About Lupus

Bone Up On Osteoporosis in Lupus

Here's some news that may surprise you: all people with lupus—young, old, female, male—are at risk for thinning and easy-to-break bones, a condition called osteoporosis.

Most people think of osteoporosis as a problem for older women. But "secondary osteoporosis" can develop in people of all ages who take the lupus medication prednisone, a corticosteroid (steroid).

While steroids help to control the immune system, they also weaken bones by robbing bone cells of oxygen and preventing the body from absorbing bone-strengthening calcium. Taking steroids for as little as three to six months raises the risk for osteoporosis, and research shows that one in three people who take the drug for a year or more will eventually break a bone.

But having lupus alone, even without taking steroids, also increases the chances that bones will get fragile and break. With lupus, inflamed blood vessels can block blood flow to bone cells, weakening the bones. And the pain and fatigue of lupus can keep a person from walking and other activities that help keep bones strong.

Even in their teens and twenties, women with lupus need to be very aware of the threat to their bones. Half of women with lupus who break a bone are younger than age 50.

Post-menopausal women should talk to their doctors about drugs that can offset the side-effects of steroids and treat osteoporosis. Most drugs are not recommended for younger women because they could cause problems during a pregnancy; however, there are some options for at-risk men. Everyone should ask their doctor about bone density tests, which can spot weaknesses in bones before a break happens and help in prescribing treatments.

Steps to prevent osteoporosis:

  • Eat foods high in calcium like yogurt, cheese and milk
  • Take calcium and vitamin D supplements
  • Increase weight-bearing exercise, like walking
  • Avoid alcohol and stop smoking
  • Lower your dose of steroids, if possible

Common Question:

What is the best exercise for people with lupus?

Lupus can make it feel impossible to be able to exercise. But too much time off your feet can cause stiffness and muscle weakness, as well as weight gain and many other problems. My answer? Get your feet wet.

Swimming and water aerobics are safe, low-impact exercises perfect for people who deal with muscle aches and pain. Warm water also helps increase blood flow and relieves stress on joints. Plus, it's easier to get your heart pumping in water than on land. The downside? Water activities do not strengthen your bones, so be sure to combine them with weight-bearing exercises like stair-climbing or dancing.

If you don't know how to swim, try water aerobics, which take place standing up in the shallow end of the pool using flotation devices. Join a class taught by a certified instructor at your local YMCA or recreation center with an indoor pool, which will shade you from the sun and keep the water at a nice warm temperature year-round.