***Moderator addition: please keep in mind as you read this thread and the replies that while inhaled steroids can have some side effects, not everyone will be affected, and untreated or poorly controlled asthma is also very harmful and can be fatal. Please **don't** stop taking, reduce or replace any of your asthma medication without consulting your doctor or asthma nurse, and be mindful that alternative remedies may be unproven, harmful, or interact with other medications.***
Is anyone aware of the fracture risks from inhaled steroid inhalers being mentioned in annual asthma reviews? See this link nottingham.ac.uk/news/stero...
I had a fragile fracture in Oct 22 and then found the research showing the increased risk of fractures. I’m 53 and have used an inhaler corticosteroid for 40 years and had periodic steroid tablets for chest infections. I was in hospital nearly 4 months until I was permitted to walk on my shattered leg.
Trying to get the word out. Asthma and bone health there is a proven risk and connection. I think it ought to be in annual asthma reviews.
Written by
Rosesgrower
To view profiles and participate in discussions please or .
Good point. For women especially there needs to be more awareness. I'm not quite 40 but because of high dose steroid inhaler, prednisolone, being low in estrogen for a couple of years and not having a huge amount of calcium in my diet I've been advised to have a Dexa scan to check my bone density.
Ask your GP about bone profile tests ,i have a blood test every 6 months and a scan once a year to check my bones Im also on hrt patches which i was told help to protect bones .
Thanks for raising this awareness. My daughter has been using alot of inhaler corticosteroid and tablets in major attacks every year atleast two doses and now she keeps having wrist, knee issues she feels fragile like it will break and she has been saying her hips are also affected and finding it hard to walk especially one. I didn’t know how to get help.
I would certainly agree that it should be in the plan atleast yearly review. Asthma takes a toll on daily life as well as overall body. I hope you are well and able now.
Nice of you to warn others Rosesgrower, thank you. I dont think many are aware and you don't usually get a dexa (bone density) scan until you have a fracture. I had my first dexa scan at 53 after breaking my ankle and foot (I had dropped my large motorbike on it though). I rang the gp practice as requested, the receptionist told me it was fine. Unfortunately it was only when being investigated with lung issues in 2012 that the gp asked me what I take for the osteopenia. Doh! I was hopping mad as I'd never been a milk drinker. Since then I've had 4 more fractures.
I'd like to add why I'm a double candidate for osteoporosis . As a female we're also very prone to if if our menstruation years are short (mine was 17 to 41).
Not many women know that either. I warn my daughters who also started very late.
In my opinion the 400iu of vitamin D3 GPs offer us is inadequate, for this reason I take 2000iu daily along with vitamin K2 (which ensures the D3 gets to yr bones). And eat plenty of plain organic yogurt daily plus nearly a pint of milk and cross my fingers (carefully!)
There is the added issue that women, particularly once they start getting perimenopausal symptoms, get automatically written off as suffering from health anxiety, so any concerns get dismissed as being 'all in the mind' so it takes a lot longer for problems to be picked up!
You're right there, my daughter has been through this, offered antidepressants at 38 until I told (suggested, because life was a nightmare for the whole family especially the two small children, talk about walking on eggshells!) to her she must insist on a hormone blood test. Yes, she was perimenopausal. Now been on essential HRT (for bone density) for 7 years. I'm going to ask her to get a dexa scan asap
No! I didn't so thanks for letting us know. As I'm averse to any meds, I did ask asthma nurse about steroid damage, told so little gets into the body it was negligible. Already have 6 vertebral # s from OP so don't want any more thanks! 🙄 Am on Adcal D3, refused Prolia etc re side effects. What else can I do? I need my asthma meds for sure though rarely have to use Ventolin now, just Flixotide preventer x 2 puffs bid. Am going back on MSM, today! Hope you ok now, what did your gp say about it? 🤔
Sorry to show my ignorance but is this talking about Prednisolone courses or regular inhalers for asthma eg preventers and Ventolin etc? And how can they differentiate between those 'susceptible' and OP which can happen anyway for different reasons? And what is a high dose?You do not cite the research source or its validity? I find this a little disturbing.... 🤔
I've attached 2 links in the replies. As the lifestyle changes to prevent some of the risks are innocuous..vit D, calcium, weight bearing exercise and falls prevention awareness ..I think it's sensible to add to asthma reviews...simple and uncontroversial 🥰
fraid, click on the University of Nottingham link in Rosegrowers post above. It's quite clear (if I've known for years I cant possibly be alone). Basically it's about weighing up the benefits to the risks. I wouldn't survive without my inhalers so I look after my bones with plenty of calcium, fruit, veg vitamins D3 and K2 as well as weight bearing exercise (walking is free) and keeping my weight healthy so I can exercise - expecially balance classes (which can be found on youtube)
Thanks, did that and as usual didn't feel any conclusions were reached beyond doubt of other factors like genetics etc. It's hard to know who is right as so many opinions on this, like most things I expect a contradictory report any day now. 🤷♀️
I agree. I’m from Australia where they try to avoid giving asthmatics steroids - but the past 8 yrs of being in the UK I was put on steroids. I’ve broken my back from a simple fall in the garden & broken 3 bones in my foot…from walking on a pebble beach & I’ve been told my bones are weak in my hips. I’m 55 & was in great health when I arrived here. I’ve found alternatives to steroids & my asthma is now more controlled (there was a turbulent change over month as steroid use weakens your lungs) but I’m now back to full health - and my oesophagus is no longer irritated by the steroids so my chronic inflammation is clearing . There needs to be AWARENESS for asthmatics as we are often putting out one fire by starting several in other places. There are alternatives which when guided by a natural health doctor can really change your life.
