Medications that may harm your bones    

                In an age when almost every malady can be cured or at least relieved, many of us take in a stew of drugs every day. Some studies show that the typical 65-year-old takes an average of four prescription drugs. Almost every prescription drug has some side effects. Most are simply uncomfortable, causing stomach upset, drowsiness or skin rash. More serious problems include intestinal bleeding, severe muscle pain or psychiatric disturbances. For persons who are at risk of osteoporosis there are several medications that lead to or worsen that bone-thinning disease.

            Glucocorticoids such as hydrocortisone have long been known to adversely affect bone health, especially in the spine. Although they are often taken for relatively short periods there are some chronic diseases that require long-term use. Patients with asthma who take the inhaled form of corticosteroids may also suffer from bone loss.

            Depression is such a common illness that antidepressants are among the most-prescribed drugs in the United States. They have numerous side effects, one of which is to inhibit cells that build bone. Although depression itself is associated with an increased incidence of fractures, persons who take the most commonly prescribed antidepressants have nearly double the risk of those not on these drugs.

            The dramatic increase in type 2 diabetes over the past two decades has led to the development of several classes of anti-diabetic drugs. The so-called glitazones have been associated with an increased risk of fractures. 

            Sufferers of gastric reflux are familiar with the “purple pill” that lowers gastric acidity and relieves the heartburn-like symptoms. Unfortunately, reducing stomach acid also inhibits the absorption of calcium and magnesium, important minerals in maintaining bone health. The consequence is an increased risk of fractures of the hip, wrist and spine.

            Some of these drugs can be life-saving and others can significantly improve the quality of life.      These important considerations must be taken into account and weighed against the risk of bone fractures. Fosamax and similar medications that combat osteoporosis have been shown to slow the progression of drug-induced bone loss but they also have side effects.

Lifestyle changes that include increased physical activity and optimal nutrition are especially important and are relatively easy to implement. With rare exceptions, advanced age and chronic illness are not excuses to avoid exercise. Physical therapists are quite knowledgeable about designing a safe exercise program that takes these factors into account, thus reducing the harmful effects on bone of prescription drugs.