Preventing Glucocorticoid-Induced Osteoporosis

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Abstract
Glucocorticoid hormones have revolutionized the management of many illnesses, reducing morbidity in conditions such as rheumatoid arthritis and mortality in other diseases such as asthma. However, they have many side effects, one of the most troubling being osteoporosis. Glucocorticoids interact with calcium metabolism at many levels1; in particular, they reduce the synthesis by osteoblasts of the principal proteins of bone matrix, including type I collagen and osteocalcin. Glucocorticoids probably cause malabsorption of calcium (and possibly phosphate) in both the gut and the renal tubule, and they reduce serum sex hormone concentrations, particularly in men and postmenopausal women. However, they . . .
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