Can I ask where you got the help to get off of steroids please? Also can I ask what you are using now please? I’m really worried about taking mine - I won’t stop taking it of course until I can find an alternative x
Hi KBalders, just to let you know we had to remove CeeCee3's reply here as it was in breach of our community guidelines, including those around promoting products claiming to help asthma.
Please be careful about replacing your asthma medications with alternative options - this is something to discuss with your doctor. Asthma medication can have some risks, but it's a balance of risks and benefits, considering that asthma can kill. For most people with asthma, these medications are necessary and either do not cause significant side effects or the effects of *not*using them are even worse, and it would be dangerous to stop using the medications.
That’s a mis representation- I certainly didn’t ‘promote’ any product at all. I’m actually finding it odd that you would try to invalidate my personal experiences in that way?
Promoting doesn't have to be trying to sell something or profit from it. In context, you were talking about things you have tried with the suggestion that they would help asthma and replace asthma medication. I realise you were asked about it, but it's still against the community guidelines, and you've also mentioned that this is apparently medical advice you were given by someone whose qualifications can't be checked by other users. We don't even typically allow actual healthcare professionals to give advice on here in their professional capacity or say that they are a healthcare professional, because we can't check their qualifications and it isn't appropriate for them to advise people on a forum or suggest they have additional expertise without the proper framework.
Even if you aren't directly telling people to try something, by writing explicitly about what you've taken to help yourself - especially in response to someone who's actively considering trying it - it can potentially be dangerous. It might not be suitable for them and their situation, and they might think it's fine to try it because it worked for you, and because you said it was prescribed by a doctor.
Your personal experience is just that - your personal experience. It doesn't mean that it will be the same for everyone else, or that something you can do or take safely is safe for other people. I'm glad you seem to have found something that helps you, but that doesn't necessarily make it appropriate to share with others.
The forum is about sharing personal experiences, but that stops at the point when the sharing is in danger of becoming informal medical advice or could encourage someone to follow medical advice meant for someone else.
That applies to all things that are discussed on here…all are personal to the individual & all could cause harm to others. Put no one is directing anyone people are getting & giving support. It is very clear that pharmaceuticals no matter how dangerous they are known to be when used or prescribed wrong are fine to “promote” but anything that’s natural is not. I find that extremely concerning.
Actually, it's not ok on the forum to promote or recommend specific prescription pharmaceuticals either, even based on personal experience. And it does happen at times - someone finds the one that works for them and starts telling everyone else on the forum their asthma would be controlled if they just had that inhaler, with no regard for other people's individual asthma or situation. Not allowed/encouraged either, even if they're just sharing their personal experiences.
However, practically speaking, it's harder for people to go away and just take prescription medication by themselves. I have previously more than once removed posts where people were discussing their pharmaceutical regimes in a potentially dangerous way which people might try without medical advice, or advising other people to take the same or do the same as they do with their prescribed medicines. I also personally am cautious about whether and how to tell someone what my experience has been and how I manage my asthma, especially when it comes to something like home nebulisers, which my consultant has approved for me but which may not be right for someone else.
