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Сorticosteroids
What are corticosteroids?
Corticosteroids are drugs that resemble a hormone developed in the human body called ‘cortisol,’ a steroid hormone produced by the adrenal glands. Cortisol is responsible for the smooth management of multiple bodily processes like metabolism and immune response.
They are anti-inflammatory medicines that are prescribed by doctors for treating a variety of diseases like asthma, lupus, and even multiple sclerosis (MS).
Although man-made corticosteroids are often called ‘steroids’ in general terms, they shouldn’t be mistaken for anabolic steroids (drugs used to increase muscles and boost athletic performance).
Some examples of synthetically produced corticosteroids include
- Cortisone
- Hydrocortisone
- Prednisone
- Triamcinolone
- Betamethasone
- Dexamethasone
These corticosteroids are generally available in the drug stores under the following brand names
- Celestone
- Prednisone Intensol
- Prelone
- Medrol
These brand names are usually available on local stores in the United States. However, they might differ, depending on your country.
How do corticosteroids actually work?
As discussed, corticosteroids are used to mimic a naturally produced hormone called cortisol. Our adrenal glands that are housed right above the kidneys are responsible for the production of this hormone.
Corticosteroid is available in multiple forms, which is instantly distributed throughout the body upon use. Prescribed doses have to be greater than the bodily production of cortisol for effective results. This allows the body to suppress inflammation and reduce the impact of painful conditions.
According to studies, such drugs are often found to replace the steroids in people with misfunctioning adrenal glands, such that they’re unable to produce the desired amount.
Corticosteroids are also used to help control diseases related to the immunity system as it can also be used to suppress the immunity system in cases of harmful conditions.
What are they used for?
Corticosteroids possess many advantages and are used to prevent and even cure multiple conditions, including:
- Asthma
- Hay fever
- Atopic eczema
- Inflamed muscles, tendons, or joints
- Inflammatory bowel disease (IBD)
- Lupus
- Bronchitis
- Rheumatoid arthritis
- Multiple sclerosis (MS)
- Addison’s disease – the body stops producing certain hormones naturally, and thus corticosteroids can be used to replace their production, to continue operating properly
Since corticosteroids are available in several different forms, each of them has a different set of diseases it can be used to help with.
How can corticosteroids be taken?
Corticosteroids are locally available drugs (available on prescription only) in multiple forms and thus, can be consumed in the following ways:
- Oral Steroids
Such drugs can be taken by mouth using tablets, capsules or syrups. They’re extremely helpful in treating inflammation and other painful conditions like asthma, eczema, or arthritis. Common examples of oral steroids include prednisolone and betamethasone.
- Inhalers or Sprays
Corticosteroids are also possible in the form of sprays or inhalers which can be used to alleviate discomfort related to asthma and nasal allergies by reducing swelling, inflammation, and mucus production. Sprays generally lead to fewer side effects and don’t require hospitalization for long.
- Topical Steroids
Creams, lotions, gels, and ointments are several different forms of topical corticosteroids. These can be applied as per the doctor’s recommendation, or once or twice a day depending on the pain and inflammation. Conditions in which topical steroids are normally prescribed include eczema, nappy rash, or insect bites. Although they can greatly reduce the pain temporarily, they can’t, unfortunately, be used to cure the conditions permanently.
- Injections
Creams, lotions, gels, and ointments are several different forms of topical corticosteroids. These can be applied as per the doctor’s recommendation, or once or twice a day depending on the pain and inflammation. Conditions in which topical steroids are normally prescribed include eczema, nappy rash, or insect bites. Although they can greatly reduce the pain temporarily, they can’t, unfortunately, be used to cure the conditions permanently.
Are steroids the right treatment?
Usage of steroid is not general, and thus the decision to use these is dependent on the individual. A doctor might take into consideration many different factors that are used to determine whether or not; steroids should be used for relief. Age, weight, physical movement, history, and usage of other medicines are some of the factors used to make a discussion.
Because of the severity of the side-effects and the drug itself, a doctor will surely be telling you all about the possible side effects and benefits of this medical pathway.
Side-effects of Corticosteroids
Corticosteroids have numerous benefits which are paired with an intensively long list of side effects. These side-effects range from mild to severe on the risk scale. Some of these can be life-threatening as oral corticosteroids travel throughout the body and don’t target a particular body organ.
The severity of the side-effects depends on the dose of medication prescribed by the doctor. It is for the same reason; corticosteroids are started off with very lower doses (but effective) and then gradually increased with time.
Usually, there are no side effects if injections, inhalers or oral steroids are taken for a short course. In most cases, corticosteroids are only preferred by doctors when their supposed advantages outweigh the side effects.
Potential side effects of using oral corticosteroids, for a long period of time include
- Increased chances of catching an infection
- Mood swings, depression, and anxiety. Other psychological effects like a state of confusion or delirium can also be observed
- Diabetes
- Increase in appetite which ultimately results in increased weight. Fat is normally deposited in huge amounts near the back and neck.
