Do You Have Asthma? Take Measures to Strengthen Your Bones

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
March 9, 2021
Asthma Medications and Bone Health

If you have asthma, there’s a good chance that you’ll be prescribed a steroidal medication to ease airway constriction, coughing and wheezing. However, taking steroid inhalers or tablets to manage asthma or treat flare-ups raises your risk for osteoporosis and bone fractures, according to a study published in Thorax.

Asthma is a common condition in which inflammation causes airways to swell, narrow and produce unnecessary mucus. When your asthma flares up, you may need a fast-acting medication like an oral steroid, (e.g., Medrol dose pack or Prednisone) or even intravenous steroid administered in a hospital emergency department to get immediate relief. And if your asthma is chronic, you may be prescribed a longer-lasting medication to help keep the airways opened -- typically an inhaled corticosteroid such as Breo, Advair, Flovent, Pulmicort, Asmanex, Symbicort, Qvar RediHaler or Alvesco. 

Steroids can affect how the body uses calcium and vitamin D to build bones, raising the risk for bone loss, osteoporosis and fractures. But it’s not well understood if taking corticosteroids to control asthma will weaken the bones. 

Researchers in the new study found that taking inhaled corticosteroids and/or oral steroids raised the risk for osteoporosis and fractures. And the risk corresponded with the cumulative dosage and number of times a patient used one of these drugs.

“Steroidal medications are an important of asthma management; in fact, these drugs can prevent hospitalizations and save lives,” says Bernard Kaminetsky, MD, MDVIP’s medical director. “But like all medications, there are side effects. And one of them is weaker bones.” 

The good news is you can take steps to protect your bones. The Colorado Center for Bone Health suggests:

Eat a well-balanced diet that includes foods rich in calcium and vitamin D such as low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. 

Exercise, particularly weightbearing activities (walking, running and hiking) and strengthening training (using free weights, machines or resistance bands/tubing), are known for helping strengthen bones. Talk to your doctor before beginning or changing an exercise program) and remember to keep your rescue inhaler on hand when working out. 

Curb caffeine, as studies suggest caffeine intake interferes with calcium retention and  decreases bone mineral density, raising the risk for hip fractures.

Avoid tobacco. Smoking damages your bones. If you still smoke, work with your doctor to help you quit. 

Limit alcohol, as heavy alcohol consumption weakens bones’ mechanical properties and decreases bone density. Studies suggest that drinking more than two alcoholic drinks a day may damage bones. 

“If you have asthma, work closely with your doctor to help manage it, maintain your bone health and adjust your medications as needed to exercise,” says Kaminetsky. 

MDVIP-affiliated doctors have the time and tools to develop a strong patient relationship and can create a personalized wellness plan that can focus on lung and bone health. Don’t have an MDVIP-affiliated doctor? MDVIP has a nationwide network of physicians. Find one near you and begin your partnership in health.

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About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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