Lupus and Osteoporosis
Reviewed by: HU Medical Review Board | Last reviewed: January 2020 | Last updated: January 2020
Osteoporosis is a condition that causes the bones to become less strong and more likely to break (fracture). Fractures from osteoporosis can be painful and impact the quality of life. People with lupus have an increased risk of developing osteoporosis for several reasons.
First, it appears that simply having lupus increases your risk of bone loss. Next, long-term use of steroids to control lupus is known to trigger bone loss. The joint pain and fatigue felt by many people with lupus can make it hard to engage in the type of exercise and activities that prevent osteoporosis.
Finally, 90 percent of people with lupus are women, who are already at a higher risk of developing osteoporosis.1 The Lupus Foundation of America estimates that women with lupus are five times more likely to experience a fracture due to osteoporosis.2
Other risk factors for developing osteoporosis include:
- Family history of osteoporosis
- Early menopause or irregular menstrual periods
- Small frame or thinness
How is osteoporosis diagnosed?
A bone density test, or DEXA scan, is a special type of x-ray that is used to diagnose osteoporosis. DEXA stands for dual-energy x-ray absorptiometry. It takes about 15 minutes to perform and measures bone density. The hips and lower spine area are most often scanned, but the fingers, hand or forearm may also be tested.
What are the treatments for osteoporosis?
Osteoporosis can sometimes be prevented, and if not prevented, then managed. The ways someone with lupus can handle the condition is similar to the ways those who do not have lupus.
Bones are like muscles in that they become stronger with exercise. Recommended exercises include walking, climbing stairs, dancing, and lifting weights.
Foods rich in vitamin D and calcium help your body build stronger bones. Sources of calcium and vitamin D include dairy products, egg yolks, spinach, broccoli, almonds, liver, and saltwater fish. Avoid alcohol since it has negative effects on bone health.
Smoking damages your bones as well as your lungs and heart. Plus, women who smoke tend to go through menopause at younger ages which reduces levels of estrogen, a bone-preserving hormone, earlier.
Your doctor may ask you to take vitamin D and calcium supplements to beef up the amount of those nutrients in your system.
There is no cure for osteoporosis but there are several drugs that help prevent or treat it, including bisphosphonates; calcitonin; hormone therapy; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERM); parathyroid hormone drugs; RANK ligand (RANKL) inhibitor; and tissue-selective estrogen complex (TSEC). Not all of these medicines may be possible for someone with lupus to take, depending on their disease and its complications.
Living with osteoporosis
If you have osteoporosis it is important to do what you can to preserve your bone health by preventing falls. Some simple steps you can take to reduce your chances of a fall include:
- Wear low-heeled shoes with rubber soles for good traction.
- Keep floors clear of clutter and remove loose cords and throw rugs.
- Make sure all carpet and area rugs are tacked to the floor or come with skid-proof backing.
- Install handrails in the shower or tub, beside the toilet, and on any stairs.
- Add non-skid rubber mats in the shower, in front of the kitchen sink and stove.
- Keep hallways, stairs, and outdoor areas well-lit.
- Use a fanny-pack, backpack, or shoulder bag to keep your hands free.
- Use a walker or cane if you need it.3
If you live alone, consider getting a personal emergency response device to wear around your neck, or carry a mobile phone with you at all times.