The Bad of Corticosteroids | Johns Hopkins
18
January

By Adem Lewis / in , , , , , , /


(gentle music) – The human body is very
familiar with the consequences of prednisone because
naturally your body makes the equivalent, which is called cortisol. In fact, your body is so knowledgeable about the consequences
of too much prednisone that it has an extremely
tight system to prevent your adrenal gland from
making and secreting too much. Your body knows that if it
secretes too much cortisol, this can be bad news. Now I’m going to briefly
review some of the important side effects of prednisone. It is a good idea to discuss
these and any other potential issues with your doctor
when starting prednisone. This will allow you to develop
a proactive plan together, which will minimize your overall risk. Increased blood sugar. Prednisone will increase fasting and postprandial blood glucose,
so if you have diabetes, your medications may need to be adjusted while you are on prednisone. If you are borderline for diabetes, prednisone may temporarily
increase your sugar enough to push you into the diabetic category while you’re on the medication. By watching your diet very
closely and minimizing sugar and high carbohydrate
containing foods, this will help minimize
this prednisone side effect. Be sure to discuss with your doctor how to check and manage blood sugar when you start prednisone. Moodiness, irritability and insomnia. Prednisone affects everyone differently. Some people taking
prednisone may experience a change in mood, this can
range from feeling irritable and short-tempered or sad and tearful to euphoric and energetic. It is best to be prepared
that your mood may be affected and discuss with your physician a plan to manage and monitor for this effect. Along the same lines,
prednisone may affect your sleep patters and
contribute to insomnia or sleeplessness, if this occurs, it is best to take your
dose in the morning to minimize the impact
on your nighttime sleep. Osteoporosis and avascular necrosis. Prednisone can impact your bone health. Although this is generally
with longterm use, there are some effects in the short term on your bones as well. Steroids can contribute to
osteopenia and osteoporosis. Both of these conditions are a decrease in bone mineral density. Low bone mineral density is a risk factor for bone fractures. Osteonecrosis is a rare
complication of steroids where there is an interruption to the blood supply to the bone. Steroids increase the
risk of this complication especially if there is
trauma, alcohol use, or if you have certain
concurrent hematologic conditions such as sickle-cell disease. It is important to discuss
with your physician ways to protect your
skeleton while on steroids. Medications, exercise and
vitamin D supplementation may be good options for you. Ocular health. Long term use of prednisone
can affect your eyes. It can accelerate or increase the risk of cataracts and glaucoma. If you’re going to be on
prednisone for more than a few days discuss with your doctor if a referral to and ophthalmologist or eye
doctor in order to monitor for these conditions is appropriate. Infections, part of why
prednisone is so effective in treating inflammation
is that it decreases the immune reaction which is causing the problematic inflammation, but the downside to
decreasing an immune reaction is an increased
susceptibility to infections. This is a dose-related
side effect of prednisone. And susceptibility to
very serious infections occurs predominantly at
high prednisone doses, around 20 milligrams or more daily. Vigilant hand washing and
avoiding sick contacts can be helpful to minimize this risk. Discuss with your doctor
if other precautions to prevent infections would
be appropriate for you while on prednisone. The prednisone dose and
duration of treatment are important factors when thinking about these steroids side effects. The higher the steroid dose, and the longer the steroid
treatment duration, the more we consider these side effects. But remember, you doctor
has prescribed prednisone as a treatment for an important reason and to treat a serious condition. And as with many medications, the risks and benefits need to be
carefully weighed and discussed. Although these are common
side effects of prednisone, they do not occur in every
patient or all of the time.


One thought on “The Bad of Corticosteroids | Johns Hopkins

  1. I was prescribed prednisone for 14 years with only a short break for a surgery. Prednisone combined with inhaled steroids for asthma my teeth are gone. My skin has thinned and bloody bruises happen easy. My blood sugar went up considerable. Enough to cause my doctor to diagnose me with steroid induced diabetes. My weight is up 80 pounds. My endocrinologist finally got my GI doctor to let me stop. I tried to wean off over a 1 month period but still had withdraw for 2 weeks after stopping. My GI doctor finally gave in and got me a surgical option to end my colitis. Something I have wanted for year. Complete removal of my colon, rectum, and anal tissue with a permanent ileostomy. Since stopping prednisone I have lost 50 pounds in 3 months and my blood sugar has settled with the use of metformin.

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