Osteoporosis and epilepsy
Epilepsy and taking anti-epileptic drugs may contribute to the risk of developing osteoporosis for some people.
What is osteoporosis?
The mineral calcium is important for our bones. Vitamin D helps calcium to get into the bones and the calcium helps to make bones strong. When calcium is lost, bones become thinner, more brittle, and break more easily. This is called osteoporosis.
Risks of developing osteoporosis
Anyone can develop osteoporosis, but it is more common in women, especially after the menopause when levels of oestrogen start to decrease.
Having epilepsy and taking anti-epileptic drugs (AEDs) may contribute to the risk of developing osteoporosis, but how much they contribute to this risk is not clear, and will vary from person to person.
Taking enzyme-inducing AEDs
Taking high doses of several different AEDs for many years may contribute to the risk of developing osteoporosis. Studies have shown that some enzyme-inducing AEDs may increase the levels of chemicals in the liver that destroy vitamin D, reducing the amount of vitamin D in the body.
NICE recommends that all adults taking enzyme-inducing AEDs have their vitamin D levels checked every 2 - 5 years to make sure their bones are healthy.
A bone density scan can check bone strength and provide information on whether treatment for osteoporosis may be helpful. Calcium and vitamin D supplements can help replace the natural loss of calcium.
If you have concerns about osteoporosis, talking to your neurologist about having your vitamin D levels checked or a bone density scan might help.
See contraception and epilepsy for a list of enzyme-inducing AEDs.
If osteoporosis happens when a woman goes through the menopause, HRT containing oestrogen or a combination of oestrogen and progestogen, may be prescribed. HRT is generally used to relieve the symptoms of the menopause. See more about menopause and epilepsy.
Contact the Royal Osteoporosis Society
Information produced: February 2020
Changes in hormone levels means that epilepsy treatment may need to change through a woman’s life. In this section, when we refer to women, this also includes girls of childbearing age.
Taking hormone replacement therapy (HRT) may increase the risk of seizures for some women with epilepsy.
Some methods of contraception may be less effective in preventing pregnancy for women taking certain anti-epileptic drugs (AEDs). This is because some AEDs (enzyme-inducing AEDs) affect how well methods of contraception work. Non-enzyme-inducing AEDs are unlikely to affect contraception.