Regular consumption of antacids & steroid based drugs causes bone loss: Know your risk

Acidity and reflux is a bane of our stressful times. Most of  us do not think twice before popping in an antacid to check heartburn. But do you know that regular consumption of antacids can fasten the depletion of your bones and cause osteoporosis?bone-loss

Sumedha, 38, discovered it the wrong way. When she suffered a fracture of the arm after a very minor fall, her doctor ordered a bone density test. The results showed that Sumedha’s bones resembled those of a 60 year old. She then reported that she was consuming antacids very often for several years.

Doctors at Indian Spinal Injuries Centre caution against indiscriminate use of over-the-counter antacids for a long period of time as it may have unintended negative consequences. 

“Antacids work by neutralizing the active acids in the stomach to prevent them from causing heartburn. A number of antacids are aluminum or magnesium based which can interfere with the absorption of calcium and phosphorous in the body. Now, our bones are made of both calcium and phosphorous and a depletion of any of the two is sufficient to cause bone weakening. If you consume antacids containing aluminum or magnesium regularly you may be at risk of early osteoporosis,” says Dr Maninder Shah Singh, Senior Consultant Orthopaedic Surgeon, Chief, Foot & Ankle Unit, Coordinator Sports Injury Unit, Indian Spinal Injuries Centre.

If you have a chronic acidity problem, you must look for lifestyle and diet modification to check it as continuous use of antacid might be helpful in the short term but may not be amenable to your bones in the longer run.

“If your condition demands a continuous use of antacids do not buy them over the counter, rather consult a doctor who may prescribe you safer drugs,” says Dr Maninder Shah Singh, Senior Consultant Orthopaedic Surgeon, Chief, Foot & Ankle Unit, Coordinator Sports Injury Unit, Indian Spinal Injuries Centre.

At the same time, osteoporosis is also associated with chronic steroid therapy and is regarded as a serious medical problem. Steroid hormones such as glucocorticoids are very commonly used to treat auto-immune diseases such as rheumatoid arthritis. Steroid therapy is a valuable medical intervention for many patients. However, it also has the negative impact of bone depletion.

“When consumed in large doses, steroids can interrupt the normal process of bone formation by having a negative impact on the metabolism of calcium and vitamin D. This causes weakening or softening of bones. While steroid therapy is essential in some patients, it is important to consult your doctor about its negative repercussions and seek help in preventing it by intake of calcium and vitamin D supplements,” says Dr Maninder Shah Singh, Senior Consultant Orthopaedic Surgeon, Chief, Foot & Ankle Unit, Coordinator Sports Injury Unit, Indian Spinal Injuries Centre.

Understanding Osteoporosis

The term ‘porosis’ means porous and aptly describes the appearance of osteoporotic bones. Brittle bone syndrome, as it is often called, osteoporosis is usually an age-related loss of bone mineral density that makes bones weak and prone to fractures, so that even a mild fall or injury may result in a fracture. However, even younger people can suffer from brittle bone syndromes if they have insufficient calcium intake over a long time or as discussed above are consuming too many antacids. The condition is more common in women who face rapid depletion of bone minerals after menopause. A range of factors are making urban Indians more prone to osteoporosis or osteopenia including low intake of calcium, low sun exposure and a resultant deficiency of vitamin D, lack of physical exercise and poor habits such as smoking. 

Clinical evidence also suggests a downward shift in the age threshold of osteoporosis in India. Osteoporosis is calculated by comparing the bone mineral density (BMD) of the patient with that of a normal person, as per the criteria set by WHO. As per set criteria, a standardized score called, T-score is used to determine the condition.

BMD is the test that measures the level calcium and other types of minerals of a suspected osteoporotic bone and is represented by T-score. It is a case of osteoporosis if the T-score is 2.5 as normal condition is when the T score is 1.0 and above. A T-score below 2.5 is considered to the condition of severe osteoporosis. However, there also occurs a condition where the T-score lies between 1.0 and 2.5. It is known as osteopenia. In this condition, although the bone density is lower than normal, it remains higher than osteoporotic levels. Osteopenia is a signal that osteoporosis may not be far ahead.

Preventing Osteoporosis

•          Consume a good amount of calcium rich foods such as milk and other dairy products to maintain your calcium levels 

•         Try to expose your skin to sunlight for 10-15 minutes daily to ensure your body makes sufficient vitamin D

•         Inactive people are at a higher risk of osteoporotic fractures. Exercising is very important to keep bones strong. Much like muscles, bones are also living tissues that respond to weight bearing exercises by becoming stronger 

•          Limit intake of over the counter antacids

•         Speak to your physician about the need for supplementation

•         Get a bone mineral density test done every few years to check your bone status and take remedial measures if needed

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