What are steroids?

Steroids are hormones that occur naturally in the body. Steroid medicines are man-made but are similar to these natural hormones.

Oral steroids are steroids that you can take by mouth - tablets, soluble tablets and liquids (solutions). They come in various different brand names. Prednisolone is the most commonly used oral steroid.


When oral steroids are usually prescribed?

Oral steroids are used to treat a large number of conditions. Some examples include: inflammatory bowel diseases, autoimmune diseases, joint and muscle diseases, allergies and asthma. They are also used to treat some cancers. In addition they can be prescribed as replacement treatment for people who have stopped making their own steroids - Addison's disease.


Some general points about oral steroids

  • A short course of steroids usually causes no side-effects. For example, a 1-2 week course is often prescribed to ease a severe attack of asthma. This is usually taken without any problems.

  • Side-effects are more likely to occur if you take a long course of steroids (more than 2-3 months), or if you take short courses repeatedly.

  • The higher the dose, the greater the risk of side-effects. This is why the lowest possible dose which controls symptoms is aimed for if you need steroids long-term. Some diseases need a higher dose to control symptoms than others. Even for the same disease, the dose needed often varies from person to person.

  • A common treatment plan is to start with a high dose to control symptoms. Often the dose is then slowly reduced to a lower daily dose that keeps symptoms away. The length of treatment can vary, depending on the disease. Sometimes the steroid treatment is gradually stopped if the condition improves. However, steroids are needed for life for some conditions, as symptoms return if the steroids are stopped.


Possible side-effects of oral steroids

The possible side-effects include the following:

  • Osteoporosis - However, there are some medicines that can help to protect against this if the risk is high. For example, you can take a medicine called a bisphosphonate to help prevent bone loss.

  • Weight gain. You may also develop a puffiness around the face.

  • Increased chance of infections, as steroids may suppress the immune system.

  • Increase in blood pressure

  • High blood sugar which may mean extra treatment if you have diabetes. Steroids may occasionally cause diabetes to develop.

  • Skin problems such as poor healing after injuries, thinning skin, and easy bruising. Stretch marks sometimes develop.

  • Muscle weakness.

  • Mood and behavioural changes. Some people actually feel better in themselves when they take steroids. However, steroids may aggravate depression and other mental health problems, and may occasionally cause mental health problems.

  • An increased risk of developing cataracts.

  • An increased risk of duodenal and stomach ulcers.


Stopping oral steroids

Do not stop taking oral steroids suddenly if you have been taking them for more than three weeks.


Why is it necessary to reduce the dose gradually before stopping oral steroids?

Your body normally makes steroid chemicals by itself which are necessary to be healthy. When you take oral steroids for a few weeks or more, your body may reduce or stop making its own steroid chemicals. If you then stop taking oral steroids suddenly, your body does not have any steroids. This can cause various withdrawal symptoms until your body resumes making natural steroids over a few weeks. The withdrawal symptoms can be serious, even life-threatening and include: weakness, tiredness, feeling sick, vomiting, diarrhoea, abdominal pain, low blood sugar, and low blood pressure which can cause dizziness, fainting or collapse.


If the dose is reduced gradually, the body gradually resumes its natural production of steroids and the withdrawal symptoms do not occur.


Who cannot take oral corticosteroids?

There are very few people who cannot take oral corticosteroids. Only people who have serious infections (and are not taking treatment for the infection) should not take oral steroids. This is because steroids suppress your immune system.

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Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.