Corticosteroid information by Ray Sahelian, M.D.

Corticosteroids are a type of steroid hormones made mostly in the adrenal gland cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and neuropsychiatric response.

Corticosteroid use and Osteoporosis
Patients who use high-dose corticosteroids, which are associated with adverse skeletal side effects, do not appear to be adequately screened and followed for side effects. "Increased risk of osteoporotic fracture, a well-recognized adverse effect of high-dose corticosteroid exposure, has focused attention on exposure to orally administered corticosteroid drugs," write Dr. Maggie Che, of Kaiser Permanente Medical Center in Vacaville, California, and her associates. The researchers examined high-dose corticosteroid use, osteoporosis screening and treatment trends in 18,737 subjects taking high-dose oral or inhaled corticosteroids. The patients were drawn from the Kaiser Permanente Medical Center Program in Northern California. The team reviewed electronic records of inhaled and oral corticosteroid use and osteoporosis intervention in 2002, and developed an algorithm to quantitate high cumulative exposure to corticosteroids. High-dose corticosteroid use ranged from 0.2% in young adults to 2.2% in subjects 75 years or older. Of those who used high-dose corticosteroids, 72% used the drugs orally only, 15% used the drugs in the inhaled form only, and 13% used combined oral and inhaled corticosteroids. Twenty-seven percent of women exposed to oral corticosteroids underwent bone densitometry, compared with only 9% of men. Of those exposed to inhaled corticosteroids, 23% of women and 4% of men underwent bone densitometry. The team reports that 6% of men and 11% of women receiving oral corticosteroids and 1% of men and 5% of women receiving inhaled corticosteroids filled prescriptions for osteoporosis drugs. Ann Allergy Asthma Immunol 2006;97:497-501.