Encourage exercise to decrease the risk of muscle mass loss. Recommend adequate dietary, vitamin D and calcium using a variety of calicum-fortified foods and calcium supplements. Although preventive measures should be applied to all patients, additional pharmacologic interventions may be recommended, based on BMD test results. In women, HRT, in conjunction with calcium supplementation, is a well-established preventive and therapeutic intervention for osteoporosis and clinical data has shown a positive effect on BMD in patients receiving glucocorticoids. Bisphosphonates are an alternative to HRT in postmenopausal women, if HRT is contraindicated, or refused by the patient.
Bisphosphonate therapy is effective against glucocorticoid-induced bone loss.
Calcitonin is another alternative when HRT is contraindicated or refused. It is also thought to have an analgesic effect, reducing bone pain.