Drug-Induced Osteoporosis: Could Your Medications Be Harming Your Bones?

Vivian Goldschmidt, MA Drugs

Evidence-Based

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7 min Read
medications

Many commonly prescribed medications cause bone loss and can lead to osteoporosis. Furthermore, doctors are often unaware that the drugs they prescribe can have this effect.

Once again, it's incumbent upon Savers to look out for themselves and their bones. Today you'll get a comprehensive review of medications–both prescription and over-the-counter–that can lead to an osteoporosis or osteopenia diagnosis.

Refer to this list before you start any medication– and as always, consult with a functional or naturopathic doctor about potential non-pharmaceutical alternatives.

Drugs And Osteoporosis

When medications cause enough bone loss to warrant an osteoporosis diagnosis, the condition has a special name: Drug-Induced Osteoporosis. It's outrageous that the pharmaceutical interventions championed by the Medical Establishment can cause new health conditions.

Of course, for Big Pharma, this is only a benefit. They inevitably have another drug to prescribe for the condition caused by the prescribed drug– and on and on the cycle goes.

All drugs contribute to bone loss through acidification and the burden they place on the body's toxin filtration system, but the following medications have a direct and outsized negative impact on the health and density of your bones.1

Synopsis

Drug-Induced Osteoporosis occurs when a medication causes loss of bone density. While all drugs are acidifying and therefore bad for bone health, the following drugs have an additional direct negative impact on bone density.

Corticosteroids

Steroids are commonly prescribed to reduce inflammation and pain caused by rheumatoid arthritis, lupus, Crohn’s disease, or asthma, and other health issues. Common steroids include:

  • prednisone (Deltasone, Rayos, Prednisone Intensol)
  • prednisolone (Omnipred, Pediapred, Pred Mild)
  • methyprednisolone (Medrol, Solu-Medrol, Depo-Medrol, ReadySharp, P-Care D40, P-Care D80)
  • dexamethasone (Decadron, Ozurdex, DexPak 6 Day, DexPak 13 Day, Dexamethasone, Intensol, DexPak 10 day, Maxidex, LoCort)
  • cortisone (Cortison, Cortisone, Cortisone Acetate, Cortone, Cortistab, Cortisyl, Adreson)
  • triamcinolone (Aristocort, Aristocirt Forte, Aristospan, Clinacort, Kenalog-10, Kenalog-40, Triamcot, Triam-Forte, Triesense)

Some steroids are administered with an inhaler, usually to treat asthma. These can also cause bone loss. Common inhaled steroids include:

  • fluticasone (Flovent Diskus, Flonase Allergy Relief, Aller-Flo)
  • budesonide (Rhinocort Allergy, Pulmicort, Pulmicort Flexhaler)

Diabetes Medications

Some diabetes medications increase the production of fat cells in bone marrow, displacing bone-forming osteoblasts. The two categories to look out for are thiazolidinediones (TZD) and SGLT-2 Inhibitors.

Thiazolidinediones (TZD) include:

  • pioglitazone (Actos)
  • rosiglitazone (Avandia)

SGLT-2 inhibitors include:

  • canagliflozin (Invokana)
  • dapagliflozin (Forxiga)
  • empagliflozin (Jardiance)

Drugs For Mental And Emotional Healh

Selective serotonin receptor uptake inhibitors (SSRIs) are frequently prescribed to treat the symptoms of depression. However, they have been found to increase fracture risk in older women.

SSRIs include the following drugs:

  • Prozac
  • Paxil
  • Zoloft

Lithium is a compound frequently used to treat bipolar disorder. However, it increases parathyroid gland activity, causing bone resorption to outpace bone formation.

Beware of these lithium mood stabilizers:

  • Eskalith
  • Eskalith-CR
  • Lithobid

Acid-Reducers

Use of acid-reducing drugs such as antacids and proton pump inhibitors can reduce the body's capacity for absorbing calcium, leading to bone loss.

Antacids with aluminum impede calcium absorption, including:

  • Maalox
  • Mylanta
  • Riopan

Proton pump inhibitors include:

  • dexlansoprazole (Dexilant, Kapidex)
  • esomeprazole (Nexium)
  • lansoprazole (Prevacid)
  • omeprazole (Prilosec, Zegerid)
  • pantoprazole (Protonix)
  • rabeprazole (Aciphex)

Loop Diuretics

Loop diuretics prescribed to people with high blood pressure, congestive heart disease, kidney disease, and liver disease flush calcium and other alkalizing and bone-building minerals from the body. This loss of bone-building minerals results in a loss of bone mass.

  • furosemide (Lasix)
  • ethacrynic acid (Edecrin)
  • bumetanide (Bumex)
  • torsemide (Demadex)
  • spironolactone (ldactone)
  • triamterene (Dyazide)
  • acetazolamide (Diamox)

Anti-Coagulants And Blood Thinners

Certain blood thinners and anti-coagulants can prevent calcium absorption and inhibit Vitamin K metabolism.

