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Coronavirus and osteoporosis

Last updated: 11:21 Tuesday 28 April 2020

Having osteoporosis does not increase your risk of catching coronavirus (COVID-19).

We’ve gathered some key information to help you manage your osteoporosis and bone health during the outbreak.

We understand that it’s an anxious time. Be reassured that most people who get the coronavirus only get a mild illness, and recover well at home.

Shielding - do I need to?

Social shielding means staying at home and avoiding all face-to-face contact for 12 weeks. The Government announced this new measure on Sunday 22 March, to help protect those most vulnerable to the virus.

If you're not sure whether social shielding applies to you, you can discuss your situation with a specialist nurse on our free Helpline.

If multiple spinal fractures and a significant change in body shape mean you have serious breathing issues, we recommend you consider social shielding.

This is because you might be more at risk of complications if you do get the coronavirus.

Not everyone with breathing problems because of spinal fractures needs to consider social shielding. If you have minor breathing problems, your risk of complications is lower

You may be more at risk of complications if you get the coronavirus, and should consider social shielding.

Find out more about who should consider social shielding on the Government website.

You don’t need to take special measures to protect yourself from infection. You can and should continue to take your medication.

Denosumab is an antibody-based medication, but it doesn't suppress your immune system. This means it doesn't increase your risk of complications from the coronavirus.

This is unlike other antibody-based medications used to treat diseases like rheumatoid arthritis.

Help with social shielding

If you think you need to start social shielding, you can register with the Government to tell them whether you need support or not. You may have already received a letter from the NHS, or been contacted by your GP, inviting you to do this. Registration can be done by you, or on your behalf.

  1. Discuss your situation with a Specialist Nurse on our free Helpline - they can help you consider if you're at risk and need support
  2. Register online, or by calling 0800 028 8327
  3. If you've not been contacted by your GP or hospital, contact your GP to let them know you've registered

To help you adapt your routine to social shielding, the Government has put together this advice.

Managing your osteoporosis and bone health

Your treatment

It’s important that your next injection isn’t delayed for more than four weeks, as the benefits wear off quickly.

You can have repeat injections up to four weeks early, so you have some flexibility.

The NHS is recommending to hospitals and GPs that they make sure you still get your treatment on time.

If you're reluctant to go into hospital for your injection, Amgen, the manufacturer of Prolia® (denosumab), has made resources available to help with self-administration.

A decision on whether you're able to self-administer should be made by your healthcare professional, together with you.

Your healthcare professional then enrols you in the Prolong patient support programme.

If you're accepted, you can collect your injection from a pharmacy. You can self-administer the injection or, if you have a carer, they can do it for you.

To help you do the injection, you can watch a video tutorial on Prolia.co.uk.

Healthcare professionals are being contacted and asked to enrol people who they feel would benefit from the scheme.

A delay of a few months does not increase your risk of breaking a bone, and doesn't cause your bone density to significantly drop.

Zoledronic acid is a long-lasting drug. It stays in your body for longer than 12 months, and probably more than 24 months.

If you're prescribed calcium and vitamin D, keep taking them, even if your medication is delayed.

A delay of a few months does not increase your risk of breaking a bone, and doesn't cause your bone density to significantly drop.

Ibandronic acid is a long-lasting drug.

If you're prescribed calcium and vitamin D, keep taking them, even if your medication is delayed.

You should continue your teriparatide injections as normal during the coronavirus pandemic.

If you can't get your prescription, contact your clinical team. Many routine face-to-face appointments are being cancelled, but a telephone appointment may be available instead.>

If you miss a few doses, don't worry. This is unlikely to affect your overall bone health. Restart your treatment as soon as you are able.

If you're completing your two-year course, it is important to discuss your treatment plan with your clinical team. Find out more about ending your teriparatide treatment.

If you have any questions, our specialist nurses are here for you. Contact our free Helpline by calling 0808 800 0035, or email nurses@theros.org.uk.

If you miss a number of doses over a few weeks, your overall bone health is unlikely to be affected.

If you need to collect your prescription, and are unwell, self-isolating or social shielding, ask family, friends or a neighbour to help you.

Most areas now have networks and voluntary groups that help people in this situation, so check social media to see if you have any locally that can help you.

If you're prescribed calcium and vitamin D, keep taking them, even if your medication is delayed.

Face-to-face appointments

Most routine face-to-face GP and hospital appointments have now been cancelled. This is to reduce pressure on the NHS, and keep you safe from unnecessary exposure to the coronavirus.

An urgent decision about your bone health is not needed right now.

A delay is unlikely to affect your bone health and risk of breaking bones in the long term.

It's still important that you get a new appointment when the current situation improves.  

Your hospital or GP should have special arrangements in place to make sure you're protected from the virus as much as possible during your visit.

Check the hospital or GP website first.

