Steroid Side Effects: How to Reduce Corticosteroid Side Effects
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Not all side effects occur in everyone. Most side effects are more commonly associated with use of higher doses for prolonged periods of time and disappear with the decrease and discontinuation of prednisone. Prednisone can increase your appetite, which can lead to weight gain. When taken for long periods of time prednisone can cause you to lose calcium from your bones, which can lead to weakened bones and osteoporosis if not appropriately managed. Prednisone can cause nausea, indigestion, increased blood pressure, fluid retention, increased blood sugars, glaucoma, cataracts, difficulty sleeping, mood swings, increased cholesterol and skin changes acne, or make your skin thinner, more easily damaged and slow to heal.
The lowest dose of prednisone that controls symptoms should be used to reduce adverse effects. The duration of steroid use should also be limited. High-dose prednisone bursts often are used to suppress disease flares.
High doses are used for several days until symptoms are controlled, followed by a taper to the lowest effective dose. To avoid weight gain while taking prednisone, follow a healthy diet and, if possible, exercise regularly. Despite the numerous potential side—effects of corticosteroids listed below, their introduction into patient care 50 years ago revolutionized the treatment of many diseases, including vasculitis. When used properly, these drugs save lives and avert threats to the function of important organs.
One of the numerous potential side—effects of prednisone and other forms of corticosteroid treatment is hirsutism — excessive growth of body hair. Patients vary in the degree to which this side—effect of steroids occurs. Although some experience minimal hirsutism, the patient depicted here developed this side effect after taking 10 milligrams of prednisone for a few months.
Weight gain is usually the most dreaded side—effects of steroid use, incurred to some degree by nearly all patients who take them. The amount of weight gain varies from individual to individual. In addition to causing weight gain, prednisone leads to a redistribution of body fat to places that are undesirable, particularly the face, back of the neck, and abdomen.
If you need any medical treatment, make sure the person treating you knows you are taking prednisone. This is because your dose may need to be increased for a short while. Prednisone belongs to a group of medicines called corticosteroids. It is sometimes referred to simply as an oral steroid. Rheumatoid arthritis RA causes inflammation, pain, and swelling of joints. Corticosteroids like prednisone are good at reducing inflammation. By doing this, prednisone reduces the swelling and stiffness in the joints affected by RA.
This also helps to ease the pain. Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken.
For these reasons, before you start taking prednisone it is important that your doctor or pharmacist knows:. Steroids affect your metabolism and how your body deposits fat.
This can increase your appetite, leading to weight gain, and in particular lead to extra deposits of fat in your abdomen. Steroids, especially in doses over 30 milligrams per day, can affect your mood. Just being aware that steroids can do this sometimes makes it less of a problem. Sometimes, this side effect requires that the steroid dosage be decreased.
When the steroids are absolutely necessary, sometimes another medication can be added to help with the mood problem. Make sure your family knows about this possible side effect. Because cortisone is involved in regulating the body's balance of water, sodium, and other electrolytes, using these drugs can promote fluid retention and sometimes cause or worsen high blood pressure.
Since cortisone is involved in maintaining normal levels of glucose sugar in the blood, long-term use may lead to elevated blood sugar or even diabetes. It is possible that steroids may increase the rate of "hardening of the arteries," which could increase the risk of heart disease. This risk is probably much more significant if steroids are taken for more than a year, and if taken in high dose. By ; Theodore R. Understanding corticosteroid side effects With long-term use, corticosteroids can result in any of the following side effects.
Increased doses needed for physical stress Steroid use for over two weeks can decrease the ability of your body to respond to physical stress. Self-care tips: Discuss this possibility with the surgeon or dentist, etc.
Your physician or surgeon may not feel you need to take the extra steroid at the time of surgery, but if they know you have been on corticosteroids they can watch you more carefully after surgery. Self-care tips: If you get symptoms like these when you taper your steroids, discuss them with the doctor.
Your physician will work with you to continually try to taper your steroid dose, at a safe rate of decrease, depending on how you are doing. On each visit, discuss with the physician whether it is possible to decrease your steroid dose. Note that even if you are having a steroid side effect, however, steroids still must be tapered slowly. Unlike corticosteroid pills corticosteroid creams eyedrops sprays and injections into joints or bursae are less likely to cause side effects in other parts of the body.
