- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
read biographyclose windowBiography of
April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology and Internal Medicine at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale University School of Medicine and had been with Mayo Clinic in Rochester, Minn., between 1991 and 2002 when she relocated to Mayo Clinic, Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
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Question
Osteoporosis and long-term prednisone use: Is there a connection?
I've been taking prednisone for my rheumatoid arthritis, but I've heard that it can increase my chances of developing osteoporosis. How big is the risk?
Answer
from April Chang-Miller, M.D.
It's difficult to say exactly how big the effect is because other factors — including rheumatoid arthritis itself — can lead to bone loss, too. In general, though, the higher the dose of prednisone you take and the longer you take it, the greater the risk.
Prednisone is one of the most common types of steroids prescribed to help control the inflammatory symptoms of rheumatoid arthritis. But prednisone also reduces the amount of calcium absorbed by your intestines and increases the amount of calcium excreted through your urine. This can dramatically weaken bones and lead to osteoporosis.
Taking calcium and vitamin D supplements can help reduce the amount of bone loss caused by steroids such as prednisone. In some cases, your doctor may prescribe medications specifically designed to combat osteoporosis.
Next questionArthritis pain medications: Do they raise blood pressure?
- Rosen HN. Glucocorticoid and osteoporosis: Pathogenesis and clinical features. http://uptodate.com/home/index.html. Accessed Jan. 23, 2009.
- Rosen HN. Prevention and treatment of glucocorticoid-induced osteoporosis. http://uptodate.com/home/index.html. Accessed Jan. 23, 2009.
- Firestein GS. Glucocorticoid-induced osteoporosis. In: Firestein GS. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders; 2008. http://www.mdconsult.com/das/book/body/117661802-3/795461296/1807/696.html#4-u1.0-B978-1-4160-3285-4..10092-0--s0190_3400. Accessed Jan. 23, 2009.