  • Heparin
  • Lovenox (low molecular weight heparin)
  • Warfarin
  • coumadin (Jantoven)

Anti-Convulsants

Some drugs prescribed to treat seizures and epilepsy increase Vitamin D metabolism in the liver. The resultant reduction in Vitamin D levels prevents adequate calcium absorption, leading to bone loss.

  • phenytoin (Phenytek, Dilantin)
  • phenobarbital (Luminal)
  • sodium valproate (Depakote)

Thyroid Medications

The thyroid gland plays an important role in regulating bone health, and when drugs affecting the thyroid are taken in too large a dose, they cause bone demineralization.

  • levothyroxine (LT4) (Levoxyl, Synthroid, Unithroid)
  • dessicated thyroid gland (Armour Thyroid)

Sex Hormone Drugs

Drugs that reduce levels of estrogen or androgens cause an increase in the activity of the osteoclasts, which are the cells responsible for bone reabsorption.

Common hormone blockers include aromatase inhibitors:

  • anastrozole (Arimidex)
  • exemestane (Aromasin)
  • letrazole (Femara)

Androgen/estrogen deprivation therapy uses gonadotrophin agonists/antagonists including:

  • leuprorelin (Lupron, Lupron Depot)
  • leuprolide (Eligard)
  • goserelin (Zoladex)
  • buserelin (Suprefact)
  • flutamide (Eulexin)
  • bicalutamide (Casodex)
  • triptorelin (Trelstar)
  • histrelin (Vantas)
  • degarelix (Firmagon)
  • cetrorelix (Cetrotide)
  • ganirelix (Antogon)

Depomedroxyprogesterone acetate injections include:

  • Depo-Provera
  • Depo-Ralovera

Antiretroviral Therapies

Certain HIV medicines can cause bone loss of up to 2-6% in the first two years after starting treatment. Tenofovir disoproxil fumarate (TDF) and regimens containing TDF are well known to have this effect:

  • Cimduo
  • Complera
  • Delstrigo
  • Stribild
  • Truvada
  • Vemlidy
  • Viread

Tramadol Pain Relievers

Tramadol is a synthetic opioid associated with a higher risk of hip fracture than other types of pain relievers. Pain relievers containing tramadol include:

  • Conzip
  • Qdolo Rybix ODT
  • Ryzolt
  • Ultram
  • Ultram ER

Immunosuppressants

Calcineurin Inhibitors are prescribed to suppress immune function after organ transplants or in people with autoimmune disorders. They disrupt the cells that regulate bone remodeling.

  • cyclosporine (CsA) (Sandimmune, Neoral, Gengraf, Restasis MultiDose, Restasis)
  • tacrolimus (Protopic, Envarsus XR, Prograf, Astagraf XL)

How To Avoid Bone-Damaging Drugs

If a bone-damaging drug is recommended to you, either as a prescription from your doctor or as an over-the-counter drug, always seek natural alternatives.

The first question should be whether there is a non-pharmacological intervention you could try. No matter what drug you take, it will increase acidification and tax your liver and kidneys, which will spend resources to filter the drug from your body.

Consult with a functional or naturopathic medicine doctor whenever possible. Ask about treatments that don't involve drugs, and do your own research as well. Much like osteoporosis, many conditions can be corrected through changes to diet, exercise, and lifestyle.

In the event that you need a pharmacological intervention, ask your doctor about alternative drugs that are not on this list. Always ask your doctors about the potential impact on your bones of any drug or procedure they suggest.

Synopsis

Seek alternatives to bone-damaging drugs on this list and for any other drugs you are recommended. Consult a functional or naturopathic medicine doctor whenever possible. As with osteoporosis, there are often safer and more effective non-pharmaceutical interventions you can pursue.

What This Means To You

Sometimes it's necessary to take a drug– so it's essential to know which ones could cause outsized harm to your bones. Check this list before starting any new drug therapy, and always ask your doctor directly about the impact of treatment on your bones.

One way or another, we all come into contact with substances that harm our bones– in the air, water, and food. That's unfortunately a fact of modern life. The Save Institute developed a seven-day cleanse as a tool for you to periodically give your body a break from those day-to-day toxins.

The Osteoporosis Fresh Start Cleanse gives your bones a chance to catch up– that's why we call it a fresh start. The Osteoporosis Fresh Start Cleanse protocol is backed by research and broken into a simple six-step structure. It is quick and painless compared to most other cleanses and less restrictive on food and drink. And you’ll get over 40 delicious, cleansing recipes!

The ideal health interventions don't have side effects– only side benefits. That's why you're pursuing a natural path to building stronger longer-lasting bones.

References

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206646/