Corticosteroids ease swelling and irritation. Doctors often prescribe them to treat conditions like asthma, hives, or lupus. Side effects can depend on the type of corticosteroid, such as inhaled or topical.
Corticosteroids are a class of human-made or synthetic drugs used in almost every medical specialty. They lower inflammation in the body by reducing the production of certain chemicals. At higher doses, corticosteroids also reduce immune system activity.
Corticosteroids resemble cortisol, a hormone naturally produced by our body’s adrenal glands. Cortisol is a major player in a wide range of biological processes, including metabolism, immune response, and stress.
Because corticosteroids ease swelling and irritation, doctors often prescribe them to treat conditions like asthma, hives, or lupus. Corticosteroids can provide substantial relief of symptoms, but come with the risk of serious side effects, especially if used long term.
We’ll explore how this important class of drugs is used to treat a wide range of health conditions, what forms corticosteroids take, and potential side effects.
Corticosteroids are used to treat everything from seasonal allergies to life-threatening organ inflammation.
- hay fever
- chronic obstructive pulmonary disease (COPD)
- inflammatory bowel disease
- multiple sclerosis
Autoimmune diseases are frequently treated with this class of drugs.
Sometimes the immune system doesn’t work correctly, and attacks your 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 someone with rheumatoid arthritis has a flare, a corticosteroid injection can provide fast relief to an inflamed joint.
Addison’s disease occurs when your body doesn’t make enough cortisol, causing weakness and fatigue among other symptoms. Corticosteroids can make up the difference.
In people who have just had an organ transplant, corticosteroids help suppress the immune system to reduce the chance of your body rejecting the organ.
Corticosteroids can be systemic or localized. Localized steroids target a specific part of the body.
They can be applied through:
- skin creams and ointments
- eye drops
- ear drops
Systemic steroids move through the blood to assist more parts of the body.
They can be delivered through:
Localized steroids are used to treat conditions like asthma or hives. Systemic steroids treat conditions such as lupus and multiple sclerosis.
Corticosteroids vs. anabolic steroids
While both are called “steroids,” they are not the same.
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.
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:
- Prednisone (Deltalone, Prednicot, Cotolone)
- Prednisolone (Orapred, Omnipred)
- Cortisone (Cortone)
- Hydrocortisone (Cortef, Hydrocort)
- Triamcinolone (Aristocort)
- Dexamethasone (Decadron)
- Mometasone (Nasonex spray)
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.
Some side effects can occur with topical, inhaled, and injected steroids. However, most side effects come from oral steroids.
Side effects from
- skin and muscle atrophy
- increased risk of infections
- high blood pressure
- mood or behavioral changes
Long-term use is associated with:
- weight gain
- facial swelling or puffiness (fluid retention)
- nausea and vomiting
- other types of stomach irritation
- bone fractures
Side effects from
- difficulty speaking (dysphonia)
- oral thrush
Side effects from
Side effects from injected corticosteroids may include:
- temporary pain and soreness
- loss of skin color at injection site
- high blood sugar
- facial flushing
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.
It’s important to talk to your doctor about pros and cons of using corticosteroid medication.
Corticosteroids can be a life changing or even lifesaving treatment, but long-term use in particular can cause serious health risks.
Here are a few complications associated with long-term corticosteroid use:
- Adults and older adults are more likely to develop issues with high blood pressure and
osteoporosis. Women have a higher chance of developing this bone disease.
- Children may experience
stunted growth. Because they suppress the immune system, corticosteroids can also cause infections like the measles or chickenpox to be more severe.
- Pregnant or breastfeeding people should use steroids with caution. The drugs can pass from parent to child in the womb or through breastfeeding. However, most corticosteroid inhalers and injections are considered safe.
Certain medical conditions may affect the use of a corticosteroid medication. Tell your doctor if you have any preexisting health conditions.
It’s particularly important to tell them if you have:
- HIV or AIDS
- herpes simplex infection of the eye
- gastrointestinal problems
- high blood pressure
- any kind of infection (viral, bacterial, fungal)
- a disease of the heart, liver, thyroid, or kidney
- have had a recent surgery or serious injury
Corticosteroids can also alter the effects of other medications. However, the likelihood of interactions happening with steroid sprays or injections is low.
Be careful what you eat when taking corticosteroids. Certain steroids shouldn’t be taken with food, as interactions may occur.
Tobacco and alcohol can also cause interactions with certain medications, including corticosteroids. If you regularly drink or smoke, talk to your doctor about the effect this may have on your treatment.
While there are risks and complications associated with corticosteroids, there are also ways to reduce or address side effects.
Here are some tips to consider:
- always take your medication as directed
- talk to your doctor about low or intermittent dosing
- maintain a healthy diet
- find an exercise routine that works for you
- attend regular health checkups
High blood sugar (hyperglycemia) is a symptom of some corticosteroids. High blood sugar can cause fatigue, thirst, and frequent urination among other symptoms. Corticosteroids can also interfere with many other bodily processes, from your bones to your blood pressure.
Here’s a breakdown of some dietary guidelines that can help you maintain a balanced diet, and reduce your risk of side effects:
|Foods to avoid||Eat more of|
|Sweets and foods high in sugar increase risk of high blood sugar. Candy, soda, cookies, and ice cream are high in concentrated sweets.||High-potassium foods help replenish lost potassium in the bloodstream. This includes bananas, avocados, potatoes, spinach, whole grain bread, and dark chocolate.|
|High-sodium foods can raise blood pressure and cause fluid retention. This includes cured meats, snacks like chips, and certain sauces.||High-calcium foods help prevent osteoporosis, which weakens bones. Prioritize milk, yogurt, cheese, nuts and seeds, and dark, leafy greens.|
|Fried foods raise cholesterol and triglycerides (lipids). Try to limit products that are high in fat and cholesterol, including heavy creams and fatty cuts of meat.||High-protein foods keep muscle tissues healthy. Meat, seafood, eggs, legumes, and tofu can help keep muscles strong.|
Corticosteroids are powerful anti-inflammatory medications that mimic our naturally occurring hormone cortisol. These drugs come in oral, topical, and injectable forms, and have benefits for a wide variety of health conditions.
Local corticosteroids can treat asthma and skin allergies. Systemic corticosteroids can help lower inflammation for those with lupus, inflammatory bowel disease, or in people recovering from an organ transplant. Some health conditions require long-term treatment with corticosteroids, while others only need a very short course.
Corticosteroids can come with serious side effects, including high blood pressure, weight gain, and increased risk of infections. This risk increases if you use them long term.
Talk to your doctor about the pros and cons of corticosteroids. Communicate any preexisting conditions you have, and any medications you take, to your healthcare team in order to minimize risk of side effects.