When taken as prescribed corticosteroids can provide welcome relief from pain and inflammation. However like any other medication corticosteroids can cause side effects and serious medical problems if not carefully monitored by a doctor. It is very important to understand the differences between safe proper use and improper use of these powerful drugs. Most side effects are predictable and related to the dose. Some side effects occur in almost anyone who takes them. Other side effects are unpredictable; they may or may not occur.
The following table is an example of how the risk increases as the dosage for the corticosteroid prednisone increases. In people who take corticosteroids for weeks to months especially at moderate to high doses:. Corticosteroids can make high blood pressure diabetes blood sugar problems or ulcers suddenly worse. If you have had any of these conditions and need to take corticosteroids it is very important to consult your doctor.
Corticosteroid use is less likely to cause side effects when you take your medication as prescribed and practice healthy habits exercise regularly eat nutritious foods get enough rest.
Following is a list of suggestions to help minimize side effects that can result from corticosteroid use. In spite of the many possible side effects corticosteroids especially prednisone can be used with relative safety during pregnancy. If you see different doctors for your rheumatic disease and for your pregnancy both need to be involved in the decision of whether or not to use corticosteroids.
If you are taking corticosteroids and planning a pregnancy be sure to discuss this with your doctor. If you are taking corticosteroids and are pregnant don't stop the medications suddenly--you must see your doctor and discuss this first.
Since corticosteroids get into breast milk nursing babies may experience side effects just like adults do except more so. Discuss the alternatives with your doctor if you wish to nurse your baby. It may be difficult to lower your dosage of corticosteroids. If you have been on corticosteroids for more than just a few days it can be dangerous to suddenly stop taking them.
Your body must have corticosteroids in case of stress but the adrenal gland that produces them may not respond quickly enough. That's why your doctor usually will prescribe a "tapering schedule" for you which is a gradual dose reduction. Be sure to follow your doctor's advice on how to do this.
Anyone who has taken corticosteroids for a couple of weeks or months will experience some discomfort when going through a dose reduction period. Fortunately the symptoms usually are not very severe and they don't last more than a couple of weeks at the most. If your corticosteroids are being tapered and you develop symptoms check with your doctor to make sure it is not the disease flaring up.
Sometimes when you have been on corticosteroids for a while your doctor may prescribe an "alternate-day" schedule. This means you take a higher dose one day then a lower dose or none the next day then the higher dose the third day and so on. The regimen is altered so your body can function with less corticosteroids on low-dose days while the overall total dose over two days will keep your disease under control.
Writing the dosage schedule on your calendar will help you remember it.
❿- Prednisone hip joint pain
Prednisone to treat inflammatory types of arthritis | Arthritis Society Canada
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you. Hi anyone who is reading this, I take a vitamin d each day and fish oil but I believe there are some supplements that can conflict with methotrexate, e. Immune boosting being the main culprit, my Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.
Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions. Your pharmacist will give you a blue 'Steroid Treatment Card'.
Carry this with you at all times. In this article About prednisone Before taking prednisone How to take prednisone Getting the most from your treatment Can prednisone cause problems? How to store prednisone Important information about all medicines.
Prednisone for arthritis In this article About prednisone Before taking prednisone How to take prednisone Getting the most from your treatment Can prednisone cause problems? Common prednisone side-effects What can I do if I experience this? Fluid retention causing swollen feet and ankles Whenever possible, sit with your feet up Headache Drink plenty of water and ask a pharmacist to recommend a suitable painkiller.
If the headaches continue, let your doctor know Feeling tired If this happens, do not drive and do not use tools or machines until you feel more awake Muscle weakness If this continues or gets worse, speak with your doctor Difficulties sleeping, increased weight If these become troublesome, speak with your doctor Long-term treatment with prednisone may cause other unwanted effects If you have any symptoms which cause you concern, you should arrange to see your doctor for advice.
