Steroids and osteoporosis: how Mayrine’s experience of a new health condition made her think twice about her bones

At the age of 52, I was fortunate enough to have had perfect health all my life. Having worked as an Osteoporosis Nurse Specialist for much of my nursing career and for the last six years at the Royal Osteoporosis Society, I always hoped that my risk of developing osteoporosis was low.

I had no risk factors for osteoporosis; no family history or underlying health conditions, did not smoke, drank very little alcohol, had a reasonable amount of calcium in my diet and took regular exercise - going to the gym twice weekly and walking my dog three times a day.

However, in early 2021, I became unwell very suddenly and was admitted to hospital and diagnosed with Autoimmune Haemolytic Anaemia (AIHA). The treatment was high dose steroids, along with other drug treatments and a blood transfusion. I responded well and over the next three months was able to reduce the steroids and eventually stopped them in the spring.

I was concerned about the effect steroids might have had on my bones though, so the Haematologist referred me for a bone density (DXA) scan. He also checked my vitamin D and the results showed that my level was low so I started on a supplement.

The DXA scan showed mild osteopenia, which considering the very large amount of steroids I had had, I was very pleased with. It also meant that I didn’t need to take any additional treatment such as Alendronic acid.

Unfortunately though, just a few days after stopping the steroids, I suffered a significant relapse and ended up back to square one and was readmitted to hospital for another week. I had to restart on high dose steroids and the other medications I had previously taken. This time, I also received biological infusions called Rituximab for four weeks, which will hopefully mean that I will be able to reduce my steroids over the next few months but stay well when they are stopped.

I am feeling a lot better these days and have started to exercise again. I continue to ensure I have plenty calcium in my diet, including at least one yoghurt a day as well as milk and cheese whilst taking my vitamin D supplement. If I continue to need steroids longer term, I know that I will need to repeat my DXA scan after the first year to assess the impact the steroids may have had on my bones.

A positive out of all of this, has been that I’ve been able to use this opportunity to talk to the healthcare professionals I’ve met about steroids and their potential risk of osteoporosis, and also to raise awareness of osteoporosis itself.

This health scare has reminded me that although I thought I was at low risk of developing osteoporosis, life can change very quickly, and it’s important to look after our bones throughout our lives.

Read more about how steroids can affect bone density or find out more about other risk factors for osteoporosis.