7 Ways to Prevent Osteoporosis if You Have Ulcerative Colitis
Digestive HealthUlcerative Colitis

7 Ways to Prevent Osteoporosis if You Have Ulcerative Colitis

7 Ways to Prevent Osteoporosis if You Have Ulcerative Colitis
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Updated on May 18, 2026
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If you have ulcerative colitis (UC), a form of inflammatory bowel disease (IBD), chances are that one of your main priorities is controlling your symptoms so you can live your best life — and rightfully so.

But if you’ve been treating your condition with medications called glucocorticoids (also called corticosteroids or steroids) like prednisone or budesonide, you may be at an increased risk for a common UC-related health complication: bone density loss.

There are several reasons for bone density loss in UC. The first is that while glucocorticoid therapy reduces the inflammation associated with IBD, it can weaken bones. Inflammation, poor nutrient absorption, low levels of physical activity, and low testosterone in men increase the risk, too.

As your bones become less dense, you may develop osteopenia (weakening of the bones) or osteoporosis, a serious condition that makes your weakened bones more likely to fracture. Both women and men, especially men over age 50 with UC, need to be mindful, as an estimated 18 to 42 percent of people with IBD develop osteoporosis. If you have UC, here’s what you need to know about osteoporosis and what you can do to prevent it.

What Is Osteoporosis?

Known as a silent condition because it often goes undetected for many years, osteoporosis causes bones to become less dense and more likely to fracture. Bone fractures resulting from osteoporosis can be extremely painful and cause disability.

Unfortunately, many people with osteoporosis aren’t diagnosed until after they’ve had one of these debilitating fractures. Part of the reason is that those with the condition may not experience any symptoms, other than some back pain or a change in posture, which they may associate with advancing age.

Most osteoporosis-related fractures occur in the wrist, spine, and hips, which can make it difficult to perform tasks, walk, sit, and stand, so getting screened for bone loss (bone density testing) and taking preventive measures to halt it are extremely important.

7 Tips for Preventing Osteoporosis in UC

If you know you’re at risk for bone loss because of UC, here are steps you can take to prevent it.

1. Undergo Routine Bone Density Testing

If you have UC and take a glucocorticoid or have other risk factors, like inflammation or nutrient malabsorption, it’s important to have your bone density checked regularly, says Madalina Butnariu, MD, an assistant professor in the division of gastroenterology, hepatology, and nutrition at Ohio State University Wexner Medical Center in Columbus.

If you’re not currently getting routine tests, talk to your primary care doctor or gastroenterologist. “We perform what’s called a DEXA scan to assess bone density in people at risk of bone loss, especially those with a history of long-term steroid use,” says Dr. Butnariu. “If the DEXA scan is consistent with osteoporosis, we refer them to an appropriate specialist for treatment.”

2. Take Calcium

Experts recommend a diet rich in calcium, a mineral essential for bone building. If you have low bone density, past calcium deficiency, or a history of steroid use, daily 1,200 to 1,500 milligram (mg) calcium supplements are recommended, taken in split doses, as the body can absorb only 500 to 600 mg of calcium at a time.

The best sources of calcium are dairy products like milk, yogurt, and cheese. It can also be found in almond and soy milk, tofu, dark green leafy vegetables, dried peas and beans, fish with bones, and calcium-fortified juices and cereals.

Extra calcium may be particularly helpful during a UC flare, when absorption of the mineral declines.

3. Make Sure You’re Getting Enough Vitamin D

Vitamin D is essential for your body to absorb calcium, and it’s estimated that about half of people with UC are deficient in the nutrient. Sunlight works to synthesize vitamin D in your skin, so if you don’t get adequate natural sunlight, you can supplement with food sources (including fortified milk, fish, egg yolks, and cheese) or by taking 800 international units of vitamin D daily, which can be found in most over-the-counter multivitamins.

“I typically recommend all my patients with UC take a multivitamin, and in those patients with low vitamin D levels, we supplement to achieve a goal of vitamin D levels in blood above 30 nanograms per milliliter,” says Jami Kinnucan, MD, an IBD specialist and associate professor of medicine in the division of gastroenterology and hepatology at Mayo Clinic in Jacksonville, Florida. “We check this through regular blood tests. Typically, you can take supplements of calcium with vitamin D in addition to vitamin D alone.”

4. Consider Changing Your Medication

Steroid use is a risk factor for osteoporosis, so it is ideal to consider steroid-sparing treatments for UC.

 Joseph Feuerstein, MD, the clinical chief of gastroenterology at Beth Israel Deaconess Medical Center in Boston, recommends steroid-sparing drugs like immunomodulators or biologics.

“Corticosteroids have long been associated with bone loss that can be persistent and long-standing,” he says. “Once someone is on a high dose of corticosteroid for more than four to six weeks, there is a risk of osteoporosis. Steroids should be used sparingly to treat UC and avoided unless absolutely necessary.”

5. Limit Alcohol Consumption

Drinking excessive amounts of alcohol — more than two drinks per day — is a risk factor for osteoporosis. It also isn’t ideal for managing UC, as research suggests it may cause flares or worsened symptoms.

Although there are no hard-and-fast rules for a healthy degree of alcohol consumption, moderate alcohol use for healthy adults is typically defined as up to one drink a day — that’s 12 ounces (oz) of beer, 5 oz of wine, or 1.5 oz of hard liquor — for women and up to two drinks a day for men. For adults with a chronic illness such as UC, there are no standard recommendations for safe alcohol use; discuss your consumption with a doctor or registered dietitian.

6. Quit Smoking

Like excessive alcohol consumption, smoking is a risk factor for osteoporosis and bad for your overall health. If you quit smoking, you can reduce your risk of bone density loss and other health complications.

7. Exercise Regularly

Weight-bearing exercises help build bones and maintain their strength, Dr. Feuerstein says. If you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises. If you’re well enough to exercise, you can try bone-building, weight-bearing exercises such as dancing, aerobics, hiking, jogging, running, and tennis. Low-impact exercises such as using an elliptical machine and walking fast on a treadmill can also help keep bones strong and are a safe alternative if you can’t do high-impact exercises.

Resources We Trust

Additional reporting by Ashley Welch.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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