If you have any questions about this medicine ask your pharmacist. Prednisone can increase your appetite, which can lead to weight gain. When taken for long periods of time prednisone can cause you to lose calcium from your bones, which can lead to weakened bones and osteoporosis if not appropriately managed.
Prednisone can cause nausea, indigestion, increased blood pressure, fluid retention, increased blood sugars, glaucoma, cataracts, difficulty sleeping, mood swings, increased cholesterol and skin changes acne, or make your skin thinner, more easily damaged and slow to heal. The lowest dose of prednisone that controls symptoms should be used to reduce adverse effects. The duration of steroid use should also be limited. High-dose prednisone bursts often are used to suppress disease flares.
High doses are used for several days until symptoms are controlled, followed by a taper to the lowest effective dose. To avoid weight gain while taking prednisone, follow a healthy diet and, if possible, exercise regularly.
To prevent calcium loss from bones, if you are taking prednisone regularly it is important to take extra calcium and vitamin D. Please speak to your healthcare provider about how much you need. If you are taking prednisone for longer periods of time 7. If you experience difficulty sleeping while taking prednisone, make sure you are taking prednisone in the morning and avoid taking the medication in the evening or close to bed time.
Routine blood tests may not be required while you are taking prednisone. However, if you are taking prednisone for longer periods of time more than three months your prescriber will likely request regular blood work to monitor for blood sugar changes and increased cholesterol and periodic bone mineral density BMD tests of your bones. Your prescriber will also monitor for vision changes if you are taking prednisone long-term.
Your prescriber may also want to meet with you regularly to monitor your blood pressure and to evaluate whether you need to continue taking prednisone.
Store this medication at room temperature 15 to 30 degrees Celsius and keep it out of reach of children. When used properly, these drugs save lives and avert threats to the function of important organs. One of the numerous potential side—effects of prednisone and other forms of corticosteroid treatment is hirsutism — excessive growth of body hair. Patients vary in the degree to which this side—effect of steroids occurs.
Although some experience minimal hirsutism, the patient depicted here developed this side effect after taking 10 milligrams of prednisone for a few months. Weight gain is usually the most dreaded side—effects of steroid use, incurred to some degree by nearly all patients who take them. The amount of weight gain varies from individual to individual.
In addition to causing weight gain, prednisone leads to a redistribution of body fat to places that are undesirable, particularly the face, back of the neck, and abdomen. Pictured below is a example of redistribution of body fat to the back of the neck. High blood sugar, or steroid—induced diabetes.
This usually resolves when the steroids are decreased or discontinued. The higher the steroid dose and the longer the duration of therapy, the greater the risk of infection. The risk is also increased when patients receive combinations of immunosuppressive medications, such as cyclophosphamide cytoxan and prednisone. The risk of some infections can be greatly reduced by taking specific types of antibiotics prophylactically.
Corticosteroids are medications often used to treat arthritis and related conditions. These medications are widely used because of their overall effectiveness in reducing inflammation--the process that causes the joint pain warmth and swelling of arthritis and related conditions.
Examples of corticosteroids include cortisone prednisone and methylprednisolone. These medications are related to cortisol which occurs naturally in the body. Cortisol is a hormone that controls many important body functions. You could not live without cortisol. Corticosteroids are hormones but they are not sex hormones.
Sex hormones regulate sexual and reproductive function; corticosteroids do not. Doctors sometimes refer to corticosteroids as steroids. However corticosteroids are not the same as anabolic steroid drugs that some athletes abuse. This is a partial list and includes generic and brand names. Various corticosteroid syrups are available for children. Some corticosteroid preparations can be taken by injection. Corticosteroids are used in arthritis for two reasons. First they are anti-inflammatory; that is they decrease inflammation.
Many people who have rheumatic diseases experience a lot of inflammation which is the process that causes the joint pain warmth and swelling of arthritis and related conditions.
Inflammation can take place in the joints rheumatoid arthritis in the tendons tendinitis or in different organs at the same time lupus. In rheumatic diseases one of the purposes of therapy is to stop inflammation and the damage it causes. Medications known as nonsteroidal anti-inflammatory drugs NSAIDs are often used to stop inflammation but they may not be strong enough or may have too many side effects.
