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Asthma and Osteoporosis

What Is Asthma?

Asthma is a chronic lung disease that affects about 15 million Americans, more than five million of whom are under the age of 18. Asthma is becoming more common, and African Americans are especially at risk. For a person with asthma, everyday things can trigger an attack. These things include air pollution, allergens, exercise, infections, emotional upset, or certain foods.

Typical asthma symptoms include coughing, wheezing, tightness in the chest, difficulty breathing, a rapid heart rate, and sweating. Children with asthma often complain of an itchy upper chest or develop a dry cough. These may be the only signs of an asthma attack.

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Asthma itself does not pose a threat to bone health. However, certain medications used to treat the disease and some behaviors triggered by concern over the disease can have a negative impact on the skeleton.

What Is Osteoporosis?

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in significant pain and disability. Osteoporosis is a major health threat for an estimated 44 million Americans, 68 percent of whom are women.

Risk factors for developing osteoporosis include:

  • being thin or having a small frame
  • having a family history of the disease
  • for women, being postmenopausal, having an early menopause, or not having menstrual periods (amenorrhea)
  • using certain medications, such as glucocorticoids
  • not getting enough calcium
  • not getting enough physical activity
  • smoking
  • drinking too much alcohol.

Osteoporosis is a silent disease that can often be prevented. However, if undetected, it can progress for many years without symptoms until a fracture occurs.

The Connection Between Asthma and Osteoporosis

People with asthma tend to be at increased risk for osteoporosis, especially in the spine, for several reasons. First, anti-inflammatory medications, known as glucocorticoids, are commonly prescribed for asthma. When taken by mouth, these medications can decrease calcium absorbed from food, increase calcium lost from the kidneys, and decrease bone formation. Doses of more than 7.5 mg (milligrams) each day can cause significant bone loss, particularly during the first year of use. Corticosteroids also interfere with the production of sex hormones in both women and men, which can contribute to bone loss, and they can cause muscle weakness, which can increase the risk of falling and related fractures.

Many asthma sufferers think that milk and dairy products trigger asthmatic attacks, although the evidence shows that this is only likely to be true if the person has a dairy allergy. This unnecessary avoidance of calcium-rich dairy products can be especially damaging for children with asthma who need calcium to build strong bones.

Since exercise often can trigger an asthma attack, many people with asthma avoid weight-bearing physical activities that are known to strengthen bone. Those people who remain physically active often choose swimming as their first exercise of choice because it is less likely than other activities to trigger an asthmatic attack. Unfortunately, swimming does not have the same beneficial impact on bone health as weight-bearing exercises that work the body against gravity. These exercises include walking, jogging, racquet sports, basketball, volleyball, aerobics, dancing, and lifting weights.

WebMD Public Information from the U.S. National Institutes of Health

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