When the body naturally produces corticosteroids, it is as the hormone cortisol. Produced by the adrenals glands, cortisol manages stress, blood pressure, and glucose levels, balances metabolism, regulates sleep, and controls immune and inflammatory responses. Corticosteroids are synthetically made and administered as a medication, helping treat excessive inflammation and overactive immune systems.
How do Corticosteroids Work?
Corticosteroid medications act like cortisol in the body. Doctors prescribe them to help suppress inflammation through a higher dose than what the body can create on its own. These medications work by reducing the production of chemicals that cause inflammation and, by affecting white blood cell activity, reduces hyperactive immune systems.
What Conditions do Corticosteroids Treat?
Synthetic corticosteroids treat severe disorders of the immune system that create excessive inflammation. Most of the conditions are autoimmune disorders such as rheumatoid arthritis, lupus, psoriasis, inflammatory bowel disease, vasculitis, and myositis. In people with these conditions, the immune system mistakenly attacks the tissues. Doctors may also administer them for conditions such as asthma, allergies, and certain cancers that cause an overreaction of the immune system. Untreated, the symptoms of these conditions can cause long-term or life-threatening damage.
How are Corticosteroids Taken?
Corticosteroid medications come in several forms, and doctors will prescribe certain ones depending on the location and type of illness. Topical creams can treat skin conditions. Patients with severe lung conditions can inhale the compound. For systemic illnesses, doctors usually prescribe corticosteroids in pill or injection form. Lastly, they can treat eye or ear conditions as drops. For clarity, the facts in the rest of this article will address corticosteroids as the more common pills or injections.
What are the Side Effects?
Corticosteroids have many side effects, so they need to be strictly prescribed and monitored by a doctor or medical specialist. The side effects occur because corticosteroid suppress the immune system and affect the other systems that respond to cortisol. Some of these side effects are weight gain, hunger, swelling, high blood pressure, osteoporosis, cataracts, glaucoma, diabetes, stomach issues, anxiety, mood swings, and sleep difficulties.
Due to side effects, some patients must adjust their diet. Following a low-sodium, high-potassium diet helps maintain healthy blood pressure, eating more protein and reducing excess caloric intake maintains a healthy weight. Also, getting more calcium can ease symptoms of osteoporosis and muscle weakness. People taking corticosteroids should avoid grapefruit and grapefruit juice, as they will affect the absorption of the medicine in the body.
People with pre-existing conditions such as diabetes, osteoporosis or depression, or liver, kidney, or eye problems, will likely find these issues grow worse when taking corticosteroids. Contraindications include serious infections such as tuberculosis. Pregnant or lactating women should avoid corticosteroids, and people taking the medications should not receive live virus vaccines.
Minimizing Side Effects
There are several ways to decrease the side effects corticosteroids or limit the damage they can cause. It is best to take the smallest dose to achieve the desired benefits. Topical or local corticosteroids are a good alternative to pills or injections if this type of treatment can be effective — they have fewer side effects. Finally, a doctor should monitor blood pressure, blood sugar, and bone density closely while the person is taking the medication. The doctor may also prescribe other medications to decrease or suppress corticosteroid side effects.
How Doctors Determine The Right Treatment
Since, in addition to side effects, corticosteroids can cause serious withdrawal issues, doctors should ensure no other, less potentially dangerous medications would help instead. Corticosteroids are usually the last resort when health conditions are not responding to other treatments, or when the outcome of not using them is more serious than the dangers. When possible, doctors prescribe only a short course of corticosteroids.
What Happens when Corticosteroids are Discontinued?
Discontinuing corticosteroids can lead to hazardous health issues. The synthetic use of this medication can stop the adrenal glands from producing cortisol as the body begins to rely on the synthetic version. Therefore, once the patient finishes the course, the body goes into immediate withdrawal, prompting a lowering of blood pressure, nausea, fatigue, headache, depression, vomiting, low blood sugar, and dizziness. Instead, doctors usually prescribe a slow tapering of the corticosteroid to reduce these withdrawal symptoms.
Alternatives to Corticosteroids
Many individuals with less severe inflammatory conditions can manage them through changes to diet or herbal and vitamin supplements. Research shows turmeric and ginger root are highly effective for inflammation, and more and more people are trying the inflammation diet, which eliminates inflammatory items such as sugar, wheat, and dairy, and increases anti-inflammatory foods. Lastly, activities such as meditation, yoga, exercise, and hydrotherapy may reduce inflammation. People can learn more about these options by speaking to their regular physician or a naturopath, but should never stop taking existing medications without the express direction of their doctor.