When side effects from NSAIDs present a problem or inflammation is severe and threatens to cause serious damage your doctor may prescribe corticosteroids to decrease inflammation. Second corticosteroids are immunosuppressive. This means that they reduce the activity of your immune system. A healthy immune system helps defend your body against bacteria viruses and cancer.
However sometimes the immune system goes out of control and starts attacking the tissues and organs of its own body. This is called autoimmunity and most doctors feel that with diseases like rheumatoid arthritis lupus and vasculitis the immune system has started attacking the body's own tissues and organs.
In these diseases corticosteroids help by decreasing the harmful autoimmune activity. However they also decrease the body's helpful immune activity which can increase susceptibility to infection and interfere with the healing process. Arthritis affects people in different ways. For this reason only your physician can determine how much medication you need to effectively treat the symptoms of your disease and how much you can tolerate.
Corticosteroids are used to treat several forms of arthritis. Following are examples of some of the rheumatic diseases and conditions that respond to corticosteroid treatment:. Doctors often prescribe corticosteroids in pill form but there are other ways of taking them. For osteoarthritisbursitis corticosteroids often are injected directly into the joint or bursa.
For other conditions they are injected into a muscle or vein. Doctors may use "pulse" corticosteroids--a procedure in which a very high dose of the medication is injected into a vein--e.
Pulse corticosteroid treatment is a serious procedure that involves risks. It should only be used by specialists with appropriate training preferably in a hospital. Skin conditions caused by certain forms of arthritis often are treated with corticosteroid creams applied directly to the spot. Certain eye conditions associated with arthritis are treated with corticosteroid eyedrops.
Some allergies can be treated with nasal sprays. Unlike corticosteroid pills corticosteroid creams eyedrops sprays and injections into joints or bursae are less likely to cause side effects in other parts of the body. When taken as prescribed corticosteroids can provide welcome relief from pain and inflammation. However like any other medication corticosteroids can cause side effects and serious medical problems if not carefully monitored by a doctor.
It is very important to understand the differences between safe proper use and improper use of these powerful drugs. Most side effects are predictable and related to the dose. Some side effects occur in almost anyone who takes them. Other side effects are unpredictable; they may or may not occur. The following table is an example of how the risk increases as the dosage for the corticosteroid prednisone increases.
In people who take corticosteroids for weeks to months especially at moderate to high doses:. Corticosteroids can make high blood pressure diabetes blood sugar problems or ulcers suddenly worse. If you have had any of these conditions and need to take corticosteroids it is very important to consult your doctor. Corticosteroid use is less likely to cause side effects when you take your medication as prescribed and practice healthy habits exercise regularly eat nutritious foods get enough rest.
Following is a list of suggestions to help minimize side effects that can result from corticosteroid use. In spite of the many possible side effects corticosteroids especially prednisone can be used with relative safety during pregnancy. If you see different doctors for your rheumatic disease and for your pregnancy both need to be involved in the decision of whether or not to use corticosteroids.
If you are taking corticosteroids and planning a pregnancy be sure to discuss this with your doctor. If you are taking corticosteroids and are pregnant don't stop the medications suddenly--you must see your doctor and discuss this first. Since corticosteroids get into breast milk nursing babies may experience side effects just like adults do except more so. Discuss the alternatives with your doctor if you wish to nurse your baby.
It may be difficult to lower your dosage of corticosteroids. If you have been on corticosteroids for more than just a few days it can be dangerous to suddenly stop taking them. Your body must have corticosteroids in case of stress but the adrenal gland that produces them may not respond quickly enough. That's why your doctor usually will prescribe a "tapering schedule" for you which is a gradual dose reduction.
Be sure to follow your doctor's advice on how to do this. Anyone who has taken corticosteroids for a couple of weeks or months will experience some discomfort when going through a dose reduction period. Fortunately the symptoms usually are not very severe and they don't last more than a couple of weeks at the most. If your corticosteroids are being tapered and you develop symptoms check with your doctor to make sure it is not the disease flaring up.
