Osteoporosis Risks in the Home Medicine Cabinet

This is the 3767th article of Da Yi Xiao Hu

Let me tell you a story first: My good neighbor Aunt Wang broke her wrist accidentally in March this year. Fractures are not uncommon, but what is uncommon is that she just pulled the door handle, and with that "inch force", her wrist was broken by chance... I believe you must be very surprised to hear about Aunt Wang's story: Although older women are prone to osteoporosis, but for Aunt Wang to break her bones so easily, how "porous" must her bones be...

In fact, there are causes for Aunt Wang's strange fracture and severe osteoporosis. In addition to the congenital factor of being a "postmenopausal middle-aged woman", the more important reason is that Aunt Wang is a patient who has had her thyroid nodules removed and has been taking drugs to regulate thyroid function for a long time. So, in other words, it is certain drugs that people have been taking for a long time that aggravate osteoporosis. Perhaps in your family medicine cabinet, there are these commonly used drugs that aggravate osteoporosis. Today, let's sort them out and help you avoid the risk of osteoporosis from the perspective of medication.

1. Thyroxine

Currently, more and more people are suffering from thyroid diseases, especially those with thyroid nodules or even thyroid cancer. After surgical treatment, these people often have a decrease in thyroid hormone secretion. At this time, they must take thyroid hormone drugs for supplementary treatment. Common thyroid hormone drugs include Euthyrox and Levitra.

Generally speaking, in order to prevent the recurrence of thyroid tumors, a slightly larger dose of thyroid hormone drugs is often given clinically to supplement thyroid hormone and keep the thyroid gland in an "excited" state. However, in the long run, excessive thyroid hormone will cause the destruction of bone cells to be greater than the regeneration of bone cells, that is, our bones are in a state of "not enough to cover expenses" for a long time, and osteoporosis is very likely to occur.

Therefore, if you have abnormal thyroid function, even if you have not yet developed osteoporosis, but have entered middle-aged or elderly age, it is best to take some preventive measures under the guidance of a doctor as soon as possible.

2. Glucocorticoids

Glucocorticoids are also widely used because they play an important role in anti-allergy/anti-infection/anti-shock/treatment of autoimmune diseases. For example, patients with asthma/allergic purpura/meningitis/toxic pneumonia/cardiogenic shock/rheumatism/lupus erythematosus/nephrotic syndrome will use glucocorticoids for long-term treatment.

However, long-term use of such drugs will cause a decrease in osteoblasts, that is, a continuous decrease in trabeculae in the bones, leading to osteoporosis and even femoral head necrosis. Such drugs mainly include hydrocortisone/prednisone/dexamethasone/betamethasone, etc. If glucocorticoid drugs are used for more than one year, the incidence of osteoporosis can be as high as 30%-50%.

Therefore, if you experience chronic back pain/joint pain/limited mobility while using glucocorticoids, you must seek professional medical intervention as soon as possible to determine whether drug-induced osteoporosis has occurred, and start taking osteoporosis prevention drugs such as calcium supplements/vitamin D as soon as possible.

In fact, among the common osteoporosis in clinical practice, 9%-17% is caused by drugs, so drug-induced osteoporosis is not uncommon, but it is easy to be overlooked by us.

Of course, you still need to take the medicine to control the disease process on time. You can't give up because of fear. But from today on, you have to prepare for the possible risk of osteoporosis. Fortunately, your family doctor is by your side. If necessary, you can seek guidance and help from your contracted family doctor.

Author: Xinjing Town Community Health Service Center, Changning District, Shanghai

Zhou XiangjunDeputy Chief Physician