Final answer:
Long-term use of cortisone and other steroids can lead to osteoporosis and muscle wasting due to increased protein breakdown. Steroids also decrease calcium absorption, which contributes to bone density loss, and affect hormone levels essential for maintaining bone health.
Step-by-step explanation:
Long-term therapy with steroid drugs, such as cortisone, can cause osteoporosis and muscle wasting primarily because of increased protein breakdown. These medications are a class of glucocorticoids, a type of corticosteroid. Glucocorticoids, like cortisol, have anti-inflammatory effects and are used for conditions like arthritis, asthma, and to suppress the immune response. Unfortunately, a side effect of these steroids is the stimulation of protein catabolism, which not only weakens the muscles but also affects the bones. This occurs because cortisol causes proteins to be broken down to make glucose via gluconeogenesis, which can lead to muscle wasting and bone pain.
Moreover, glucocorticoids can decrease the absorption of calcium in the gut and increase its excretion, leading to lower calcium levels in the bones and contributing to bone loss. This disruption in bone remodeling, where bone resorption exceeds bone formation, contributes to the development of osteoporosis. Additionally, these drugs can indirectly affect bone health by decreasing the secretion of sex hormones, which play a role in bone density maintenance.
While osteoporosis and muscle wasting are significant concerns, steroid drugs present additional risks such as increased blood glucose and potential dependence after prolonged use. These effects highlight the importance of careful management when prescribing and using steroid medications for chronic conditions.