- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
read biographyclose windowBiography of
April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies, such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale School of Medicine. Dr. Chang-Miller joined the Mayo Clinic staff in Rochester, Minn., in 1991, and in 2002 she relocated to Mayo Clinic in Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
Complications (2)
- Rheumatoid arthritis: Can it affect the eyes?
- Rheumatoid arthritis: Can it affect the lungs?
Treatments and drugs (4)
- Osteoporosis and long-term prednisone: What is the risk?
- Hip resurfacing: An alternative to conventional hip replacement?
- Arthritis pain medications: Do they raise blood pressure?
- see all in Treatments and drugs
Lifestyle and home remedies (4)
- Rheumatoid arthritis diet: Do certain foods reduce symptoms?
- Isometric exercises: Good for strength training?
- MSM for arthritis pain: Is it safe?
- see all in Lifestyle and home remedies
Alternative medicine (3)
- Mangosteen juice: Can it relieve arthritis pain?
- Do infrared saunas have any health benefits?
- Yucca: Can it relieve arthritis pain?
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Question
Osteoporosis and long-term prednisone: What is the risk?
I've been taking prednisone for my rheumatoid arthritis, but I've heard that it can increase my chances of developing osteoporosis. How big is the risk?
Answer
from April Chang-Miller, M.D.
Prednisone and similar drugs all cause bone loss. It's difficult, however, to separate prednisone use from the other things that might increase your risk of osteoporosis — your age, your sex and some aspects of your lifestyle, for example. Rheumatoid arthritis itself can lead to bone loss.
Prednisone is a corticosteroid (kor-tih-ko-STARE-oid) medication, highly effective for treating inflammation in rheumatoid arthritis and many other conditions. Unfortunately, corticosteroids also interfere with bone maintenance and limit the amount of calcium absorbed by your intestines. This can dramatically weaken bones and lead to osteoporosis.
In general, the higher the dose of prednisone you take and the longer you take it, the greater the risk. To counter the risk, do weightbearing exercise, avoid alcohol and do not smoke. Taking calcium and vitamin D supplements also can help reduce the amount of bone loss caused by steroids such as prednisone.
If you'll be taking prednisone for more than a few months and you have other risk factors for bone loss, your doctor may prescribe medications specifically designed to treat osteoporosis.
Next questionHip resurfacing: An alternative to conventional hip replacement?
- Grossman JM, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care & Research. 2010;62:1515. http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2151-4658. Accessed March 21, 2011.
- Rosen HN. Pathogenesis and clinical features of glucocorticoid-induced osteoporosis. http://uptodate.com/home/index.html. Accessed March 22, 2011.
- den Uyl D, et al. Advances in glucocorticoid-induced osteoporosis. Current Rheumatology Reports. In press. http://www.springerlink.com/content/h7526480765p4648. Accessed March 22, 2011.
Find Mayo Clinic on