About Lupus

Bone Health

Preventive Care Strategies: Living with Lupus

Osteoporosis (bone thinning) occurs when the bones lose calcium and other minerals that keep them strong. Osteoporosis can lead to fractures and cause bone pain. People with lupus are at greater risk for osteoporosis than those who do not have lupus.

Why are people with lupus at risk?
Dr. Fradlis explained that osteoporosis can occur in people with lupus because of ongoing use of steroids as well as from chronic inflammation from the disease itself. Additional risk factors are age and menopause because the hormone estrogen helps protect against osteoporosis. Chronic inflammation can also increase the risk of osteoporosis for people with lupus.

How is osteoporosis diagnosed?
A bone density test (DEXA) checks areas of the body such as the hips, hands and feet for signs of mineral loss and bone thinning.

What can you do to prevent osteoporosis?

  • Modify lifestyle factors
    • Eliminate cigarette smoking
    • Limit alcohol consumption
    • Maintain a weight-bearing exercise regimen
  • Work with your rheumatologist to limit steroid therapy to the lowest possible dose and duration
    • Supplement your diet with calcium and vitamin D
    • People need an average of 1,200 mg of calcium and an average of 800-1,000IUs of Vitamin D every day.
    • Calcium is necessary to build and maintain bone strength and structure.
    • Vitamin D helps absorb calcium and phosphorous in foods and helps decrease bone breakdown.

How is osteoporosis treated?

  • Dr. Fradlis recommends asking your healthcare provider about taking Vitamin D and calcium supplements as well as increasing calcium intake in your diet, such as dairy products, dark green vegetables, salmon and tofu.
    • Vitamin D helps the body absorb calcium to help prevent bone breakdown
  • Your healthcare provider may also prescribe bisphosphonates -- medications which help to slow the breakdown and removal of bone (resorption).
    • Common bisphosphonates include:
      • Alendronate (Fosamax)
      • Risedronate (Actonel)
      • Ibandronate (Boniva)
      • Zoledronic Acid (Reclast)

Interested in learning more about other preventive care strategies for living with lupus? Click Here to watch a previous presentation Dr. Fradlis gave about how to prevent osteoporosis and many other complications of lupus.

This column is not meant to substitute for medical advice from your own healthcare provider – please talk to your doctor about recommendations for preventing lupus complications.  

Dr. Bella Fradlis is an attending rheumatologist who divides her time between Jacobi and Montefiore medical centers, treating a variety of systemic rheumatologic conditions. She received her medical training at Stony Brook University School of Medicine. She then completed an internship year at Long Island Jewish Hospital and internal medicine residency training at Columbia University Medical Center – New York Presbyterian Hospital. Dr. Fradlis completed a clinical rheumatology fellowship at Columbia University Medical Center.