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Corticosteroids: Facts, Potential Benefits, and Side Effects

Linda Crampton is a writer and teacher with a first-class honors degree in biology. She often writes about the scientific basis of disease.

Skin irritation caused by poison ivy is sometimes treated with a hydrocortisone skin cream. Hydrocortisone is a type of corticosteroid medication.

Skin irritation caused by poison ivy is sometimes treated with a hydrocortisone skin cream. Hydrocortisone is a type of corticosteroid medication.

Useful Chemicals and Medications

Corticosteroids are important and very useful chemicals. Natural corticosteroids are made in the outer layer of the adrenal glands, a region known as the adrenal cortex. We have two adrenal glands, one on top of each kidney. Artificial corticosteroids are produced for use as medications. Like the natural chemicals, they can be very helpful. They can produce side effects, however, some of which may be serious.

Corticosteroid medications are frequently used as anti-inflammatory drugs. They are also prescribed to suppress the activity of the immune system. This suppression is useful in autoimmune diseases and in organ transplants. In addition, the medications may be used to make patients being treated for cancer feel more comfortable. In specific cases, certain corticosteroids are used to treat cancer itself, often at the same time as chemotherapy.

Natural Steroids in the Body

A steroid is a molecule made of four connected rings of atoms. Important steroids in humans are cholesterol, vitamin D, estrogen, progesterone, testosterone, cortisol, and aldosterone. Cortisol and aldosterone are made by the adrenal cortex and are classified as corticosteroids.

Corticosteroids in the body are either mineralocorticoids or glucocorticoids. An important example in each class is described below.

  • Aldosterone is a mineralocorticoid that increases the amount of sodium ions and water in the blood by acting on the kidneys. This action indirectly causes blood pressure to rise.
  • Cortisol is a glucocorticoid and has many functions. Some of these functions are to increase the level of glucose in the blood, decrease the activity of the immune system, help in the metabolism of proteins, fats and carbohydrates, reduce inflammation, and help the body respond to stress.
This is a molecule of cortisol, which is made by the adrenal gland. Like other steroids, it contains four fused rings in its structure.

This is a molecule of cortisol, which is made by the adrenal gland. Like other steroids, it contains four fused rings in its structure.

Differences Between Corticosteroids and Anabolic Steroids

Artificial corticosteroids that are used as medicines are quite similar in structure to cortisol. They are not the same as anabolic steroids. Anabolic steroids are structurally related to the male sex hormone testosterone and have very different functions from corticosteroids. One of these functions is to stimulate the development of muscle.

Anabolic steroids are helpful in maintaining muscle mass in people with AIDS and are sometimes prescribed for men with hormone problems. They are also used by some athletes to help build muscle. In the concentrations used by athletes, anabolic steroids can cause very serious side effects.

An asthma inhaler containing budesonide, a corticosteroid medication that suppresses inflammation in the airways

An asthma inhaler containing budesonide, a corticosteroid medication that suppresses inflammation in the airways

Inhaled Corticosteroid Medications and Asthma

Inhaled corticosteroids are often prescribed for asthma patients. They are used in low doses every day to reduce inflammation in the airways and reduce the chance of an asthma attack. The more inflamed the airways, the more sensitive they are to triggers that can cause asthma. The inhaled medication is known as a preventer or a controller medicine. A different medication known as a rescue medicine is inhaled if an asthma attack occurs.

I use an inhaler containing a corticosteroid myself and find it very effective. If I don't use the inhaler on a regular schedule, my asthma returns. Inhaled corticosteroids often cause fewer side effects than the oral forms of the medications.

The most common problem caused by an inhaled corticosteroid is the development of a yeast infection inside the mouth, which is known as thrush. Patients are advised to rinse their mouth out thoroughly after each use of an inhaler to prevent this infection from developing. Inhaler use may also cause mouth or throat irritation or hoarseness.

Three corticosteroids that are commonly inhaled to control asthma are budesonide, fluticasone, and beclomethasone. The medications are sold under various brand names. It's important that an asthma patient talks to their doctor about the benefits and disadvantages of each medication in their particular case.

Inhaler Advice From a Doctor

Possible Help for Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. The body’s immune system normally fights disease-causing bacteria and viruses that enter the body. In rheumatoid arthritis, the immune system mistakenly attacks the lining of the sufferer’s joints, which is called the synovium or the synovial membrane. The attack causes inflammation, swelling of the lining, and pain. If the inflammation continues, it may damage the articular cartilage that covers the ends of the bones in the joint.

Oral or injected corticosteroids often reduce or relieve the symptoms of rheumatoid arthritis. Prednisone and prednisolone are common oral corticosteroids given to arthritis patients. Newer medications that can actually stop the joint damage in rheumatoid arthritis are available, as described in the video below. Corticosteroids may still be used to help patients even when they are taking other medications, however. Someone with rheumatoid arthritis should discuss the medication situation with their doctor.

Structure of a synovial joint; the surrounding tendons and ligaments are omitted

Structure of a synovial joint; the surrounding tendons and ligaments are omitted

The synovial joint is the most common type in our body, so rheumatoid arthritis can produce major effects. We also have other types of joints.

Treating Rheumatoid Arthritis

Possible Aid in Some Cancer Treatments

Corticosteroids may play a useful role in cancer treatment. Since they are strongly anti-inflammatory, they are sometimes prescribed to reduce swelling and pain. They may be used with other drugs to reduce nausea and vomiting created by chemotherapy treatment. They may also increase appetite. In a few types of cancer, specific corticosteroids may be used to destroy cancer cells. It's important to note that while corticosteroids can be an important aspect of treatment in some types of cancer, they may not be helpful in all types.