Sometimes when you have been on corticosteroids for a while your doctor may prescribe an "alternate-day" schedule. This means you take a higher dose one day then a lower dose or none the next day then the higher dose the third day and so on. The regimen is altered so your body can function with less corticosteroids on low-dose days while the overall total dose over two days will keep your disease under control.
Writing the dosage schedule on your calendar will help you remember it. Your doctor may prescribe a "steroid-sparing agent" if your disease flares when corticosteroids are tapered. A steroid-sparing agent refers to another medication that can help keep the disease under control while corticosteroids are being tapered. It usually is an immunosuppressive drug. A steroid-sparing agent might be safer for long-term medication use than corticosteroids.
You still will need to taper the corticosteroids slowly though. The most commonly used steroid-sparing agents are methotrexate Rheumatrex azathioprine Imuran and hydroxychloroquine Plaquenil. If you only have muscle or joint symptoms while tapering nonsteroidal anti-inflammatory drugs NSAIDs may be used to control your symptoms. If you have been on corticosteroids for more than a few months and now you are off be sure to mention this to your doctors for the next year.
This is especially important if you become very ill require surgery for any reason or need invasive diagnostic tests. In such instances you may be given a brief course of corticosteroids because your body may be making less than what would be required under those stressful circumstances. Corticosteroids have been around for a long time but research is still needed to improve the treatment of various diseases.
In recent years new corticosteroids have been developed that may be safer than prednisone. However they still are experimental and not available for general use. The Arthritis Foundation and the University of Washington Department of Orthopedics do not endorse any brand name or generic name medication listed here.
Some of this material may also be available in an Arthritis Foundation brochure. Adapted from the pamphlet originally prepared for the Arthritis Foundation by James L. This material is protected by copyright. You are here Home Corticosteroids for Arthritis. What are they? Why corticosteroids? Dosage benefits and risks Arthritis affects people in different ways.
The benefits and the risks of corticosteroid treatment depend upon many factors including: Dose. With some forms of arthritis the treatment may start off with high doses.
However the treatment goal is to find the smallest possible dose that is still effective. Dosage form. Length of treatment. This can range from several days to many years. The specific disease being treated.
Prednisone is a steroid used to treat inflammatory types of arthritis, such as rheumatoid and psoriatic arthritis, lupus and polymyalgia rheumatic. Can Short Courses of Prednisone Cause Osteonecrosis of the Hip? Osteonecrosis is a rare but recognized complication of corticosteroid therapy. Can Short Courses of Prednisone Cause Osteonecrosis of the Hip? Osteonecrosis is a rare but recognized complication of corticosteroid therapy. the joint pain warmth and swelling of arthritis and related conditions. Examples of corticosteroids include cortisone prednisone and methylprednisolone. In OA, synovitis plays a key role in pain and disease progression. While in systemic diseases, such as rheumatoid arthritis, it is logical to target the. Prednisone can increase your appetite, which can lead to weight gain. How to think about the suggestions below: Any suggestion here which is not clear or which you think may not apply to you should be discussed with the your physician. Most side effects are predictable and related to the dose. The benefits of taking prednisone usually outweigh the side-effects; however, they can sometimes be troublesome.How to think about the suggestions below: Any suggestion here which is not clear or which you think may not apply to you should be discussed with the your physician. Note also that the side effects of steroids very much depend on the dose and how long they are taken. If your dose is low, your risk of serious side effect is quite small, especially if precautions, as discussed below, are taken.
Reading about these side effects may make you uncomfortable about taking steroids. You should be well aware of the risks before starting these medications. However, please be reassured that many people take steroids with minor or no side effects. Please also remember that steroids are often extremely effective and can be life-saving. If any of the suggestions here is unclear, or seems irrelevant to you, please discuss it with your physician.
With long-term use, corticosteroids can result in any of the following side effects. However, taking care of yourself as discussed below may reduce the risks. Steroid use for over two weeks can decrease the ability of your body to respond to physical stress. A higher dose of steroid may be needed at times of major stress, such as surgery or very extensive dental work or serious infection.
