What should be supplemented in patients on long-term steroids to reduce osteopenia?

• A. Calcium and Vitamin D
• B. Iron and Vitamin B12
• C. Magnesium and Vitamin C
• D. Potassium and Vitamin K

Answer: (D)

Long-term steroid use accelerates bone loss by reducing new bone formation and increasing bone resorption, while also interfering with calcium balance by lowering gut absorption and increasing renal excretion. Supplementing with calcium and vitamin D directly supports bone mineral content and calcium readiness in the body. Vitamin D helps the gut absorb calcium and supports calcium deposition in bone, while calcium provides the essential mineral needed to build and maintain bone density. In adults on chronic steroids, a practical goal is about 1000–1200 mg of calcium daily combined with roughly 800–1000 IU of vitamin D daily, adjusted to individual needs and risks. Other nutrients listed don’t address this specific issue as effectively; they don’t target bone mineralization and steroid-induced bone loss in the same direct way.