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Corticosteroids, Uses, Types, Side Effects

by | Jun 28, 2022 | Uncategorized | 0 comments

Corticosteroids Overview

Corticosteroids, such as prednisone and cortisone, are a class of drugs that can effectively reduce inflammation. However, they also cause a range of side effects that limit their use.

Corticosteroids are different than the performance-enhancing drugs that some athletes and bodybuilders use. Those are anabolic steroids.

In this article, we take a look at the types of corticosteroids and their uses. We also look at how these drugs work and the possible risks of using them.

How corticosteroids work?

Corticosteroids mimic the effects of hormones, such as cortisol. A doctor will prescribe corticosteroids to either increase the action of these hormones above a normal level or return it to a normal level.

A patient with Addison’s Disease, for example, can benefit from this treatment as their body will not produce enough cortisol.

The increase in hormonal activity suppresses the immune system, which is responsible for activating inflammation in the body. By suppressing immune system activity, corticosteroids can reduce inflammation.


Uses of Corticosteroids

Corticosteroids have several different effects on the body, which means that they can treat a range of medical conditions. They can reduce inflammation, suppress overactive immune system responses, and help with hormonal imbalances.

Corticosteroids are fast-acting in the body, which makes them useful for treating sudden, severe symptoms. For example, they can effectively manage allergic responses.

These drugs can also suppress the immune system, which makes them helpful for treating autoimmune diseases.

Some conditions that corticosteroids can help treat include:


Autoimmune diseases are frequently treated with this class of drugs.

Sometimes the immune system doesn’t work properly, and attacks the body’s own organs, bones, or tissues. Corticosteroids can decrease the inflammation and prevent damage. They also affect how white blood cells work and reduce the activity of the immune system.

When a patient who has rheumatoid arthritis (RA) has a flare, a corticosteroid injection can provide fast relief to an inflamed joint.

Addison’s Disease develops when your body does not make enough cortisol, causing weakness and fatigue among other symptoms. Corticosteroids can help make up the difference.

Doctors may also use them to treat patients who are recovering from an organ transplant. In patients who have just had an organ transplant, corticosteroids help suppress the immune system to reduce the chance of your body rejecting the organ.


Types of Corticosteroids

Corticosteroids can be systemic or localized. Localized steroids target a specific part of the body.

They can be applied through:

  • Eye drops
  • Ear drops
  • Inhalers 
  • Skin creams and ointments

Systemic steroids move through the blood to assist more parts of the body.

These can be delivered through:

  • Injecting into a muscle
  • Intravenous (IV) line
  • Oral medications

Corticosteroids can come in the form of:

  • Capsules
  • Eye drops
  • Injections
  • Lotions, creams, ointments, or gels
  • Nasal or mouth sprays
  • Tablets

A doctor will prescribe different forms of corticosteroids, depending on the problem. For example, they may prescribe a cream, lotion, ointment, or gel to treat skin conditions.

Localized steroids are used to treat conditions like asthma or hives. Systemic steroids treat conditions such as lupus and multiple sclerosis.

Among patients hospitalized with COVID-19 who need oxygen treatment, the administration of systemic corticosteroids has been found to reduce mortality rates.


Corticosteroids vs. Anabolic Steroids

While both are called “steroids,” they are not the same.

Anabolic steroids are based on the human growth hormone testosterone. They can be used productively in hormone replacement therapy (HRT), or to treat growth disorders and other diseases.

However, anabolic steroids have been frequently misused in high doses by athletes and the general public to increase muscle. In this usage, they are called performance enhancing drugs. Anabolic steroids are banned in all athletic competitions. In the United States, it is illegal to possess anabolic steroids without a prescription.


Common Corticosteroids

There are a number of both localized and systemic corticosteroids available. Most of these drugs come in oral, topical, and injectable forms.

Some of the common generic and brand names include the following:

  • Cortisone (cortone)
  • Dexamethasone (Decadron)
  • Hydrocortisone (Cortef, Hydrocort)
  • Mometasone (Nasonex spray)
  • Prednisone (Deltalone, Prednicot, Cotolone)
  • Triamcinolone (Aristocort)
  • Prednisone (Orapred, Omnipred)

As you can see, corticosteroids are a versatile group of drugs. Dosages vary widely depending on what condition the doctor is treating you for, and your overall health.


Side Effects of Corticosteroids

Some side effects can occur with topical, inhaled, and injected steroids. However, most side effects come from oral steroids.

All corticosteroid types can put you at risk of developing fungal infections. Some may also cause high blood sugar, or hyperglycemia.