This could be needed for as long as a year after you have stopped steroids. Taking these anti-inflammatory steroids can suppress the hypothalamus, as well as the pituitary gland, which are all involved the process of stimulating the adrenal gland to make cortisol. For example, the pituitary gland production of ACTH which stimulate the adrenal to make cortisol can be inhibited. The adrenal gland itself can also show some suppression of its ability to make cortisol.
Rapid withdrawal of steroids may cause a syndrome that could include fatigue, joint pain, muscle stiffness, muscle tenderness, or fever. These symptoms could be hard to separate from those of your underlying disease.
Even with slower withdrawal of steroids, some of these symptoms are possible, but usually in milder forms. At times, rapid withdrawal of steroids can lead to a more severe syndrome of adrenal insufficiency.
This can cause symptoms and health problems such as drops in blood pressure, as well as chemical changes in the blood such as high potassium or low sodium. Sometimes this can be set off by injuries or a surgical procedure. Because of this, make sure your doctors always know if you have been treated with steroids in the past, especially in the past year, so they can be on the alert for the development of adrenal insufficiency at times such as a surgical procedure.
Long-term steroids can suppress the protective role of your immune system and increase your risk of infection. Steroids may increase your risk of developing ulcers or gastrointestinal bleeding, especially if you take these medications along with non-steroidal anti-inflammatory drugs NSAIDs , such as ibuprofen or aspirin. If you are on low-dose aspirin for heart protection, your physician may want you to continue this when you take the prednisone, but might consdier adding a medication for stomach protection during the course of steroids.
Steroid therapy can cause thinning of the bones osteopenia and osteoporosis , and increase the risk of bone fractures. At the beginning or before your steroid therapy, many patients will be asked to have a bone density test, especially if the steroid dose is high.
If density is low, the bone density study It will be repeated in the future to assess the effectiveness of measures you will be using to prevent bone loss. Steroids affect your metabolism and how your body deposits fat. This can increase your appetite, leading to weight gain, and in particular lead to extra deposits of fat in your abdomen. Steroids, especially in doses over 30 milligrams per day, can affect your mood. Just being aware that steroids can do this sometimes makes it less of a problem.
Sometimes, this side effect requires that the steroid dosage be decreased. When the steroids are absolutely necessary, sometimes another medication can be added to help with the mood problem. Make sure your family knows about this possible side effect. Because cortisone is involved in regulating the body's balance of water, sodium, and other electrolytes, using these drugs can promote fluid retention and sometimes cause or worsen high blood pressure.
Since cortisone is involved in maintaining normal levels of glucose sugar in the blood, long-term use may lead to elevated blood sugar or even diabetes. It is possible that steroids may increase the rate of "hardening of the arteries," which could increase the risk of heart disease.
This risk is probably much more significant if steroids are taken for more than a year, and if taken in high dose.
By ; Theodore R. Understanding corticosteroid side effects With long-term use, corticosteroids can result in any of the following side effects. Increased doses needed for physical stress Steroid use for over two weeks can decrease the ability of your body to respond to physical stress. Self-care tips: Discuss this possibility with the surgeon or dentist, etc. Your physician or surgeon may not feel you need to take the extra steroid at the time of surgery, but if they know you have been on corticosteroids they can watch you more carefully after surgery.
Self-care tips: If you get symptoms like these when you taper your steroids, discuss them with the doctor. Your physician will work with you to continually try to taper your steroid dose, at a safe rate of decrease, depending on how you are doing. On each visit, discuss with the physician whether it is possible to decrease your steroid dose.
Note that even if you are having a steroid side effect, however, steroids still must be tapered slowly. When used for less than two weeks, more rapid tapering of steroids is generally possible Infection Long-term steroids can suppress the protective role of your immune system and increase your risk of infection. Self-care-tips: Since steroids can decrease your immunity to infection, you should have a yearly flu shot as long as you are on steroids.
Your physician will take your age and risk factors into account when deciding which vaccinations you need. If you have a history of tuberculosis, exposure to tuberculosis, or a positive skin test for tuberculosis, report this to your doctor. Gastrointestinal symptoms Steroids may increase your risk of developing ulcers or gastrointestinal bleeding, especially if you take these medications along with non-steroidal anti-inflammatory drugs NSAIDs , such as ibuprofen or aspirin.
