Short- and Long-term Side Effects of Steroids

Most are minor but others can be severe—and even permanent

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Corticosteroids—usually simply called "steroids”—are like the army knives of medications, useful for treating lots of different health problems. As topical creams or ointments, for example, they can relieve redness, itching, and irritation of eczema and other skin disorders.

Steroids that can be taken by mouth or injected are highly effective for treating a wide range of diseases by working systemically—that is, by affecting the entire body.

The conditions systemic steroids are typically prescribed for are those associated with inflammation, including autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Systemic steroids also are given to treat asthma attacks and, on occasion, even symptoms of severe hay fever.

Prednisone, which is sometimes sold under the brand names Prednisone Intensol, Deltasone, or Rayos and Medrol dose pack (methylprednisolone) are examples of commonly prescribed systemic steroids. 

As with any medication, systemic steroids have side effects. So although these drugs often are necessary and sometimes even life-saving, it's important to keep the potential drawbacks of taking them in mind.  

Short-Term Side Effects

Most people are prescribed systemic steroids for just a few days at a time and so any side effects they experience are temporary; most resolve after a few days once the steroids have been stopped.

The most common side effects for otherwise healthy people taking steroids include insomnia, changes in mood or behavior, flushing of the face, an increase in appetite, and short-term weight gain due to increased water retention. 

Certain underlying medical conditions sometimes worsen while a person is taking steroids.

For example, someone with diabetes mellitus may have an increase in blood sugar levels. Similarly, a person who has high blood pressure may experience a rise in blood pressure readings. People with glaucoma who are taking steroids sometimes have an increase in eye pressure. Those with congestive heart failure may retain water.

Long-Term Side Effects

When a systemic steroid is used for a long period of time, or when steroids are taken on multiple occasions, more serious side effects are possible. For that reason, doctors tend to keep both the dose and the duration to a minimum when prescribing them.

The risk of some side effects can be decreased when a steroid is taken every other day rather than daily, even if the total dose winds up being the same. Long-term side effects often go away once a person stops taking a steroid, but sometimes they're permanent. 

Side effects of long-term steroid use include:

Regardless of a person's overall health, it's important that a person taking a systemic steroid be closely monitored.

It's also often recommended that anyone on a steroid for a long period of time guard against bone loss by taking supplemental calcium and vitamin D, and perhaps even medication—a bisphosphonate such as Fosamax (alendronate) or Boniva (ibandronate), and have his or her bone-mineral density measured regularly.

Source:

Saag KG, Furst DE. Up To Date. Major Side Effects of Systemic Glucocorticoids, 2013.

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