Long term steroid use: Experts explain ways to manage side effects

This was during the second wave of coronavirus in India when administration or rather steroid misuse on COVID-19 patients caused an upheaval and created unprecedented health challenges. From severe side effects to rare but invasive fungal infections, steroid use has become notoriously popular for treating covid patients but with high risk.

However, steroid use is not new to medicine, and it has been around since before the onset of SARs-CoV-2 infection. It is used to treat a number of conditions where the body’s immune system does not function properly and causes tissue damage.

According to Dr. Sunil Kumar K, Lead Consultant – Interventional Pulmonology, Aster CMI Hospital, steroids (corticosteroids) are anti-inflammatory drugs used to treat a variety of conditions. These usually include medications prescribed for many lung conditions such as severe asthma, intermittent lung disease, respiratory distress syndrome (RDS), and COPD.

Dr. Nimish Shah, Consultant Pulmonologist, Jaslok Hospital, adds that some conditions, such as inflammation of the heart muscle or lining, such as sarcoidosis, meningitis, vasculitis, arthritis, myositis, dermatitis, and some inflammatory bowel diseases, may also occur. Steroid use.

Steroids are usually prescribed for short-term use, resulting in very few side effects. However, most of the side effects can occur if the course of steroid use is prolonged i.e. more than 2-3 months.

How to take care of side effects from long term steroid use

Long-term use of steroids can affect every part of the body, which is why doctors usually prescribe this drug only when the benefits outweigh the risks.

That said, if you are someone who needs high doses of steroids, Dr. Sunil recommends seeing your doctor regularly to check for side effects.

“It is recommended that standard protocols for steroid use should be followed, always keeping an eye on the potential risks of prolonged use. The key is to get the most out of these drugs with minimal risk. Please consult with your doctor for case-specific recommendations.

In addition, inhaled corticosteroids for asthma can help reduce exposure to the rest of the body by reaching directly to the surface of the lungs resulting in fewer side effects, he thinks.

Long-term corticosteroid therapy can cause bone loss (osteoporosis), and doctors recommend taking calcium and vitamin D supplements to help protect the bones (according to the doctor’s advice).

Additionally, he highlighted how long-term oral corticosteroids can cause the adrenal glands to produce less natural steroid hormones, so he says doctors can gradually reduce the dose – slowly because if the dose is reduced too quickly, one’s adrenal glands may shrink. There is no time to recover and one may experience fatigue, body aches and mild headaches.

Dr. Shah, on the other hand, recommends that people have bone scans (DEXA) for osteoporosis risk assessment, regular sugar tests and periodic HbA1c tests for diabetes to assess the risk of long-term steroid use. In addition, she recommends maintaining a healthy balanced diet and regular exercise to reduce the risk of developing side effects.


What are the side effects of long term steroid use?

“Systemic steroids are associated with significant adverse effects,” says Dr. Sunil Kumar.

Systemic steroids are natural steroids produced by the adrenal glands, synthetic or synthetic derivatives of cortisol.

“Prolonged use of these drugs can reduce your risk of diabetes, cataracts, osteoporosis, or bone loss or infection. Steroids can also suppress your immune system, which can help control situations where your immune system mistakenly invades its own tissues.” The doctor explained.

Dr. Shah shares some of the possible side effects of long-term steroid use:

– Osteoporosis
– Obesity
– Thinning of the skin
– Wearing hair
– Gastritis and gastric ulcer
– Diabetes – glaucoma and early cataracts
– Increased susceptibility to infection
– Mood swings and obstructive sleep apnea (OSA)
– Avascula necrosis, which is the death of bone tissue due to lack of blood supply.

FAQs

1. What is a steroid?
   According to the UK National Health Services (NHS), steroids, also called corticosteroids, are anti-inflammatory drugs used to treat a variety of conditions.
2. When are steroids prescribed?
   Steroids are used to treat people with health problems such as allergies, asthma, eczema, inflammatory bowel disease, arthritis and more.
3. Are there any possible side effects of steroids?
   Side effects of steroid use include heartburn, mood swings, increased appetite, risk of infection, poor bone health, diabetes and more.
4. How to reduce side effects from long term steroid use?
   You can ask your doctor to reduce the dose gradually. Make sure you take calcium and vitamin D supplements to prevent bone loss from prolonged steroid use. Eat a healthy diet and exercise regularly.