I have been intending to write a more comprehensive page about this, with better evidence tables, but in the meantime will give a sketch about this disease. Corticosteroids cause osteoporosis and fractures in a high percentage of patients. There is a dose-dependent effect, which is difficult to define because of varying durations at each dose. The beneficial effects of steroids on the underlying disease may partially offset the detrimental effects on bone. Because the effects are so variable and can be clinically severe, patients embarking on long-term steroid treatment should have bone density monitored, and measures taken to try to preserve bone.
Corticosteroids have several adverse effects on bone metabolism.
The trabecular bone is affected more rapidly than the cortical bone. Some patients suffer multiple vertebral compression fractures within a year of initiating steroid therapy. Diagnostic work-up Bone density should be measured in patients who are expected to remain on corticosteroids. In males it is very important to remember to check the testosterone level . Measurement of LH or FSH will not be helpful in this situation, since the hypogonadism is usually hypogonadotropic, and thus low estrogen will not be associated with high FSH the way it is in a postmenopausal woman.