Corticosteroid risk, side effects, information
July 22 2016 by Ray Sahelian, M.D.
Corticosteroid side effects, safety,
risks and danger
High dosages of corticosteroids for prolonged periods can increase the risk of infection, high blood pressure, peptic ulcers, diabetes mellitus (high blood sugar), osteoporosis (thinning of the bones), and depression. Medication in the form of prednisone or another form of corticosteroid increases the risk for atrial fibrillation. This treatment worsens this arrhythmia no matter what the underlying reason of the corticosteroid treatment.
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.
How often to take and for how long
Each medical condition is different and each person is different, but, as a general guideline, use the lowest dosage for the least period of time.
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," says Dr. Maggie Che, of Kaiser Permanente Medical Center in Vacaville, California. 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.
Wounds. 2008. The effects of topical and systemic Beta glucan administration on wound healing impaired by corticosteroids. Corticosteroid hormones are widely used to treat a variety of diseases. Corticosteriods have been shown to impair wound healing, which has become a serious clinical problem in wound care. The present study was designed to evaluate the efficacy of topical and systemic beta glucan administration on wound healing impaired by corticosteroids. Wistar albino rats were used for the incision and excision wound models. Percentage of wound contraction, epithelialization period, hydroxyproline level, histopathological examination, and tensile strength were evaluated. Although both systemic and local administration of beta glucan enhanced percentage wound contraction, improved epithelialization time, tensile strength, and elevated hydroxyproline level, systemic administration was found to be more effective. These results indicate that systemic and topical beta glucan improve wound healing that has been impaired by corticosteroids, and that systemic administration is more effective than topical application.