Asthma & Osteoporosis

Updated: June 26, 2023

Reviewed By:
Dr. Liz Lipski – AlgaeCal Scientific Advisory Board Member
PhD, CNS, FACN, IFMP, BCHN, LDN
Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.

Several health conditions increase your risk for osteoporosis and osteopenia, but one that many overlook is asthma. In this article, we’ll explain the connection between asthma and osteoporosis and provide tips to reduce risk and enhance bone health.

The Link Between Asthma and Osteoporosis

Asthma is a condition that affects the airways in your lungs, causing them to become inflamed and narrow, resulting in difficulty breathing[1].

But how does this lung condition relate to osteoporosis? 

A handful of factors contribute to the link between asthma and osteoporosis, including medications, food allergies, and exercise habits. Let’s take a look at each in more detail.

Corticosteroids and Osteoporosis

Corticosteroids are anti-inflammatory drugs prescribed to asthma patients to help calm their airways. Reducing lung inflammation is vital for people with asthma to ensure proper airflow and oxygen delivery. Unfortunately, one of the major drawbacks of corticosteroids is their impact on bone formation.

While these drugs do a fantastic job of reducing inflammation, they can also inhibit the function of osteoblast cells in your bones – the cells that are responsible for building and reconstructing bone. 

Studies show that these anti-inflammatory drugs can reduce both the development and function of osteoblast cells while also enhancing the production of their counterpart, osteoclasts. With more osteoclasts breaking down cells and fewer osteoblasts rebuilding, bone health and integrity takes a serious hit[2].Corticosteroids can also inhibit the absorption of dietary calcium, which in turn weakens bone mineral density. This is why it’s suggested that patients taking these types of drugs also supplement with calcium and vitamin D to protect their bone health[3].

Limiting Exercise Leads To Weaker Bones

Physical activity is one of the most impactful ways to enhance bone mineral density — specifically, weight-bearing exercises like walking, jogging, weight training, stair climbing, and aerobics. 

As you enhance your muscle tone by engaging in these exercises, it puts more pressure on your bones, increasing bone growth[4]. Unfortunately, many people with asthma avoid physical activity because it can induce asthma attacks. As a result, they miss out on an excellent way to enhance and maintain bone health[5].

Avoiding Allergens Reduces Nutrient Intake

Allergies not only trigger asthmatic symptoms, but studies show that people with allergies are more likely to develop asthma[6][7]. 

This is true for all types of allergies but can become a problem for bone health if you have food allergies that require you to avoid calcium-rich foods like dairy products or omega-3-rich foods like shellfish. 

That said, some people with asthma will avoid allergens like dairy and shellfish out of caution, but this is not necessary. Unless you have an allergy to a specific food, dietary “allergens” shouldn’t impact your asthma symptoms[8].

How People With Asthma Can Protect Their Bones

Get To The Root Cause of Asthma

Asthma does not just occur on its own; there is always some type of trigger that instigates inflammation in your lungs and results in asthmatic symptoms. Getting to the root of your asthma can help you reduce your need for medication or even allow you to get off it altogether. 

While everyone’s body is different, at the root, asthma is a condition that’s triggered by the immune system. This could be due to imbalanced gut bacteria, unrecognized food allergies, environmental toxins, and so on. 

Working with a functional medicine doctor is a great way to gather information about what might be causing your asthma in the first place and how to treat it naturally.

Exercise Tips for Asthma

If you’ve been inactive for a while, starting with short walks is a great place to begin. You don’t want to push your lung capacity too far beyond what you’re used to, but you also want to ensure that you’re strengthening your body. 

As you build up stamina, you can move to other activities like biking, hiking, and swimming. You’ll likely want to avoid activities requiring long exertion periods, like long-distance running or team sports like basketball and soccer. 

Yoga is another fantastic weight-bearing exercise that also requires consistent deep breathing, which can benefit lung health. Research shows that regular yoga practice can decrease asthmatic episodes and reduce the need for asthma medications due to its ability to enhance lung capacity[9].

Consider Nutritional Support

Your bones require specific nutrients like calcium, vitamin D, and omega-3 fatty acids, to stay healthy and strong. If you’re taking asthma medication, you may be interfering with the dietary absorption of some of these nutrients, which means that supplementing with them to enhance your overall intake is a good idea. 

Getting enough calcium is crucial for bone density, but it also happens to be one of the nutrients most impacted by corticosteroid use. Finding a high-quality calcium supplement will provide the basic building blocks you need to enhance bone integrity.

Look for a calcium supplement that includes vitamin D, as vitamin D deficiency may increase the risk of both osteoporosis and asthma. Research also shows that vitamin D supplements may improve the response to corticosteroid treatment[10]. 

