Corticosteroids Side Effects
Corticosteroids are extremely effective drugs. They are synthetically produced steroid hormones similar to hormone cortisol, which is produced in the adrenal cortex. In our body, cortisol and its derivatives belong among the stress hormones that allow us to adapt to prolonged stress. Their effect is very wide - from the redistribution of body fat, to increase of blood sugar (glycemia) and suppression of the immune system. It is the suppression of the immune system, which makes the corticosteroids so popular. This is due to the fat that increased activity of the immune system is undesirable in many conditions such as severe allergic reactions (asthma, anaphylactic shock), in autoimmune diseases and other pathological conditions (COPD).
Excessive doses of “our own” corticosteroids may occur in the body in excessive production in the adrenal glands (for example, a tumor of the adrenal gland producing corticosteroids) and artificial corticosteroids may be administered in medications. No matter the origin of the corticosteroids, these substances have many side effects that could be summarized under the term Cushing's syndrome.
Side effects and other disadvantages
We must realize that corticosteroids do not cure the cause of autoimmune or allergic disease, they only dampen the symptoms. In chronic diseases, discontinuation of the therapy may lead to quick recurrence of symptoms.
Sudden discontinuation of medication
If the patient uses the corticosteroids for a long time and when they are suddenly discontinued, the resulting effect can be life-threatening. The adrenal glands of the person cease to produce cortisol, because of outer intake of the hormones. Sudden loss of corticosteroid hormones can be fatal. Therefore, when used chronically, the corticosteroids should be discontinued gradually.
Corticosteroids dampen the immune response generally and cause overall immunosuppression. This makes the chronic users of high doses of corticosteroids more susceptible to infections and probably even to a more frequent occurrence of cancer diseases.
Redistribution of body fat and obesity
Fat of people using the corticosteroids accumulates in the face and abdomen. This results in typical obese “moon face” and big belly with relatively thin limbs. The fat accumulation is accompanied by muscle atrophy.
Elevated blood sugar
Corticosteroids have a negative influence on the formation of collagen, which is located in the skin. The skin begins to crack and this causes occurrence of bluish stretch marks (usually on the skin of the abdomen). Local usage of corticosteroids in ointments has no significant general effect, but it can damage the local skin areas at the site of the ointment application. Corticosteroids also impair healing of skin wounds.
Corticosteroids inhibit the formation of gastric mucous layer, which protects the stomach from the effects of gastric acid. However, according to new studies, corticosteroids alone have no significant impact on development of peptic ulcers, but they significantly increase the risk of peptic ulcers, when combined with NSAID medications.
Corticosteroids affect the bone metabolism. They cause loss of bone tissue and their long-term usage may cause osteoporosis.
Coarsening of the voice
Permanent use of inhalation form of corticosteroids may induce voice changes by affecting the lining of vocal cords.
The best prevention is prescription of corticosteroids only to indicated patients in as low dosage as possible. In many chronic diseases, corticosteroids are not administered continuously, but only temporarily in case of acute deterioration. When possible, we prefer local corticotherapy to the systemic one, i.e. we rather use corticosteroids in enemas, skin ointments or inhalation, than oral or intravenous forms of corticosteroids.
Although corticosteroids are drugs with many side effects, the patient should not avoid these drugs, when they are prescribed by a doctor. A competent physician is aware of their side effects, and always administers corticosteroids for a good reason. On the contrary, patients should never try to chronically use corticosteroids without consulting a physician.