When my golden retriever had lymphoma, the vet prescribed prednisone for him at one point during his illness. For one glorious week after the medication was started, Sam seemed to feel much better and behaved much more normally. Sadly, after about a week Sam returned to his prior condition. This experience may or may not be related to human biology and is purely anecdotal. It impressed me at the time, though. I wish Sam's improvement had lasted for longer.

Hydrocortisone is used to treat irritation by poison sumac.

Hydrocortisone is used to treat irritation by poison sumac.

Other Uses of the Medications

Corticosteroids are not as widely used to treat osteoarthritis as they are to treat rheumatoid arthritis. They are occasionally injected into the affected joints of people suffering from osteoarthritis, however, and have sometimes provided temporary relief from pain.

Osteoarthritis is often known as a wear and tear disease. The articular cartilage breaks down, removing cushioning from the joint. Although not traditionally considered to be a disease that involves inflammation, the inflammatory process may be involved in the disorder. The idea that inflammation is present in osteoarthritis seems to be becoming more common in medical circles.

Corticosteroid medications are sometimes prescribed for other autoimmune diseases besides rheumatoid arthritis, such as lupus and the autoimmune form of Addison's disease. In Addison's disease, the adrenal glands no longer produce sufficient cortisol and aldosterone.

Possible Side Effects of Oral Corticosteroids

Doctors often prefer to prescribe oral corticosteroids at low doses or for short periods if possible due to the potential side effects. Some of the most common side effects of oral corticosteroid use are as follows:

  • appetite increase
  • weight gain
  • increased body fat
  • mood changes
  • fluid retention

There may also be increased blood pressure and fluid buildup in the eye, producing an eye disorder called glaucoma.

Long-Term Use of the Medications

If a person takes oral corticosteroids for a long time, he or she may develop osteoporosis, muscle weakness, cataracts, high blood sugar, skin bruising, slow healing of wounds, and acne. The person may also experience stomach ulcers and an increased incidence of infections due to suppression of the immune system by the corticosteroid. Children and teenagers may experience slowed growth.

Despite the possible side effects, in many cases taking a corticosteroid medication can be very worthwhile. If a person stops taking the medication, its use must be reduced slowly under a doctor’s guidance. Artificial corticosteroids may reduce the production of natural cortisol by the adrenal glands. A gradual reduction in medication dose allows the adrenal glands to slowly recover and helps to prevent the patient from experiencing unpleasant withdrawal symptoms.

House dust mites are a common cause of allergies.

House dust mites are a common cause of allergies.

Allergies, Nose Sprays, and Eye Drops

Sometimes corticosteroid nose sprays are prescribed to relieve allergy symptoms such as a stuffy and runny nose, nasal itching, and sneezing. The medications may cause side effects, which can include a burning sensation in the nose or occasionally nosebleeds. Some people experience an unpleasant taste or smell after using a corticosteroid nose spray. Side effects from corticosteroids in nose sprays are often less common than those caused by the oral medications, however.

Corticosteroids are also added to some eye drops to treat eyes that are inflamed, red, and itchy due to an allergic reaction. The long term use of these eye drops isn't recommended, since they can increase the risk of eye infections, cataracts, and glaucoma.

A Description of Eczema or Atopic Dermatitis

Topical Corticosteroids

Topical corticosteroids are rubbed on the skin, where they can help to relieve the itch and redness of inflammatory skin conditions such as eczema. The medication may be added to a cream, lotion, or gel. It may not be a cure for the skin problem but can relieve the symptoms. The corticosteroid may be only part of the prescribed treatment for eczema, or atopic dermatitis.

Topical corticosteroids generally produce fewer side effects than oral ones. This may not be true if a product containing the medication is rubbed over large areas of the body or is used for a long time. In these cases, a significant amount of the medicine may be absorbed into the body. The most common side effect of long-term use of a topical corticosteroid is thinning of the skin. A doctor should be consulted about possible effects of the medication.

Non-prescription creams or lotions containing a low dose of a corticosteroid called hydrocortisone can be bought in drug stores. They are used to relieve itchy skin and skin irritations cause by factors such as insect bites, poison ivy, and allergic reactions to detergents or cosmetics. More concentrated hydrocortisone creams can be obtained with a prescription.

Monitoring and Reducing Corticosteroid Use

Corticosteroids are powerful drugs that can be extremely helpful in relieving pain and inflammation. They can cause unpleasant or harmful side effects, however. The potential side effects may be serious if oral medications are used. For this reason, a doctor's advice should be followed very carefully when a person is taking a corticosteroid. Any unpleasant effects of the treatment should be reported to the doctor.

It's a good idea to follow other steps to help a health problem in order to reduce or eliminate corticosteroid use, if this is possible. For example, if you know that dust mites are responsible for your asthma attacks, it's an excellent plan to keep the dust level low in your home. You may not be able to eliminate the use of a corticosteroid inhaler, but you may well be able to reduce the dose of the medication. (Don't do this without your doctor's approval.)

For serious situations in which a higher dose of a corticosteroid medication must be taken, the side effects—if they develop—may be less bothersome or less serious than the health problem being treated. A patient's condition should always be monitored by a physician, though.

References

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: Are corticosteroids shot into the joint for pain?

Answer: Yes, they are when the process is medically appropriate. The process must be carried out by a medical professional. There are many factors that need to be considered before the injections start, including the likelihood that the corticosteroid will help, the dose that's required, the frequency of injections, the period for the injections, safety concerns, and potential side effects. A doctor needs to make these decisions.

© 2011 Linda Crampton

Comments

Linda Crampton (author) from British Columbia, Canada on March 23, 2016:

Thank you very much for the comment, Hannah!

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Linda Crampton (author) from British Columbia, Canada on February 26, 2011:

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Linda Crampton (author) from British Columbia, Canada on February 22, 2011:

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