Receptionists are very busy at the moment, so for appointments in the months ahead, consider calling them closer to the time.

Phone appointments

Depending on your situation, you may be offered a phone appointment instead of your face-to-face appointment.

What happens during the call depends on your situation and risk of breaking a bone.

If you're unsure about a phone appointment and what it means for you, you can discuss your situation with a specialist nurse on our free Helpline.

Your healthcare professional may make a treatment decision by asking questions, and prescribe a tablet medication for your bones.

For example, if you:

  • are taking a steroid medication, like prednisolone
  • have broken hip
  • have had spinal fractures

Your healthcare professional may decide that you can wait until it's possible to do a face-to-face assessment, like a bone density scan, before a treatment decision is made.

This is because an urgent treatment decision is not needed right now.

Your healthcare professional may explain any special arrangements that are in place for your treatment.

Coughing with spinal fractures

If you’ve had spinal fractures, we know how painful coughing can be sometimes. But there are some simple things you can do to brace your upper body when you cough, to help make it more comfortable and effective.

In this video, Specialist Helpline Nurse Niki demonstrates some of these techniques, and shares some methods for easing any pain you might have after coughing.

Read more on managing pain after spinal fractures.

Vitamin D

Public health advice is that you consider taking a daily supplement of 10 micrograms (sometimes called 400 units) of vitamin D.

This is to help keep your bones and muscles healthy while you stay at home during the pandemic. If you're spending more time indoors, you're getting less vitamin D from the sun.

It is not because vitamin D reduces your risk of coronavirus.

You don't need blood tests to monitor your vitamin D levels before you start a supplement, or while you're taking one.

Do not take a higher dose than recommended, unless your healthcare professional tells you to. Too much vitamin D can be dangerous. Be reassured there is no risk of having too much vitamin D if you follow the advice of your healthcare professional.

If you're already taking vitamin D on the advice of your healthcare professional, you should continue with your normal dose. You don't need to take a bigger dose.

If you're unsure, speak to your healthcare professional, or contact our free Helpline.

Risk of breaking a bone

Whether you're social shielding, isolating, or just staying at home, you can still take action to look after your bone health, and reduce your risk of breaking a bone.

  • Make sure you have a well-balanced diet with enough calcium and protein
  • Find ways to get vitamin D for your bones
  • Make your daily exercise effective for your bones, and find out how you can adapt exercise to make it safe for your osteoporosis, especially if you have spinal fractures
  • If you're prescribed calcium and vitamin D, keep taking them, even if your osteoporosis medication is delayed
  • Avoid excessive amounts of alcohol
  • Avoid smoking
  • Think about how you can avoid slips, trips and falling over, to protect your bones
  • Help your muscles stay strong by doing specific exercises and avoiding long periods of sitting down, if possible 

Find out more about looking after your bones.

Getting pain relief

You should still be able to get the pain relieving medications you need, despite NHS services being reduced.

To help you manage your pain at home, we have lots of information about self-help strategies for pain, and exercise for back pain.

For more support with managing pain, speak with a specialist nurse on our free Helpline.

Ibuprofen and coronavirus

You may have heard not to take ibuprofen because it could make coronavirus worse. At the moment, there isn't any strong medical evidence about ibuprofen and coronavirus.

The NHS currently say to take paracetamol, instead of ibuprofen, if you have coronavirus symptoms. This is unless your doctor has told you that paracetamol is unsuitable for you.

If you're already taking ibuprofen (or another non-steroidal inflammatory drug), on your doctor’s advice, you don't need to stop unless your doctor advises you to.

You're not alone

It’s understandable if you feel anxious. But you're not alone.

We remain fully committed to offering you the support you need in these challenging times.

Our free Helpline is still here for you, with our team of specialist nurses now working remotely to take your call. And we're looking at new ways that we can give you support while society is social distancing.

If you need practical help, do ask family, friends and neighbours. People are very happy to help others at this difficult time.

And many areas now have local helplines and support networks, to help people who are isolating or shielding with shopping and other things. You can find local support listed on social media, through your local news outlet, or through an internet search.

If you do get very low and unhappy there are people and organisation that can help you look after your mental wellbeing:

Coronavirus (COVID-19)

Coronavirus can cause symptoms similar to flu:

  • a high temperature – you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

Most people have mild symptoms, but some will develop severe breathing problems and other complications.

If you get ill

If you think you have symptoms for coronavirus, use the 111 online coronavirus service to find out what to do.

Only call 111 if you cannot get help online. Do not go to the hospital or your GP practice.

If you are very unwell and severely breathless (severe difficulty breathing, gasping, not able to get words out, choking or your lips turning blue) call 999.

Get support from a Specialist Nurse

Contact our free Helpline for tailored information:

0808 800 0035

Or online, through live chat

About the Helpline

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