The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Glucocorticoid-Induced Osteoporosis

Long-term use of corticosteroid medications reduces bone density and increases fracture risk.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Glucocorticoid-Induced Osteoporosis?

Glucocorticoid-induced osteoporosis (GIO) is secondary osteoporosis that develops with long-term use of corticosteroids (usually ≥3 months at ≥5 mg/day prednisolone or equivalent). It is the most common cause of drug-related osteoporosis; bone loss is most rapid in the first 3-6 months of therapy.

Corticosteroids suppress osteoblast function, increase osteocyte apoptosis, decrease calcium absorption, and impair gonadal function. All these mechanisms together affect both trabecular and cortical bone. The fracture risk is higher than in postmenopausal women with the same bone density.

ACR guidelines recommend baseline DEXA bone density measurement and initiation of preventive treatments in patients on chronic corticosteroids.

Symptoms

Often asymptomatic during corticosteroid use
Back pain (vertebral compression fractures)
Loss of height and postural deformity
Fractures after minor falls or trivial trauma
Decreased bone mineral density on DEXA

Risk Factors

Use of prednisolone ≥5 mg/day or equivalent for ≥3 months
High-dose or prolonged corticosteroid therapy
Age over 60 and female sex
Pre-existing low bone density or history of fracture
Vitamin D deficiency and low calcium intake
Underlying rheumatologic or inflammatory disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When corticosteroid therapy lasting more than 3 months is initiated (for prophylaxis)
  • If back pain or loss of height develops while on corticosteroids
  • When low bone density is detected on DEXA
  • Before changing or stopping corticosteroid therapy

Treatment Methods

01
Keeping the corticosteroid dose to a minimum or using an alternative drug: primary measure
02
Calcium 1000-1200 mg/day plus vitamin D 800-1000 IU/day: should be started in every patient
03
Bisphosphonate therapy (alendronate, risedronate, or zoledronic acid): in moderate to high fracture risk
04
Denosumab: alternative in renal failure or bisphosphonate intolerance
05
Teriparatide: anabolic option in severe GIO or with a history of fracture
06
DEXA follow-up: at the start of treatment and every 1-2 years

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Endokrinoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.