Rheumatoid Arthritis and Bone Health: Is Bone Loss a Direct Cause of RA?
Osteoporosis is a condition in which the bones become less dense and more likely to fracture. People with this disease condition experience significant pain and potential disability when a fracture occurs. Osteoporosis typically affects more women than men—especially perimenopausal and postmenopausal women.
Is Osteoporosis an Indirect or Direct Cause of RA?
The connection between RA and osteoporosis is becoming clearer—having RA significantly increases chances of developing osteoporosis. In a commonly cited study published in 2000, there was a 2-fold increase in osteoporosis among people with RA at all ages.
It’s also becoming clear to the medical community that osteoporosis is both a direct and indirect cause of RA.
RA medications can also have a negative impact on bone health. Glucocorticoids—or steroid hormones—are commonly used for strategic RA symptom relief. In low doses, medical providers prescribe them as treatments for adrenal insufficiency. Inhaled and taken orally, glucocorticoids are used for inflammatory, allergic, and autoimmune therapies.
Studies have shown a that glucocorticoids in high doses can inhibit bone formation. Generally, for RAWarriors, these types of medications are administered in low doses. The goal is to use them as bridge treatment for disease-modifying antirheumatic drugs (DMARDs) until the DMARDs become effective.
RA flares are an exhausting, potentially debilitating occurrence that can make it hard to be active for days on end. For RA Warriors who experience flares on a monthly basis, osteoporosis might begin to develop because of inactivity. Activities that get the body moving as well as strengthening muscles help prevent osteoporosis.
Bones Close to Joints
The medical community is beginning to take note of the musculoskeletal systems of RAWarriors. There’s research—as well as numerous anecdotes—that the bones closest to joints suffering from flares are directly affected by the inflammation. Cases show a clear deterioration of the bone formation.
Bone Health: Prevention and Care
Every woman under the age of 30 should focus on getting enough calcium in their diet. At 30, the body has a more difficult time retaining calcium. A diet full of dark leafy greens, healthy sources of dairy (kefir milk and yogurt are excellent choices), and broccoli will deliver a healthy amount of calcium to the body.
Exercise is another important factor for osteoporosis prevention. Although exercise might seem daunting for some RAWarriors, yoga, ballet, barre, pilates, and other calisthenic exercises provide enough body weight movements to strengthen the musculoskeletal system.
Calcium pills are available to ensure there is enough calcium for the body to retain. Nutrition experts believe that calcium supplements with magnesium and vitamin d provide a better chance for optimal absorption. If osteoporosis seems inevitable and severe, Intravenous calcium therapies are available and often prescribed.
As a reminder, before making changes to your exercise regimen, diet, or supplement plan, work with your RA Treatment team.