Some medications can be harmful to your bones, especially if you take them at high doses or for a long time. One of the riskiest types of medications for bones is steroid medications. Many people take these medications to ease inflammation in conditions like rheumatoid arthritis or asthma.

It’s important to talk with your healthcare provider about the risks and benefits of any medications you take and about how they may affect your bones. Do not stop any treatment or change the dose of your medications unless your healthcare provider says it’s safe to do so. Many of the medications that can cause bone loss include the following:

• Aluminum-containing antacids
• Antiseizure medications (only some) such as Dilantin® or Phenobarbital
• Aromatase inhibitors such as Arimidex®, Aromasin® and Femara®
• Cancer chemotherapeutic drugs
• Cyclosporine A and FK506 (Tacrolimus)
• Glucocorticoids such as cortisone and prednisone
• Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
• Heparin
• Lithium
• Medroxyprogesterone acetate for contraception (Depo-Provera®)
• Methotrexate
• Proton pump inhibitors (PPIs) such as Nexium®, Prilosec® and Prevacid®
• Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
• Tamoxifen® (premenopausal use)
• Thiazolidenediones (Actos® and Avandia®)
• Thyroid hormones in excess

This list may not include all medications that cause bone loss.

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There are many health problems that can harm your bones and increase your risk of osteoporosis. Some of these include:

Anorexia Nervosa and Other Eating Disorders. Anorexia nervosa is a major risk factor for osteoporosis for many reasons. In women with anorexia nervosa, estrogen levels decrease to such an extent that menstrual periods either become irregular or stop. This drop in estrogen causes bone loss. Poor nutrition in women with anorexia and other eating disorders is also harmful to bones. Although more common in teenage girls and young women, men can also have eating disorders. They can also be at great risk for bone loss and osteoporosis

Celiac Disease People with celiac disease have trouble digesting foods with gluten. Gluten is found in grains such as wheat, rye and barley. People with this condition also have problems absorbing nutrients, including calcium and vitamin D.

Depression. Research suggests a link between depression and low bone density or osteoporosis. More studies will help us to better understand the relationship between these two conditions.

Hyperparathyroidism. This is a condition in which the parathyroid glands (two pairs of small glands located near the thyroid in the neck) produce too much parathyroid hormone (PTH). Having too much PTH causes bone loss. This condition is more common in women after menopause. A simple blood test can tell your healthcare provider if this is a problem.

Hyperthyroidism. In people with this condition, the thyroid gland produces too much thyroid hormone. This can lead to weak muscles and fragile bones. The same thing can happen if a person has an underactive thyroid and take too much thyroid hormone medication.

Inflammatory Bowel Disease (IBD). There are different types of IBD including Crohn’s disease and ulcerative colitis. Steroid medications are commonly used to treat these conditions. People with IBD may also have trouble absorbing calcium and vitamin D.

Loss of Height. Vertebral (spine) fractures cause height loss and kyphosis. In many cases, a person with spine fractures already has low bone density or osteoporosis. For many people these fractures do not cause any pain. Kyphosis is an abnormal forward curvature of the spine. When there is no pain, these fractures often go unnoticed until a person becomes aware that a significant loss of height of an inch or more has occurred.

Multiple Myeloma. This is a cancer of the bone marrow. Its first symptoms may be back pain and fractures of the vertebrae. Blood and urine tests can detect the problem. Other forms of cancer that affect bones or bone marrow can also cause fractures.

Organ Transplants. People who have organ transplants must take medications to prevent their bodies from rejecting their new organs. Some of these drugs can weaken bones.

Rheumatoid Arthritis (RA). People with rheumatoid arthritis are at increased risk for osteoporosis. In addition, RA is often treated with steroid medications, which further increases the risk.

Weight Loss. Losing weight can cause bone loss. Many serious conditions such as heart disease and diabetes are associated with obesity and excess weight. Fortunately, you can protect your bones while losing weight by exercising regularly and eating a healthy diet that provides enough calcium and vitamin D.

Other Diseases and Conditions. Many other health problems can also affect the bones. Some of these include genetic disorders and diseases of the kidneys, lungs or digestive system. With proper treatment, most people can live well with these diseases. Living well also involves taking good care of your bones.

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• AIDS/HIV
• Ankylosing spondylitis
• Blood and bone marrow disorders
• Breast cancer
• Cushing’s syndrome
• Eating disorders
• Emphysema
• Female athlete triad
• Gastrectomy
• Gastrointestinal bypass procedures
• Hyperparathyroidism
• Hyperthyroidism
• Idiopathic scoliosis
• Inflammatory bowel disease
• Diabetes mellitus
• Kidney disease
• Lupus
• Lymphoma and leukemia
• Malabsorption syndromes (examples are celiac disease and Crohn’s disease)
• Multiple myeloma
• Multiple sclerosis
• Organ transplants
• Parkinson’s disease
• Poor diet
• Post-polio syndrome
• Premature menopause
• Prostate cancer
• Rheumatoid arthritis
• Severe liver disease (including biliary cirrhosis)
• Spinal cord injuries
• Stroke (CVA)
• Thalassemia
• Thyrotoxicosis
• Weight loss

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