Asthma and Osteoporosis
Osteoporosis Management Strategies
Strategies to prevent and treat osteoporosis in people with
asthma are not significantly different from the strategies for those who do not
have the disease.
Nutrition: A diet rich in calcium and vitamin
D is important for healthy bones. Good sources of calcium include low-fat dairy
products; dark green, leafy vegetables; and calcium-fortified foods and
beverages. Also, supplements can help ensure that the calcium requirement is
met each day, especially in those with a proven milk allergy.
Vitamin D plays an important role in calcium absorption and
bone health. It is made in the skin through exposure to sunlight. While many
people are able to obtain enough vitamin D naturally and/or from fortified
foods, some individuals may require vitamin D supplements in order to ensure an
adequate daily intake.
Exercise: Like muscle, bone is living tissue
that responds to exercise by becoming stronger. The best kind of activity for
your bones is weight-bearing exercise that forces you to work against gravity.
Some examples include walking, climbing stairs, lifting weights, and
People who experience exercise-induced asthma should exercise
in an environmentally controlled facility and participate in activities that
fall within their limitations. They may also use medication when necessary to
enable them to exercise.
Healthy lifestyle: Smoking is bad for bones as
well as the heart and lungs. Women who smoke tend to go through menopause
earlier, triggering earlier bone loss. In addition, smokers may absorb less
calcium from their diets. Alcohol can also negatively affect bone health. Those
who drink heavily are more prone to bone loss and fracture, because of both
poor nutrition and an increased risk of falling.
Reducing exposure to asthma triggers, such as irritants and
allergens, can help lessen a person’s reliance on glucocorticoid medication.
Avoiding people with colds and other respiratory infections and minimizing
emotional stress can also be important.
Bone density test: Specialized tests known as
bone mineral density (BMD) tests measure bone density at various sites of the
body. These tests can detect osteoporosis before a fracture occurs and predict
one’s chances of fracturing in the future. People with asthma, particularly
those receiving glucocorticoid therapy for 2 months or more, should talk to
their doctors about whether they might be candidates for a bone mineral density
Medication: Like asthma, osteoporosis is a
disease with no cure. However, there are medications available to prevent and
treat osteoporosis. Several medications (alendronate, risedronate, ibandronate,
raloxifene, calcitonin, teriparatide, and estrogen/hormone therapy) are
approved by the Food and Drug Administration for the prevention and/or
treatment of osteoporosis in postmenopausal women. Alendronate is also approved
for use in men. For people with asthma who develop or may develop
glucocorticoid-induced osteoporosis, alendronate has been approved to treat
this condition and risedronate has been approved to treat and prevent it.
Because of their effectiveness in controlling asthma with fewer
side effects, inhaled glucocorticoids are preferred to oral forms of the
medication. Since bone loss tends to increase with increased glucocorticoid
doses and prolonged use, the lowest possible dose for the shortest period of
time that controls asthma symptoms is recommended.