But there is a difference between the following personal experiences:
'so happy, I used a salt lamp/steam/Vicks every day/went for acupuncture and came off all my asthma medication' [potentially dangerous sharing even if not actually telling anyone directly]
' I tapered my oral steroids down this way because I didn't like the side effects, here's the exact details of my personal regime' [not advising anyone else, personal experience but still dangerous as anyone could try this at home and make their asthma worse or give themselves adrenal crisis. Repeatedly posting this got someone banned]
'What you need to do is take these prescription drugs like I did, I have severe asthma and it works for me' [direct medical advice by someone unqualified to give it, to people they don't know online. Harder to follow, practically speaking, but still not allowed]
'I didn't get on with [inhaler A] either, I had x side effect, my doctor switched me to [inhaler B] and [other treatment]. You could ask your doctor if there's a different inhaler you could take if you can't tolerate the side effects'. [Helpful personal experience which prompts someone to actually get appropriate medical advice and not just try something they read online]
As I mentioned, if you go into a lot of detail and provide everyone with what they need to do whatever it is you're doing, without needing to get any medical advice, then you don't have to be explicitly telling them to do something for it to be a problem.
I’m sorry your reply is not appropriate to the question I answered from a fellow poster & the quote you’ve used as being not ok is nothing to do with me - I never said that or posted it. I find your stamp down on anyone discussing anything other than pharmaceuticals being highly disturbing. I note this website is not affiliated with the asthma foundation or with any national health body & im looking in to it further. You are controlling the debate & it’s unhealthy and odd. I’m here to learn & discuss with fellow sufferers not have to deal with your negativity & blocking of information and deleting my comments & arguing with me at every point.
I didn't actually say any quote was from you at any point. These were all examples of different types of 'personal experience' I was using to illustrate my point, and not associated with specific people or posts (though as mentioned one is based on real posts from an unnamed member).
HealthUnlocked itself is not affiliated with Asthma and Lung UK, but it hosts various health-focused online communities including this one, which is affiliated with Asthma and Lung UK. You're welcome to take it up with the moderation team who are all, apart from me, working for ALUK. You're also welcome to post here, within the rules and spirit of the community. Your reply was deleted for not being within those rules.
I’m sorry I received a message saying my reply to you breached rules by giving anecdotal evidence - I thought we were all here to learn from each others personal experience ie. anecdotal evidence? To sum up my reply to you…as they don’t want me giving you the information of what has helped me - I can only say, please find a good natural health doctor who is willing to treat your body as a whole interconnected system rather that treat one issue at the expense of creating others. And try to avoid stress as much as possible …stress is so often the underlying trigger in asthma and most other illnesses. 🌸
Thanks for posting this. I’ve been diagnosed with early stage osteoporosis ( I’m 56) this was discovered after I broke my ankle in 3 places last year. It was a life changing injury- lost my job, severe depression. I’ve since been looking into the side effects of steroid inhalers - I’m on Fostair 100/6. Basically the steroids take the minerals from your bones, causing weakness.. they cause swallowing problems, bruising problems and acid in stomach. I have all of these symptoms. I’m wondering if there is any alternative out there other than steroid inhalers to prevent asthma flare ups?
Hi, I'm so sorry to hear about your injury and the effects it's had. That's really tough and I hope things improve for you soon.
It is difficult because inhaled steroids are still a key part of asthma management and uncontrolled inflammation in asthma is very dangerous. There are non-steroid treatments but they're not typically an alternative - though definitely can be an alternative to increasing inhaled steroids.
This is a conversation you should have with your doctor or asthma nurse, if you haven't already. I'd also suggest you speak to the asthma nurses on the helpline as they can chat through options that you can take to your GP/nurse. 0300 2225800 or WhatsApp 07378 606 728 Monday-Friday 0915-5pm
I had a Dexa scan in 2021 as I've taken lots of oral steroids over the years and it found osteopenia (I'm 41 and male). I was put on alendronic acid. I think osteopenia is fairly common but if you use or will use oral steroids I think they tend to put you on bone protection treatment. Or they should do!
When I was taking high doses of prednisolone due to having Polymyalgia Rheumatica, I had. Dexa scan which showed I han osteopoenia.. Both Alendronic Acid and Risendronate caused excrutiomally painful side effects and I was taken off them. I've since taken a Calceos tablet daily.About four years after I'd finished the reducing dose of prednisolone, which itself took just under four years, I slipped going downstairs and fractured my right fibula, which healed, and damaged my right leg's peroneal nerve, which hasn't healed, causing Foot Drop of my right foot. I now wear a carbon fibre Ankle Foot Orthotic which helps me to walk.
