A New Side Effect

I was just told this afternoon by my Ortho that i have a stress fracture in my hip due to prednisone. Im shocked. Anyone heard of this?

[HeronNS]

Long term use of prednisone can, does not always, cause bone thinning. When people take pred they should be told this, and take supplements and do other things to counteract this effect. A DXA scan should have been done early when expecting to be on long term pred in order to get a baseline. Maybe this will help:

healthunlocked.com/pmrgcauk...

[yogalibrarian]

Long-term use of corticosteroids (prednisone) can significantly increase your risk of fracture.

I just checked this in the ABH Fracture Risk Calculator. I created a fictional, average woman -- white, age 65, 5'6", 140 lbs (normal BMI 22.6%), with no other risk factors -- and calculated her fracture risk with and without prednisone.

Without prednisone:

10-year risk of any fracture: 11% (just edging into the moderate risk zone because of age)

Average 10-year risk for your age: 11%

10-year risk of a hip fracture: 2%

With prednisone:

10-year risk of any fracture: 24% (well into the high risk zone)

Average 10-year risk for your age: 11%

10-year risk of a hip fracture: 3%

Knowing the T-score and including it in the calculation would be important for refining the calculation.

If you are on prednisone it's important to have regular DXA scans to determine your bone density.

You are obviously taking prednisone for a significant medical reason to manage another condition. You might talk with a doctor (endocinologist or rhematologist) about way to manage your bone health while continuing the prednisone.

Good luck with your discussions with your doctor.

[Hidden in reply to yogalibrarian]

Thank you so much for this info! I am taking it for PMR. Was on 20 mg for a year and a have and am working on reducing dose. Now on 15 mg. I held off taking it at all for a long time because of risks, but finally got to the point where my quality of life was just about zero and said I dont care about risks, just want to feel better. Thats a big increase for risk of fracture.

[yogalibrarian in reply to Hidden]

That's the things about risk -- everything carries some sort of risk. What is the right balance. I read an interesting article recently that added a new perspective. Although we'd all like to do things that are risk free, we're all ready to accept some level of risk in many activities. For example, traveling in a car carries with it some level of risk of injury or death. Yet many of us travel in a car or bus very regualrly.

If you can't eliminate the risk, how can you mitigate it? In a car, I have seat belts and air bags, and a few other modern safety features. I try to drive mindfully -- no texting or playing with my cell phone. Watch out for the crazies on the roads, etc.

Mitigate the risks caused by the prednisone with good diet (rich in calcium), vitamin D supplements, weight-bearning and muscle strenthening exercise (while avoiding high impact exercise), balance training, and fall prevention activities. And medication is appropriate.

Good luck. Please continue to share your experiences.