You may also want to consider adding fish oil to your supplement regimen as it not only enhances bone health, but studies have shown that omega-3 fatty acids can help reduce inflammation and difficulty breathing in people with asthma[11][12].

Get a DEXA Scan

If you’re taking corticosteroid medications for asthma, it’s a good idea to get a DEXA scan to evaluate your risk for fractures and osteoporosis[13].  

A DEXA scan is an imaging test that measures bone density by allowing you to see the mineral content in your bones. With this information, your physician can assess any bone loss as well as your current risk for osteopenia or osteoporosis.

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Takeaway

While it’s true that having asthma can enhance your risk for osteoporosis, this does not necessarily mean you’re destined for poor bone health. 

Regular exercise can enhance bone density while also improving lung capacity, and supplementing with a high-quality calcium supplement and fish oil will provide your body with the nutrients it needs for optimal bone formation. 

That said, the best thing you can do for long-term quality of life is to get to the root cause of your asthma. Asthma doesn’t just appear out of nowhere, so knowing your triggers can give you information on how to treat your asthma and potentially reduce your need for medications.

FAQs

Can asthma cause osteoporosis?

Medication prescribed for asthma, such as corticosteroids, can negatively impact bone density and increase your risk for osteoporosis. Furthermore, many people with asthma avoid weight-bearing exercise, which is crucial for maintaining bone strength. And finally, some people with asthma will avoid foods like dairy and fish out of fear of allergic reactions. These foods are rich in bone-building nutrients.

Do inhaled steroids affect bone density?

Both inhaled and oral steroids can impact bone density by inhibiting the activity of osteoblasts (bone-building cells) and increasing osteoclast (bone resorption cells) activity. Some steroids may also impact dietary calcium absorption, leading to reduced mineral density in your bones.

Does dairy aggravate asthma?

Dairy should not aggravate asthma unless you have an allergy or sensitivity to dairy. With that being said, people with asthma are more likely to experience food allergies, so if you notice dairy aggravates your asthma, you should get an allergy test.

What kind of exercise is good for asthma?

Medication prescribed for asthma, such as corticosteroids, can negatively impact bone density and increase your risk for osteoporosis. Furthermore, many people with asthma avoid weight-Exercises like yoga, walking, and hiking are good choices for people with asthma. These types of physical activity increase lung capacity without putting too much pressure on your body. With these activities, you can slowly build up the time and intensity of your workout.

Can I do weight training if I have asthma?

Yes, as long as your asthma is under control and you’re not pushing yourself past your limits. Weight training is an excellent choice for people with asthma because it enhances bone density, which can be a concern for asthmatics that use corticosteroids.

Article Sources

  1. https://www.nhlbi.nih.gov/health/asthma
  2. Canalis, Ernesto. "Mechanisms of glucocorticoid-induced osteoporosis." Current opinion in rheumatology 15.4 (2003): 454-457.
  3. Homik, Joanne, et al. "Calcium and vitamin D for corticosteroid‐induced osteoporosis." Cochrane Database of Systematic Reviews 2 (1998).
  4. Benedetti, Maria Grazia, et al. "The effectiveness of physical exercise on bone density in osteoporotic patients." BioMed research international 2018 (2018).
  5. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/asthma
  6. https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/allergies-and-asthma/art-20047458
  7. Foong, Ru-Xin, George du Toit, and Adam T. Fox. "Asthma, food allergy, and how they relate to each other." Frontiers in pediatrics 5 (2017): 89
  8. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/asthma
  9. Mekonnen, Demeke, and Mossie Andualem. "Clinical Effects of Yoga on Asthmatic Patients: A Preliminary Clinical Trial, Jimma, Southwest Ethiopia." Ethiopian journal of health sciences 20.2 (2010).
  10. Kumarathas, Indumathi, et al. “The risk of osteoporosis in patients with asthma.” Eur Clin Respir J 7.1 (2020).
  11. Miyata, Jun, and Makoto Arita. "Role of omega-3 fatty acids and their metabolites in asthma and allergic diseases." Allergology International 64.1 (2015): 27-34.
  12. Adams, Shahieda, et al. "Relationship between serum omega-3 fatty acid and asthma endpoints." International journal of environmental research and public health 16.1 (2019): 43.
  13. Johnson, B. L., and H. Durrington. "P49 Bone protection for patients with asthma–a service evaluation." (2021): A92-A93.

