Consider the following suggestions: Any recommendation here that you don’t understand or believe doesn’t apply to you should be discussed with your doctor. It’s also worth noting that the adverse effects of steroids are very dependent on the dosage and duration of use. If you take a modest dose, your chances of experiencing a significant adverse effect are slim, especially if you follow the precautions outlined below. You might be hesitant to take steroids after reading about these side effects. Before starting any medications, you should be fully aware of the hazards. Please rest assured that many people take steroids and experience just little or no negative effects. Please keep in mind that steroids are often quite effective and can save your life. Please with your physician if any of the advice below are unclear or seem irrelevant to you.
Take note of which “steroids” we’re discussing: Anti-inflammatory steroids (corticosteroids) such as prednisone and methylprednisolone (Medrol®) and dexamethasone (Decadron®) are referred to as “steroids” in this context. The following information does not apply to muscle-building or “androgenic” steroids (such as testosterone), which are chemically identical to anti-inflammatory steroids but work quite differently.
Understanding the negative effects of corticosteroids
Corticosteroids can cause any of the adverse effects listed below if taken for an extended period of time. However, implementing the precautions outlined below can help to lessen the dangers.
Physical tension need higher doses.
Steroid use for more than two weeks can impair your body’s ability to respond to physical stress. During times of extreme stress, such as surgery, significant dental work, or a serious infection, a higher dose of steroid may be required. This may be required for up to a year after you have stopped taking steroids.
- Discuss this idea with the surgeon, dentist, or other medical professional who is currently caring for you. Your doctor or surgeon may not think you need the extra testosterone cypionate for sale at the time of surgery, but if they know you’ve been on corticosteroids, they’ll be able to keep a closer eye on you thereafter.
Withdrawal symptoms from steroid use
When anti-inflammatory steroids are used for a long period and then abruptly stopped, our adrenal gland (which produces our body’s steroid hormones) can become slow in producing our own. Anti-inflammatory steroids can block the complex mechanism that leads to the creation of anti-inflammatory steroid hormone in our bodies (cortisol). These anti-inflammatory hormones suppress the hypothalamus and pituitary gland, both of which are involved in stimulating the adrenal gland to produce cortisol. The pituitary gland’s production of ACTH (which stimulates the adrenal gland to produce cortisol) can be suppressed, for example. The ability of the adrenal gland to produce cortisol can also be suppressed.
Rapid steroid withdrawal can result in a condition characterized by weariness, joint discomfort, muscular stiffness, muscle tenderness, and fever. It may be difficult to distinguish these symptoms from those of your underlying disease.
Some of these symptoms can occur even with a slower steroid withdrawal, albeit usually in milder forms.
Rapid steroid discontinuation might sometimes result in a more severe case of adrenal insufficiency. This can result in symptoms and health issues such as blood pressure decreases and chemical changes in the blood, such as high potassium or low sodium. Injuries or surgical procedures can sometimes trigger this. As a result, make sure your doctors are always aware whether you’ve been treated with steroids in the past, particularly within the last year, so they can be on the lookout for signs of adrenal insufficiency during procedures like surgery.
If you experience any of these symptoms while tapering your steroids, talk to your doctor. Depending on how you’re doing, your doctor will work with you to try to gradually reduce your steroid dose at a safe rate. Discuss with your doctor whether you can reduce your steroid dosage at each visit.
- Even if you’re experiencing a steroid adverse effect, drugs must still be discontinued cautiously.
- Steroids can usually be tapered more quickly when administered for less than two weeks.
- Long-term steroid use can reduce your immune system’s ability to protect you and raise your risk of infection.
Because steroids might lower your immunity to infection, you should get a flu shot every year while you’re on them. If you’re taking steroids for an extended period of time, talk to your doctor about obtaining “Pneumovax,” a pneumonia vaccine, and “Prevnar 13,” another pneumonia vaccine. Shingles vaccination (Shingrix®) is another option. When determining which immunizations you require, your doctor will consider your age and risk factors.
High temperature, active cough, pain while passing urine, or huge “boils” on the skin are all signs of infection that should be treated as soon as possible. Report tuberculosis to your doctor if you have a history of tuberculosis, have been exposed to tuberculosis, or have a positive tuberculosis skin test.
Symptoms of the gastrointestinal tract
Steroids, especially when combined with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin, can raise your risk of getting ulcers or gastrointestinal bleeding. If at all feasible, avoid using NSAIDs with steroids. If you’re taking low-dose aspirin for heart protection, your doctor may want you to keep taking it while you’re on prednisone, but you should consider taking a stomach-protecting medicine as well.
- Any severe, persistent abdominal pain or black, tarry stools should be reported to your doctor.
- Take the steroid medication after a full meal or with antacids to assist relieve stomach irritation. Steroids can make you hungrier.
