On World Lupus Day, recognizing the risk to bone health

Osteoporosis is a common complication of Lupus, a chronic autoimmune disease that causes the immune system to attack the body’s connective tissue and organs.

Today, on World Lupus Day, IOF stands with lupus organizations worldwide as they raise awareness of this serious disease and the need for more recognition and improved patient care.

Lupus develops in people of all ages, races, ethnicities and genders – although approximately 90% of those with the disease are women. According the World Lupus Day website, more than 5 million people worldwide struggle with the often debilitating health consequences of lupus. This potentially fatal autoimmune disease can damage many parts of the body, including the skin, heart, lungs, kidneys, and brain.
Lupus Europe estimates that up to 500,000 people in Europe have lupus. 80% of diagnoses are made between the ages of 15 and 45.

Lupus and osteoporosis

People suffering from lupus are at increased risk of bone loss and fracture for several reasons:

  • Glucocorticoids (steroids) are often prescribed to treat lupus, and these can lead to significant bone loss. (See IOF fact sheet)
  • Pain and fatigue caused by the disease can result in sedentary lifestyle, which increases the risk of osteoporosis.
  • Studies have also shown that bone loss in lupus may occur as a direct result of the disease.
  • 90% of people affected are women, and postmenopausal women are the population which is already at increased risk for osteoporosis.

Strategies to prevent osteoporosis in lupus

It is important that lupus patients discuss bone health with their doctors and take necessary action for prevention of bone loss. These include:

  • Good Nutrition. A healthy, balanced diet rich in calcium and other bone-healthy micronutrients is important for healthy bones. Dietary sources of calcium are recommended and supplements can help ensure adequate amounts of calcium and vitamin D if needed. The Institute of Medicine recommends a daily calcium intake of 1,000 mg (milligrams) for men and women up to age 50. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily.
  • Vitamin D plays an important role in bone health as well. While exposure to sunlight is the main source of vitamin D, food sources include egg yolks, fatty fish, and liver. Many people obtain enough vitamin D naturally from sunlight or foods, but some people may need vitamin D supplements to achieve the recommended intake of 600 to 800 IU (International Units) each day.
  • Exercise. Exercise can be a challenge for people with lupus who are affected by muscle pain, joint pain and inflammation, and fatigue. However, regular exercise, such as walking, may help prevent bone loss and provide many other health benefits. When possible, weight-bearing and muscle strengthening exercise such as brisk walking, climbing stairs, Nordic walking, or weight-training are recommended.
  • Healthy lifestyle. Smoking and excessive alcohol consumption can have a negative effect on bone health. Those who smoke or drink heavily are more prone to bone loss and fracture. Healthy lifestyle, while important to all, is especially critical in people with chronic diseases.
  • Bone health assessment and medication if needed: Lupus patients, particularly those taking glucocorticoid therapy for two months or more, should talk to their doctors about bone health and have a bone density test to check for bone loss and whether medication should be considered. Several effective medications are available for the prevention and/or treatment of osteoporosis that can help high-risk lupus patients reduce their risk of suffering fractures due to osteoporosis.

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