Health: Adverse effects of corticosteroids

She was an elderly lady who had come with a swelling over face and body. On investigations her kidney, liver, heart, all vital parts were found to be normal. Close questioning revealed that she had chronic arthritis for which she had been taking corticosteroid tablets for more than a year. Then it was understood that the swelling she had was induced by long term use of corticosteroids. Corticosteroids are hormones produced by adrenal medulla, a small gland situated over the kidneys. The corticosteroid hormones have multiple functions in the body. They help in regulation of blood pressure, and fight against allergy and inflammation. Due to their beneficial properties, corticosteroids are manufactured synthetically and used for various medical conditions. They are available as tablets, injections, syrup, inhaler, e.t.c., various forms. They are very useful for conditions like severe allergy, eczema, bronchial asthma, rheumatoid arthritis, e.t.c. But continuous use for a long time tends to produce various adverse effects in the body. Corticosteroid medications are easily available and are not very expensive. At some point an individual would have been prescribed prednisolone or some other corticosteroid and would have benefited from it. Thus after that whenever any similar problem occurs, the person may buy it directly from the pharmacy without realizing that repeated use of this drug can be harmful. People at large are ignorant about the adverse effects of long term use of corticosteroids. Corticosteroids tend to reduce the immunity of the body making one more susceptible to infections. Even when used locally in the form of ointments or spray, there is increased risk of local fungal and bacterial infections, after chronic use for a long time. These drugs promote retention of salt and fluid in the body. Therefore chronic use results in swelling over face (a condition called moon face) and body. Due to retention of salt and water in the body, weight gain and high blood pressure occurs. Chronic cardiac failure is induced or aggravated. Glaucoma (increase in the intraocular pressure), can be induced in the eyes. There is also bruising over the body due to increased fragility of capillaries (smallest blood vessels in body) causing capillary bleeding. Corticosteroids tend to cause resistance to the insulin present in the body, thus causing or aggravating diabetes mellitus. Osteoporosis occurs as a side effect of long term use of corticosteroids. Bones are softened resulting in joint pains and spontaneous fractures. The most significant effect of steroids is dependence. If an individual has taken corticosteroids for a long time for some chronic condition like asthma, body becomes resistant to effects of other drugs and responds to corticosteroids only. Thus they have to take these drugs repeatedly and develop more side effects. It is because of this dependence on exogenous steroids, that a person can develop low blood pressure, if he discontinues use of steroids suddenly. This may be severe enough to cause symptoms like dizziness and falling down on standing up or with change of posture. Women should be cautious while buying cosmetics. Many creams and lotions used for acne, blemishes, e.t.c. problems contain corticosteroids like betamethasone or beclomethasone along with other chemicals. They provide improvement temporarily but long term use can lead to local skin infections. Considering all these side effects of corticosteroids, it is important that people should be aware of their uses and also side effects. These drugs should be used judiciously and only under medical supervision. In some situations, their use is unavoidable. Here also, it is better to use them in local form to avoid effects on entire body. Like a person suffering from chronic asthma can use corticosteroid inhaler instead of tablets. The use should be for minimal duration possible. If one has used corticosteroids for long time, they should not be stopped suddenly. The dose should be tapered gradually. It should be understood that using these drugs for necessity is like magic in a sickness, but chronic use can be harmful. E-mail-rachna212002@yahoo.co.uk