
The following tips can help individuals with asthma to maximize their bone health:
- Use medications prudently. Bone loss tends to increase with increased glucocorticoid doses and prolonged use. No matter which form of medication is used, the lowest possible dose for the shortest period of time that controls asthma symptoms is recommended. Other medications are available that also may relieve symptoms without causing bone loss, although for some people steroids are necessary.
- Reduce exposure to triggers. Reducing your exposure to things that appear to trigger asthma attacks may lessen your need for medication.
- Avoid infection. Avoid people with colds and other respiratory infections whenever possible.
- Minimize exposure to irritants. Avoid cigarette smoke, strong odors, air pollution, aerosol sprays, paint fumes, red wine, beer, food coloring, food dyes, sulfite food preservatives, and extreme changes in temperature. Pay attention to air quality notices on your local weather stations.
- Reduce contact with allergens. Since asthma symptoms can be triggered by allergies, avoid known allergens, and when possible remove allergens from the home, school, or work environment. Common household allergens include animal dander, dust mites, pollen, molds, and dust.
- Monitor nutrition. A balanced diet with adequate amounts of calcium and vitamin D is critical for bone health. People with asthma who have a proven milk allergy should explore non-dairy sources of calcium and consider calcium supplementation in order to obtain enough calcium. The National Institutes for Health (NIH) recommends 400 to 600 mg of calcium for infants, 800 to 1,200 mg for children ages 1 to 10, and 1,200 to 1,500 mg for adolescents and young adults ages 11 to 24. For both children and adults on chronic corticosteroid therapy, some healthcare providers recommend a daily calcium intake of between 1,000 and 1,500 mg. Experts also recommend a daily vitamin D intake of between 400 and 800 IU.
- Exercise. Weight-bearing activities, such as walking, running, weight training, and team sports, can all have a positive impact on bone health, and participation should be encouraged. By improving muscle strength and coordination, exercise also can reduce the risk for falling and breaking bones. People who experience exercise-induced asthma should exercise in an environmentally controlled facility and participate in activities that fall within their limitations. They may also use medication when necessary to enable them to exercise.
- Stress reduction. If asthma is triggered by emotional stress, patients should consider participating in stress-reduction programs.