- High blood pressure
- Migraines or headaches
- Menstrual imbalances in women
- Slow healing process
- Increased eye pressure (glaucoma)
Side effects when using inhaled corticosteroids are slightly different as it involves the usage of mouth and some of the drugs may be deposited in the mouth or throat instead of reaching to its desired organ, the lungs. Because of this, you might experience:
- Hoarseness
- Infection in the mouth
Topical corticosteroids can lead to an increase in
- Acne – continuous usage often results in the development of pimples and opening of pores on the skin
- Thin skin which causes it to bruise easily
- Skin Lesions
Injected corticosteroids may produce side effects that are temporary and may not be carried further. Potential side effects include a burning sensation, loss of color of the skin, and intense pain.
Other than these, usage of these drugs for a longer period of time can lead to a variety of diseases which are common in all forms of it. Osteoporosis, a condition that causes the bones to weaken and fracture easily, is also bound to happen.
Adrenal glands might shrink over time causing a significant decrease in its normal production of cortisol, which can lead to a variety of medical conditions.
Although these side effects exist with the usage of corticosteroids, you’re never advised to leave your prescribed dosage without medical supervision. Prolonged use of the drug causes the body to form a dependency on the artificial supply of cortisol and might not be able to produce it on its own, causing an adrenal crisis. Nausea, fatigue, body aches, lightheadedness, and vomiting are a few observed side effects of an adrenal crisis. In this case, withdrawal is done by reducing the dosage slowly, over a few weeks or months.
Reduce the risks of these side-effects
The list of side effects of corticosteroids is very long. However, these effects can be significantly toned down to avoid crossing path with any one of them. To reduce the risk, you can try the following techniques:
- Start off with lower doses
Most of these side effects exist because of prolonged use of high doses. If the doses are reduced, the occurrence of these side effects is also reduced greatly. Consult your doctor about moving forward with a lower dosage, short-term medication, or intermittently taking these medications (alternate days only).
- Follow a proper diet plan
If you’ve been prescribed a prolonged usage or corticosteroids, following a strict diet plan is very important. A low-salt diet or a potassium-rich diet should be followed to reduce potential problems. Protein intake should be increased to see better results. Ensure that your physician is aware of all these diet decisions.
- Discontinue usage with a gradual decrease
Suddenly stopping the dosage of corticosteroids can result in an adrenal crisis which is a painful medical condition. It is advised to consult a doctor in this case, to get a healthier dosage of the drug to avoid any other disease. This gradual decrease of the drug would allow the adrenal gland to get enough time to heal itself and resume its normal functions.
- Increased usage of supplements
Osteoporosis and its impact can be stopped from worsening by regularly taking vitamin D and calcium supplements. These will help protect the bones along with the specified dosage of corticosteroids. Foods and other eatables that are rich in such minerals can also be consumed. Smoking and alcohol is also observed to have a negative impact and should be reduced for a smooth treatment process.
- Resisting infections with flu shots
As long as you’re on steroids, it’s optimal to have a flu shot yearly to prevent the occurrence of pneumonia or other forms of diseases or infections. This might still not be enough to prevent chances of developing an infection and thus, it is suggested to have a consultation with a physician.
- Regular checkups
Most of the mentioned side effects can’t be detected without supervision. It’s recommended to visit a doctor on a regular basis to consult about the prescribed dosage and whether or not any side effect showed up. This is highly recommended in case of prolonged usage of the medicine.
There are other ways as well to reduce the side effects of corticosteroid and need to be thoroughly discussed with the primary physician.
Cautions
Pregnant women can safely use steroid inhales or injections if necessary. However, it is highly recommended to consult with a doctor before usage. Only a doctor can rightly determine if the dosage of steroids or perhaps even the use of steroids is right or not, and whether or not, the risks are minimal.
Other than these, few circumstances are present in which steroid tablets shouldn’t be used which include:
- Taking medication that may not be suitable for use with corticosteroids
- Experiencing mental problems like depression or alcoholism
- Treating an ongoing infection
Interactions with other medicines
It is highly likely that corticosteroids interact with other ongoing medication, and result in an unlikely situation. Again, most of these issues are only existent with long term usage or taking a high dosage. Sprays, inhalers, or injections are not always going to result in these situations.
Some cases, where the combination of corticosteroids with other medicines is not effective, are discussed below:
- Anticoagulant medicines
Anticoagulant medicines help prevent blood clots and are used to make the blood less sticky. Corticosteroids, when combined with anticoagulant medicines, cause the effect of anticoagulants to be significantly reduced.
- Diabetes medication
Corticosteroids can also cause a decrease in the efficiency of medicine used to treat diabetes. A physician should be able to readjust your medication to accommodate both types of medications.
- Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are commonly available painkillers that are used to treat a variety of diseases or discomforts. Combining the two types of medications can cause numerous ulcers to develop in the stomach. Proton pump inhibitor (PPI), a drug used to reduce stomach acid production, might be used with these medications to observe the effective advantages of both.
Many other medications, not listed above, can also interact with corticosteroids and cause unlikely events. For best results, a physician or GP should be consulted, or read the leaflet that was shipped with your medication.
Summary
Corticosteroids are generally available prescription drugs that imitate the bodily hormone, cortisol, which allows the body to function properly. It’s used to treat several different diseases like arthritis, lupus, inflammatory conditions, and others. It exists in various forms and can be used as per the physician’s prescription.
Despite a daunting list of side effects, doctors generally prescribe the drug because of its ability to respond effectively in different conditions. However, these risks only show up, when the medicine is used for longer periods of time without supervision. Most of these side-effects can be reduced with timely checkups, proper diets, and the use of supplements.
