Corticosteroids, also commonly called steroids, are an anti-inflammatory class of drugs that are used to treat a wide range of inflammatory diseases. The drug is an analogue of the corticosteroids that are naturally produced in the human body within the cortex of the adrenal glands that sit atop the kidneys. These hormones play key roles in the body. Corticosteroids mimic the action of these hormones.

Natural corticosteroids are roughly classified into two categories: Mineralocorticoids that are responsible for mineral and water balance in the body and Glucocorticoids which have metabolic, anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictive effects.

PrednisoloneA variety of drugs are included in the corticosteroids family such as Dexamethasone, Prednisone and its derivatives, Fludrocortisone and Hydrocortisone (Cortisol). These drugs are available as topical formulations (for external use), intravenous and intramuscular injections and even as inhalational preparations.

Medical Uses of Corticosteroids

Corticosteroids are used to treat a wide variety of diseases such as:
• Respiratory conditions like acute exacerbation of asthma and chronic obstructive pulmonary disease (COPD)
• Anaphylaxis
• Nasal Polyps
• Food and drug allergies
• Dermatitis
• Adrenal insufficiency
• Inflammatory bowel diseases like ulcerative colitis and Crohn’s disease
• Blood disorders like lymphoma, leukemia, hemolytic anemia etc.
• Inflammatory joint disorders like rheumatoid arthritis, polymyalgia rheumatica
• Autoimmune diseases like systemic lupus erythematosus, multiple sclerosis
• Vasculitis (inflammation of blood vessels)
• Organ transplantation
• Nephrotic syndrome

Corticosteroid Users, Beware!

The longer you use corticosteriods, the more likely it is that you will experience their nasty side-effects. If you are suffering from a chronic illness that requires prolonged treatment with corticosteroids for more than 3 months, be mindful of the fact that corticosteroids will likely take a heavy toll on your general health. Common side effects that are frequently experienced by corticosteroids users include:

Ulcer-stomach• Stomach ulcers
• High blood pressure (Hypertension)
• High blood sugar levels
• Low blood potassium levels (Hypokalemia)
• High blood sodium levels (Hypernatremia)
• Delayed wound healing due to immunosuppressant effect
• Easy bruisibility even after minor trauma
• Weight gain
• Wearing out of bones (Osteoporosis) along with increase in the risk of fractures
• Increased risk of contracting infections due to low immunity
• Muscle weakness
• Behavioral changes such as mood swings, confusion, irritability, depression etc.
• Visual deterioration due to cataract formation

Perhaps the most common of the side effects of corticosteroids is stomach upset which initially results in abdominal discomfort and pain, bloating and cramps. The condition eventually leads to formation of stomach ulcers.

Stomach ulcers can make a hole in the wall of stomach, leading to severe internal bleeding which reveals as blood in the vomiting. Such a condition is life-threatening as the patient can go into shock due to fall in the blood pressure. Such a patient must be immediately rushed to the nearest emergency department for prompt medical treatment.

Hold On A Second!

• DO NOT stop using corticosteroids cold-turkey! The use of corticosteroids should be tapered off by gradually decreasing their dose (ONLY upon doctor’s advice). The body can go into a withdrawal state if steroids are stopped immediately with signs and symptoms such as weakness, lethargy, low blood pressure and low blood sugar etc.

• Do not use Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) and steroids simultaneously as they increase the chances of stomach ulcers manifolds. Read about a safe natural anti-inflammatory here.

• If you see a doctor for another illness while already taking steroids, do tell the physician about it so that harmful drug interactions can be avoided.

Scientific References
1) Schäcke, Heike, Wolf-Dietrich Döcke, and Khusru Asadullah. “Mechanisms involved in the side effects of glucocorticoids.” Pharmacology & therapeutics 96.1 (2002): 23-43.
2) Pharmaceutico, Bollettino Chimica, and British Medicalloumall. “Drug interactions with corticosteroids.” Bollettino Chimica Pharmaceutico 114.401: 197S.