Steroid medication can thin the bones and raise the risk of bone fractures (osteopenia and osteoporosis). Many individuals will be asked to have a bone density test at the start or before starting steroid medication, especially if the steroid dose is high. If your bone density is low, you should get a bone density test. It will be done again in the future to see how effective the actions you plan to take to avoid bone loss are. Preventative treatments are critical since corticosteroid therapy can cause a person to lose 10% to 20% of their bone mass in the first six months.
Most persons using corticosteroids will need a calcium supplement unless they acquire enough calcium from their diet (the best option is to get it from your diet). See this National Institutes of Health reference.
Health information about how much calcium you need based on your gender and age, as well as how to get as much calcium from your diet as possible.
Vitamin D has a daily minimum requirement of 800 international units (UI), which most persons on corticosteroids should meet. Your doctor may want to check your vitamin D levels to see whether you need a greater dose.
Because smoking and drinking increase the risk of osteoporosis, limiting these habits is beneficial.
Weight-bearing exercise (walking, running, dancing, etc.) is beneficial for bone mass stabilization.
Low bone density patients on corticosteroids may be prescribed drugs such as alendronate (Fosamax®) or Prolia®, among others.
Evaluate the possibility of falling. Examine your property thoroughly and rectify any problems that could lead to a fall, such as removing scatter rugs and any barriers between the bedroom and the bathroom, and installing night lights.
Steroids have an impact on your metabolism and how fat is stored in your body. This can increase your hunger, resulting in weight gain and, more specifically, excess fat deposits in your abdomen.
- To avoid excessive weight gain, keep track of your calories and exercise often. But don’t let your self-esteem suffer as a result of your weight gain. Keep in mind that losing weight in the six months to a year after you stop eating will be easier.
- Steroids might make it difficult to fall asleep, especially if taken late at night.
If at all possible, the doctor will have you take your complete daily dose first thing in the morning. This could help you get a better night’s sleep (evening doses sometimes make it difficult to fall asleep).
Steroids might alter your mood, especially if you use more than 30 milligrams each day.
Some people become melancholy, while others become incredibly “up” for no apparent cause. Knowing that steroids can cause this can help to make it less of an issue. This side effect may necessitate a reduction in steroid dosage. When steroids are absolutely necessary, additional drug to aid with the mood problem can be added. Make sure your entire family is aware of this potential adverse effect.
Simply being aware that steroids can affect your mood can make it less of a concern in some cases. However, this side effect may necessitate a reduction in steroid dosage. If continuing the same steroid dosage is absolutely essential, additional medicine to aid with the mood problem might occasionally be added.
Make sure your family and friends are aware of this potential side effect so they can understand what’s going on if you react to them in unusual ways. Tell your family and friends about this potential side effect as soon as you start taking the drug so they can help you spot any changes in your behavior.
High blood pressure and fluid retention
Because cortisone is involved in controlling the body’s water, sodium, and other electrolyte balance, taking these medications might induce or increase fluid retention, as well as cause or worsen high blood pressure.
Keep an eye out for swelling in your ankles and notify your doctor. Diuretics are useful for a few patients on a regular basis (water pills). A low-sodium diet can help regulate blood pressure by reducing fluid retention.
While on steroids, have your blood pressure checked on a frequent basis, especially if you have a history of high blood pressure. In some patients, steroids might cause blood pressure to rise.
Blood sugar levels that are too high
Long-term usage of cortisone, which is important in maintaining normal glucose (sugar) levels in the blood, may result in high blood sugar or possibly diabetes.
- Because corticosteroids might elevate blood sugar, it’s important to keep track of your blood sugar while taking steroids, especially if you’re diabetic.
- Problems with the eyes
- Steroids can induce cataracts or glaucoma in some people (increased pressure in the eye).
If you have a history of glaucoma or cataracts, talk to your ophthalmologist about it while you’re on steroids. You should contact an ophthalmologist if you experience any visual difficulties while taking steroids. Although temporary impaired vision upon starting corticosteroids is rarely a major issue, an ophthalmology evaluation should always be scheduled if you develop additional, new visual complaints while on steroids.
Atherosclerosis is a disease that affects the arteries (hardening of the arteries)
It’s likely that steroids will speed up the process of “artery hardening,” raising the risk of heart disease. If steroids are taken for more than a year and in large doses, the risk is likely to be significantly higher.
A low-cholesterol diet may be beneficial. If you notice symptoms of a cardiac disease, such as chest pain, seek medical help right away. Work with your doctor to address any modifiable cardiac risks, such as exercise, weight, and cholesterol levels.
Steroids, especially when taken in large doses for lengthy periods of time, can cause aseptic necrosis, or bone deterioration (also known as osteonecrosis or avascular necrosis). This can occur in a variety of joints, but the hip is the most commonly affected.