I think the amount of inhaled steroids would not be sufficient to cause osteoporosis or osteopoenia.
I do feel like I also need to point out to everyone reading this thread who may be worried about their inhaled steroids that untreated or poorly controlled asthma is also very harmful and can be fatal.
Perhaps in the future there will be better alternatives (we already do have non-steroid medications, though they haven't yet replaced ICS). And it's certainly good to keep an eye on your bone health and take steps to protect it, including discussing it in annual asthma reviews.
But I would want to make sure that any discussion includes the dangers of *not* taking the medication - though really that should be part of any new medication prescription, the risks and benefits of it. Apart from anything else, not taking inhaled steroids can lead to needing more courses of *oral* steroids which is worse for your bones (though may still be necessary for asthma).
True...bone health ought to be part of yearly asthma reviews though as the protections are not complicated to implement.. I'm disappointed this isn't national policy to prevent the billions that are spent on fractures (current falls prevention strategy). It seems a simple campaign issue to take forward...when I was prescribed naproxen I was given omeprazole to prevent stomach damage...this is no different..
@Lysistrata Agreed. I must admit, I was really nervous when I read that the side effects of my new medication could include 'increased risk of fractures', and yes, I'd obviously be much happier if it didn't have those side effects, but the side effects of not being able to breathe are a lot worse!!!
In 2017 I broke my elbow & in 2018 I broke my shoulder so they sent me for a dexa scan. The nurse asked if I'd had steroids. I said I'd had one course of pred. when first diagnosed with asthma & now I was on inhalers. She said she wasn't bothered about the inhalers just the tablets. Maybe it depends on the results of the scan. At that time I used to walk very quickly, people used to comment on it, so if I fell, I hit the ground very hard. I've slowed down now! I tripped in the house a couple of months ago & didn't break anything, other than skin on my arm, but I wasn't going that fast.
Beyond systemic and inhaled steroids, one of the complications for asthmatics on antacids, like Omeprazole, is the effect they have in the vitamin D receptors in the digestive system, diminishing absorption of dietary vitamin D.
Vitamin D is fat soluble, unfortunately it's not yet known what amount of fat is required to maximise absorption of VitD. So if you supplement, consider fat based items.
Ideally we would get sufficient from sunlight, but northern hemisphere countries don't have enough exposure to the right strength of sunshine all the year round, so even though a Vit D rich diet is important, even the NHS recommends Vit D supplementation.
If you do choose to supplement with Vit D, be aware that magnesium is required to activate Vit D and make it work for our bones, teeth etc, otherwise we just store it in fat cells and soft tissues. Other co-factors that maximise absorption of VitD are Vit K (best Vit K2 mk7), boron, Vit A, zinc. Vits A & K are also fat soluble.
As a bonus, Vit K2 has been considered as a component in preventing vascular calcification. BUT if you're on blood thinners, talk to your doctor before taking any Vit K supplements.
Magnesium is always twinned with another element, such as glycinate, malate, citrate or taurate. You'll see magnesium oxide too, but this is probably the least effective to use, poor absorption properties. Glycinate is good for sleep, anxiety, inflammation and has no laxative properties. Malate has energising properties. Citrate has laxative properties. Taurate is good for heart health and blood sugar levels. So choose carefully and consider what time if day you take your magnesium.
Hope this helps. I broke my shoulder in 2014 and we have a history of osteoporosis in the family, so I've done alot of homework on bone health, but I'm still learning. My first attempts at vit D supplementation showed poor results (I had a vit d test to check my levels) and I was only just in the adequate range. Covid was a real eye opener on how important excellent vit D levels are, if only for our immune system. So if you do decide to supplement, I would recommend taking a vit D test before you start and again 6 months in, just to confirm that your regime is working as expected.
I take Betteryou VitK2 Mk7, as it's an oil based spray & not derived from natto. But there are a wide range of supplements available on the market, most of which are made from natto (fermented soybean) which most people can tolerate.
The ability to reply to this post has been turned off.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
COVID & asthma: are we at risk, or are we protected?
Seretide and adrenal insufficiency/exhaustion 
Risk Assessment at work
Long-term side effects from inhaled steroids and various asthma pumps