Article Comments

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  1. Sally

    May 1, 2023 , 11:28 am

    I was diagnosed with Osteoporosis and Osteopena. My doctor started me on Alendronate Sodium tablets once per week. I took one and had the worst reaction to it. I felt like I had the flu and my whole body ached. I have continued to have my hands weaken and hurt, my jaw hurt and my feet and legs hurt. I only took it the one time and don’t plan on taking it again. Is there another medication you would suggest. Thank you

  2. Brianne AlgaeCal

    May 2, 2023 , 10:38 am

    Hi Sally,

    Thanks so much for your comment, and we are so sorry to hear about what you are going through! Please speak more with your medical professionals about your medication options. That said, if you are looking for a safe, natural approach to supporting your bones, AlgaeCal Can help!

    AlgaeCal Plus provides your body with all 16 essential bone supporting nutrients, and is clinically supported to increase bone mineral density in all 3 of our clinical research studies! AlgaeCal Plus and Strontium Boost increased bone mineral density by an average of 3% in a 12 month period, and you’re welcome to read more about this HERE!

    Please reach out to us at 1-800-820-0184 (USA & Canada toll-free) to learn more, and to speak with our specially trained Bone Health Consultants, who would be happy to answer any questions you have! 🙂

    – Brianne @ AlgaeCal

  3. Vera Klein

    May 1, 2023 , 7:47 pm

    I have bought Algaecal in past. My osteoporosis is worse! My doctor suggested I start Proleria injections! I had to quit buying AlgaeCal. I on a fixed income & couldn’t afford it. I may try to order again if I can try to find money for it! Thank you.

  4. Brianne AlgaeCal

    May 2, 2023 , 10:44 am

    Hello Vera, thanks you so much for commenting!

    We’re so sorry to hear your osteoporosis is getting worse. We guarantee your results and definitely want to make this right, so please email [email protected] or call 1-800-820-0184 (USA & Canada toll-free) to speak with one of our Bone Health Consultants. We have many pricing and bundle options available to help you save, and we are more than happy to go over these with you to find the best fit for your needs!

    I hope this helps!

    – Brianne @ AlgaeCal

  5. Jane Bryan

    May 3, 2023 , 12:30 pm

    I am using Algaecal and it has reversed my bone loss.

  6. Yoori AlgaeCal

    May 4, 2023 , 3:51 pm

    This is news we love to hear, Jane :). We are so happy for you!

    – Yoori @ AlgaeCal

  7. Rebecca Manring

    May 4, 2023 , 7:37 am

    almost looking forward to my next Dexascan

  8. Elena M. Trujillo

    May 4, 2023 , 1:22 pm

    yes I knew asthma meds increased osteoporosis; so I used to do a lot of walking and hiking until I developed severe arthritis to the point of very painful walking. finally I had total hip replacement surgery and I’m beginning to take time for walking and hopefully soon I’ll be hiking again. I’m also considering acoustic exercises.

  9. Sharon Vollett

    May 8, 2023 , 7:54 am

    I think you should also add for vegetarians there are options also, like tofu, tempeh, dark leafy greens, and beans. Today
    there are many reasons to go veg, but I am trying to be a strong vegetarian, and crazy enough to do it now at this age. I
    am hopeful that your product will assist me in doing just that. Thank you, Sharon Vollett.

  10. Manja

    May 10, 2023 , 11:44 am

    Thank you for taking the time to comment, Sharon! We appreciate your input. Your decision to go veg is commendable and if you’re looking for more ways to support your bone health during this time, you might be interested in our Vegetarian’s Guide to Collagen and Healthy Bones. I hope it helps!

    – Manja @ AlgaeCal

  11. Lois Miller

    May 31, 2023 , 11:51 am

    Thank you so much for drawing attention to the connection between corticosteroids and bone density loss. I’m in a good place in managing my asthma, and the thought of discontinuing my maintenance inhaler is somewhat disconcerting. I’m hoping that using the Bone Builder Pack plus extra vitamin D will be enough to compensate for the inhaler use, and will actually begin to rebuild my bones.

  12. Yoori AlgaeCal

    May 31, 2023 , 5:56 pm

    Not to worry too much, Lois, we do have many community members who successfully increased their bone density while on inhalers :). If you haven’t already, I encourage you to give us a call at 1-800-820-0184 (US & Canada Toll-free) or email [email protected]. We’d be happy to set you up for success and provide personalized support!

    – Yoori @ AlgaeCal

  13. Nancy

    June 2, 2023 , 9:47 am

    30% of bone is COLLAGEN PROTEIN. Missing in today’s convenience driven diet. Bone broth and jello are always given post-op for a reason. K2 is a fat soluble vitamin that regulates where calcium resides. Deficiency allows calcium to accumulate in joints, blood, and epithelial tissue.

  14. Samantha AlgaeCal

    June 2, 2023 , 12:11 pm

    Nancy, you are absolutely right, these are great takeaways about collagen, vitamin K2, and calcium deficiency! Thank you for sharing. Please let us know if you have any questions. 🙂

    – Sam @ AlgaeCal

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,