Side effects from oral steroids may include:

Long-term use of corticosteroids is associated with the following conditions:

  • Bone fractures
  • Depression
  • Facial swelling or puffiness (fluid retention)
  • Nausea
  •  Other types of stomach irritation
  • Vomiting
  • Weight gain

Side effects from inhaled corticosteroids may include:

  • Cough
  • Difficulty speaking (dysphonia)
  • Oral thrush

Side effects from topical corticosteroids may include:

  • Acne
  • Atrophy
  • Delayed wound healing
  • Perioral dermatitis
  • Rosacea
  • Stretch marks

Side effects from injected corticosteroids may include:

  • Facial flushing
  • High blood sugar
  • Insomnia
  • Infection
  • Loss of skin color at injection site
  • Temporary pain and soreness

Not everyone will develop side effects from taking corticosteroids. Side effects are more likely if corticosteroids are taken at a high dose over a long period of time.


Coping With Side Effects of Corticosteroids

Taking lower dosages over shorter periods will reduce the risk of side effects from corticosteroids. Doctors will always try to prescribe the lowest dosage that will still provide effective treatment.

Some tips to reduce the risk of problems when taking corticosteroids include:

  • Avoiding interactions by making sure that the doctor is aware of all other medications and supplements
  • Being careful to prevent infections where possible, such as by getting a flu vaccine and keeping open wounds clean and protected
  • Keeping the bones healthy through proper exercise, a healthful diet, and, for older adults, calcium and vitamin D supplements
  • Taking precautions to avoid becoming pregnant, if possible
  • Having regular eye exams
  • Watching out for signs of water retention, such as swollen ankles
  • Taking doses according to the doctor’s prescription
  • Applying a retinoid cream at the same time as corticosteroid creams, gels, or lotions to reduce the risk of thin skin
  • Avoiding sudden changes in dosage to reduce the risk of complications, such as withdrawal symptoms

 

Corticosteroids Induced Weight Gain

Steroids have some negative side effects, including weight gain. According to one study, weight gain was the most commonly reported adverse effect of steroid use, affecting 70 percent of those prescribed the drugs.

Steroids cause weight gain by altering the body’s electrolyte and water balances, as well as its metabolism, the way it uses and stores lipids, amino acids, protein, carbohydrates, and glucose, among other things. These factors contribute to weight gain by causing:

  • Changes in where the body stores fat
  • Fluid retention
  • Increased appetite

Many patients on steroids notice increased fat in the abdomen, face, and neck. Even if you successfully control steroid-induced weight gain, you’re apt to look heavier while on these drugs because of this fat redistribution.

How much and even if you will gain weight (it’s not a definite) depends on a lot of factors, including dose and duration.

Generally, the higher the dose of the steroid and the longer you’re on it, the more likely you are to encounter weight gain. Short courses of a few days to a couple of weeks don’t usually produce many side effects.

But one study published in the journal Arthritis Care and Research found that subjects who were on more than 7.5 milligrams of prednisone per day for more than 60 days were more likely to experience adverse side effects like weight gain than those on a lower dose for a shorter period of time.

The good news is, once the steroids are stopped and your body readjusts, the weight generally comes off. This usually happens within 6 months to a year.

Prevention of Corticosteroids Induced Weight Gain

The first step is talking to your doctor. Depending on the drug you’re taking and the disorder it’s treating, you may have other medication options.

Your doctor may also recommend a different dosing schedule or a different form of the steroid. For example, they may recommend every-other-day dosing or, if you have something like asthma, using an inhaled steroid that targets the lungs directly instead of a pill that can have full-body effects.

Don’t stop taking your medication (or changing when and how you take it) without medical guidance. Steroids are potent drugs that need to be tapered gradually. Stopping them abruptly can lead to serious health complications such as muscle stiffness, joint pain, and fever, not to mention a relapse of whatever disorder they were controlling.

To curb weight gain, use the same strategies you’d use to control weight in general:

  • Choose belly-filling (yet low-calorie) foods like fresh fruits and vegetables.
  • Stave off hunger by eating six small meals a day versus three large ones.
  • Choose fiber-rich and slower-to-digest complex carbohydrates versus refined ones (for example, whole wheat pasta instead of regular pasta, and brown rice instead of white).
  • Include a source of protein with each meal (meat, cheese, legumes, etc.). Research published in the American Journal of Clinical Nutrition found that meals that contain 25–30 grams of protein are most effective at curbing appetite and controlling weight.
  • Drink water. Besides filling you up, it can actually burn calories. One study published in the International Journal of Obesity found that overweight children who drank just 10 milliliters per kilogram of body weight of cold water increased their resting energy expenditure by 25 percent for 40-plus minutes after drinking.
  • Stay active. This is sometimes hard to do when you don’t feel well. Having a workout buddy can help, as can choosing an activity you enjoy.

 

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