Self-care tips: Report to your physician any severe, persisting abdominal pain or black, tarry stools. Take the steroid mediation after a full meal or with antacids , as this may help reduce irritation of the stomach. Steroids can increase your appetite. Osteoporosis Steroid therapy can cause thinning of the bones osteopenia and osteoporosis , and increase the risk of bone fractures.
See this reference from the National Institutes of Health about how much calcium you need for your sex and age, and how to get as much as possible from diet. The minimal daily requirement of vitamin D is international units UI daily, and most people on corticosteroids should take this amount. Your physician may check your vitamin D level and see if you actually need a higher dose. Smoking and alcohol increase the risk of osteoporosis, so limiting these is helpful. Weight-bearing exercise walking, running, dancing, etc is helpful in stabilizing bone mass.
Assess risk of falls. Make a thorough examination of your home and correct situations that might result in a fall, such as eliminating scatter rugs and any obstacles between bedroom and bathroom, and installing night lights. Weight gain Steroids affect your metabolism and how your body deposits fat. Self-care tips: Watch your calories and exercise regularly to try to prevent excessive weight gain. But don't let weight gain damage your self-esteem.
Know that the weight will be easier to take off in the six months to a year after you discontinue steroids. Insomnia Steroids may impair your ability to fall asleep, especially when they are taken in the evening. Self-care tips: If possible, the physician will try to have you take your entire daily dose in the morning.
This may help you sleep better at night evening doses sometimes make it difficult to fall asleep. Mood changes Steroids, especially in doses over 30 milligrams per day, can affect your mood. Self-care tips: Simply being aware that steroids can have an effect on your mood can sometimes make it less of a problem.
But, at times, this side will require that the steroid dosage be decreased. If maintaining the same steroid dosage is absolutely necessary, sometimes another medication can be added to help with the mood problem. Make sure your family and friends know about this possible side effect so they will know what's going on if you respond to them in unexpected ways. Ideally, tell your family and friends about this possible side effect as you start the medication, so that they can help you detect any changes in your behavior.
Fluid retention and elevated blood pressure Because cortisone is involved in regulating the body's balance of water, sodium, and other electrolytes, using these drugs can promote fluid retention and sometimes cause or worsen high blood pressure. Self-care tips: Watch for swelling of your ankles , and report this to your doctor. Occasional patients benefit from diuretics water pills. Low sodium diet helps reduce fluid accumulation and may help control blood pressure. Have your blood pressure monitored regularly while you are on steroids, especially if you have a history of high blood pressure.
Steroids can raise blood pressure in some patients. Elevated blood sugar Since cortisone is involved in maintaining normal levels of glucose sugar in the blood, long-term use may lead to elevated blood sugar or even diabetes. Self-care tips: Your blood sugar should be followed while you are on steroids, especially if you are a diabetic, since corticosteroids can raise blood sugar.
Eye problems Steroids can sometimes cause cataracts or glaucoma increased pressure in the eye. Self-care tips: If you have a history of glaucoma or cataract follow up closely with the ophthalmologist while on steroids.
If you develop any visual problems while on steroids, you will need to see the ophthalmologist. Temporarily blurred vision when you start corticosteroids is often not a serious problem, but ophthalmology evaluation should always be arranged if you experience other, new visual symptoms while taking steroids.
Atherosclerosis hardening of the arteries It is possible that steroids may increase the rate of "hardening of the arteries," which could increase the risk of heart disease. Self-care tips: Low cholesterol diet may help. If you develop signs suggesting heart problem, such as chest pain, get medical attention quickly. Work with your physician to address any heart risks that can be modified, such as exercise, weight and cholesterol level.
Aseptic necrosis Steroids, particularly at higher doses for long periods of time, can sometimes lead to damage to bones, called aseptic necrosis also known as osteonecrosis or avascular necrosis. This can happen in a number of joints, but the hip is the most common. Self-care tips: Hip pain, especially if you have no known hip arthritis, could be an early sign of this damage. Report this to your doctor. In-person and virtual physician appointments.
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