VERIFIED CONTENTConsultation: dr hab. n. med. Lucyna Papierska, endocrinologist

Steroid hormones, or steroids, thanks to their strong anti-inflammatory properties, are irreplaceable in the treatment of many serious diseases in children and adults. But steroid therapy should take place under strict medical supervision, because taking them is associated with serious side effects. What should you know when you need to take steroids?

Steroid drugshave a very broad spectrum of activity.Steroids( steroids ) are administered as anti-inflammatory drugs, but due to many side effects, it is recommended when the benefits of taking them outweigh the effects side effects of steroid therapy. When you cut yourself or catch an infection, your body releases a lot of cortisol (a natural glucocorticoid, or steroid) that is designed to stop the inflammatory reaction.

It achieves this by inhibiting the production of antibodies, infiltration of leukocytes to the site of infection, and the production of pro-inflammatory substances such as cytokines. These are the most important mechanisms of the action of steroid drugs, which are used in the treatment of many harmful inflammations.

What does that mean? For example, ordinary pneumonia or bronchitis is the body's natural defense response against bacteria. But when the inflammatory infiltration in the lungs becomes too great, it reduces the capacity of the lungs and inhibits oxygen from entering the bloodstream. Bronchospasm is also an exaggerated response to inflammation. The sick person begins to feel short of breath. Then you need a steroid drug to reduce inflammation.Steroidshave a very broad spectrum of activity.

Steroids: steroid hormones important for the body

Steroid hormones , produced in the adrenal cortex and in the female and male sex glands, are very important for the proper functioning of the body because they are involved in many life-giving processes. The therapy uses both sex hormones (estrogens and testosterone) and substances produced by the adrenal glands (mineralocorticosteroids, glucocorticosteroids and adrenal androgens).

One form of treatment with steroid hormones is replacement therapy, which consists in administering physiological doses of hormones to compensate for their deficiency. An example of such treatment would be hormone therapy when menopause as a result of terminationoestrogens are administered to the ovaries. Similarly, men can get testosterone during andropause.

Small doses of corticosteroids should be taken in the case of adrenal insufficiency. What we fear most are steroids administered in doses that exceed physiological amounts. Natural glucocorticoids (cortisol, cortisone) are replaced in steroid therapy with stronger and longer-acting derivatives. Cortisol disappears from the body within 7 hours, while a synthetic drug works for 12-24 hours.

Dangerous anabolics

Anabolic steroids sold as "vitamin kits" or "supplements" can be purchased without any problem. These are chemicals with effects similar to testosterone. They cause an increase in muscle mass, but at the same time adversely affect the work of most organs. Liver damage, hypertension, thrombosis, degenerative changes in the joints, acne and hair loss are some of the effects of their use.

Steroids reduce testosterone production and sperm production, leading to infertility. Women may experience a permanent lowering of the voice, body and facial hair, and irregular periods. Steroids cause the growth of the breast glands. Although "packers" find ways to avoid the side effects of anabolics, the dysregulated hormonal balance never returns to normal.

Steroids reduce inflammation

Steroids are often the only effective treatment for autoimmune disease. An important place here are diseases belonging to rheumatic diseases, e.g. rheumatoid arthritis. Immediate administration of steroids reduces inflammation. Then another treatment can be applied, so the patient does not have to be condemned to taking the steroid for the whole life.

Other autoimmune diseases in which steroids are administered include lupus, hepatitis, kidney inflammation, sarcoidosis, Graves' disease. They are administered in diseases of the respiratory system, e.g. bronchial asthma. In this case, inhaled preparations usually work (the concentration of steroids in the blood is much lower than after tablets). Oral or intravenous medications are recommended only during exacerbations.

Corticosteroids are used in allergic skin conditions that are resistant to other treatments. Many people forget that when using a cream (ointment) with a steroid, you also need to be careful, because they weaken the skin, there is a risk of so-called steroid acne and are absorbed into the body. The steroid preparation for the face should preferably be used for up to 3 days, under the supervision of a dermatologist.

According to an expertLucyna Papierska, MD, PhD, endocrinologist

Steroid drugs: balance of benefits and side effects

Sick people need to know the drugssteroids are not used "just in case" and when the life and he alth of the patient are at risk. These preparations are recommended when the benefits of taking them outweigh the side effects of the treatment. For this reason, steroids are not administered, for example, in Hashimoto's disease, although it is an autoimmune disease - here the side effects of the therapy would be more dangerous than the disease itself. You have to be aware that every drug has some side effects.

In order to minimize them, people undergoing corticotherapy must strictly follow the doctor's recommendations and systematically monitor their he alth. Do not be afraid of "mega-doses" of the drug administered intravenously in the treatment of certain diseases. Contrary to appearances, they have fewer side effects than oral preparations, with a stronger therapeutic effect.

Most side effects occur after long-acting intramuscular injections, which are taken once a month. Fortunately, they are hardly used anymore. It is important to remember that treatment must not be stopped suddenly or on its own. It must be under the supervision of a doctor.

Steroids - as indicated by the doctor

Steroid drugshave extensive side effects. Therefore, during the treatment, the doctor's instructions should be strictly followed, especially regarding the dose and duration of treatment. However, not everyone may experience all adverse effects, because sensitivity to corticosteroids is an individual matter. Most problems can be de alt with.

  • Weight gain with the accumulation of fat on the stomach, neck and face reduces the feeling of self-attractiveness. There is evidence that proper diet and physical activity (adapted to the patient's abilities) can help to solve these problems. Eat more vegetables, less fats, especially animal fats. Replace fried foods with boiled ones, choose slightly digestible dishes (you will reduce the risk of problems with the pancreas, liver, intestines).
  • You can replenish the potassium deficiency by eating tomatoes in various forms. Potatoes, citrus fruits and green leafy vegetables are good sources of this element. The most potassium is in dried fruit, avocados and bananas. However, do not overdo them with eating, because they are high in calories. When using a higher dose of the steroid, the doctor will additionally prescribe potassium tablets. Due to the risk of diabetes, you must be on a diabetic diet, avoid sweets and sugar, replace simple carbohydrates with complex carbohydrates (e.g. wholemeal bread).
  • Steroids hinder the absorption of calcium, so people who take them should supplement with calcium supplements from the beginning of the treatmentD - it protects against osteoporosis. Bone mineral density should be checked and, when it is lowered, a drug should be taken to suppress bone loss. Due to the risk of thrombotic disease, avoid sitting and standing for long periods, rest with your legs raised, and take a daily walk.
  • Examine your eyesight to catch the development of glaucoma or cataracts in time and start appropriate treatment.
  • Skin problems (becoming thin, with stretch marks, sometimes acne, easy to bruise) can be solved by taking a small amount of an anabolic adrenal steroid (dehydroepiandrosterone).

Check how to prevent the side effects of steroid treatment

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