Lupus and Osteoporosis: The Connections
Lupus is an autoimmune disease that currently affects between 1.5 and 2 million people in the United States, 90% of whom are women. It is characterized by chronic inflammation and the symptoms that result from it. Recent research shows that those with lupus are 23% more likely to develop osteoporosis than the average individual. Below is a discussion about lupus, osteoporosis, and why lupus may be responsible for early development of osteoporosis.
The Basics of Lupus
Those with lupus experience a wide array of symptoms, including joint and muscle pain, skin problems that include rashes and sores, fever, fatigue, sensitivity to light, hair loss, swollen glands, weight loss, kidney and heart failure. All of these symptoms are the direct or indirect result of a misdirected immune system . Instead of only attacking foreign objects, the immune system of a lupus patient also attacks some cells and particles of the body. A genetic defect is most likely to blame for this mix-up; however the exact cause of lupus is still unknown. The inflammation of an over-active immune system often accumulates in joints, leaving them swollen and sore. Often a fever is produced to hinder what the immune system thinks is a foreign invasion. Immune complexes (collection of antibodies and particles or cells) created by the immune system deposit in blood vessels, eventually damaging them and the tissues they supply (kidney, heart, liver, skin). Excessive immune activity can also leave one feeling washed out.
The Basics of Osteoporosis
To quickly shift gears, let's talk about osteoporosis. Osteoporosis is a skeletal disorder, characterized by decreased bone mass. Bones with less mass and density are more prone to breaks and fractures. Bones are much like muscles in that they must be exercised to keep in shape. Combating gravity (through exercise) as well as eating a diet rich in vitamin D and calcium are both required to maintain healthy bones. While lack of exercise and poor diet can accelerate bone loss, some medications have also been shown to contribute to bone deterioration, including steroids, lithium, and heparin.
Lupus and Osteoporosis
There are many factors that contribute to the higher osteoporosis occurrence in lupus patients. Fortunately, most of these factors can be avoided to prevent premature osteoporosis. As previously mentioned, the inflammation experienced by lupus patients can leave them sore from swollen joints and extremely fatigued. Being constantly tired and in pain can make a person much less likely to get the exercise needed for strong bones. The skin synthesizes vitamin D in response to sunlight exposure, which is necessary for the absorption of calcium and creation of bone cells. Because sunlight often triggers a flare of symptoms and rashes in lupus patients, many don't get near enough sunlight to synthesize the required about of vitamin D. Fortunately, vitamin D can be taken in supplement form to make up for this. All of the previously mentioned prescription drugs that contribute to bone loss are also used in the treatment of lupus. Most lupus patients need to use steroids chronically in order to keep inflammation at a minimum. Lithium is often used to treat depression, a common symptom of chronic illnesses. Many lupus patients must also treat blood clots throughout the circulatory system with anticoagulants such a heparin.
Those with lupus can do many things to help prevent osteoporosis, however. Performing moderate exercise like walking or dancing can relieve joint inflammation as well as encourage bone growth. Eating a high calcium diet with vitamin D supplements can also support bone growth. And while not all osteoporosis-causing drugs can be eliminated from the lupus medicine cabinet, anti-depression medications like lithium can be avoided by maintaining a support group of family and friends.