Smoking is bad for bones as well as the heart and lungs. Women who smoke tend to go through menopause earlier, triggering earlier bone loss. In addition, people who smoke may absorb less calcium from their diets. Alcohol can also negatively affect bone health. Those who drink heavily are more prone to bone loss and fracture, because of both poor nutrition and an increased risk of falling.

 

Specialized tests known as bone mineral density (BMD) tests measure bone density in various sites of the body. These tests can detect osteoporosis before a fracture occurs and predict one's chances of fracturing in the future. A person with rheumatoid arthritis, particularly someone who has been receiving glucocorticoid therapy for two months or more, should talk to his or her healthcare provider about whether a bone density test is appropriate.

 

Like rheumatoid arthritis, osteoporosis has no cure. However, there are medications available to prevent and treat osteoporosis. Several osteoporosis medications, such as alendronate (Fosamax^®), risedronate (Actonel^®), ibandronate (Boniva^®), raloxifene (Evista^®), calcitonin (Miacalcin^®, Fortical^®), teriparatide (Forteo^®), and estrogen/hormone therapy, are approved by the U.S. Food and Drug Administration (FDA) to prevent and treat osteoporosis in postmenopausal women. Alendronate is also approved for use in men. For women and men with rheumatoid arthritis who are on glucocorticoid therapy and who have glucocorticoid-induced osteoporosis, alendronate (for treatment) and risedronate (for prevention and treatment) are approved.