Use of corticosteroids has numerous side-effects, some of which may be severe: Severe amoebic colitis: Fulminant amoebic colitis is associated with high case fatality and can occur in patients infected with the parasite Entamoeba histolytica after exposure to corticosteroid medications. Neuropsychiatric: steroid psychosis, and anxiety, depression. Therapeutic doses may cause a feeling of artificial well-being ("steroid euphoria"). The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina.Benjamin H. Flores and Heather Kenna Gumina. The Neuropsychiatric Sequelae of Steroid Treatment. URL:http://www.dianafoundation.com/articles/df_04_article_01_steroids_pg01.html Cardiovascular: Corticosteroids can cause sodium retention through a direct action on the kidney, in a manner analogous to the mineralocorticoid aldosterone. This can result in fluid retention and hypertension. Metabolic: Corticosteroids cause a movement of body fat to the face and torso, resulting in "moon face", "buffalo hump", and "pot belly" or "beer belly", and cause movement of body fat away from the limbs. This has been termed corticosteroid-induced lipodystrophy. Due to the diversion of amino-acids to glucose, they are considered anti-anabolic, and long term therapy can cause muscle wasting (muscle atrophy). Besides muscle atrophy, steroid myopathy includes muscle pains (myalgias), muscle weakness (typically of the proximal muscles), serum creatine kinase normal, EMG myopathic, and some have type II (fast-twitch/glycolytic) fibre atrophy. Endocrine: By increasing the production of glucose from amino-acid breakdown and opposing the action of insulin, corticosteroids can cause hyperglycemia, insulin resistance and diabetes mellitus. Skeletal: Steroid-induced osteoporosis may be a side-effect of long-term corticosteroid use. Use of inhaled corticosteroids among children with asthma may result in decreased height. Gastro-intestinal: While cases of colitis have been reported, corticosteroids are often prescribed when the colitis, although due to suppression of the immune response to pathogens, should be considered only after ruling out infection or microbe/fungal overgrowth in the gastrointestinal tract. While the evidence for corticosteroids causing peptic ulceration is relatively poor except for high doses taken for over a month, the majority of doctors still believe this is the case, and would consider protective prophylactic measures. Eyes: chronic use may predispose to cataract and glaucoma. Clinical and experimental evidence indicates that corticosteroids can cause permanent eye damage by inducing central serous retinopathy (CSR, also known as central serous chorioretinopathy, CSC). This should be borne in mind when treating patients with optic neuritis. There is experimental and clinical evidence that, at least in optic neuritis speed of treatment initiation is important. Vulnerability to infection: By suppressing immune reactions (which is one of the main reasons for their use in allergies), steroids may cause infections to flare up, notably candidiasis. Pregnancy: Corticosteroids have a low but significant teratogenic effect, causing a few birth defects per 1,000 pregnant women treated. Corticosteroids are therefore contraindicated in pregnancy. Habituation: Topical steroid addiction (TSA) or red burning skin has been reported in long-term users of topical steroids (users who applied topical steroids to their skin over a period of weeks, months, or years). TSA is characterised by uncontrollable, spreading dermatitis and worsening skin inflammation which requires a stronger topical steroid to get the same result as the first prescription. When topical steroid medication is lost, the skin experiences redness, burning, itching, hot skin, swelling, and/or oozing for a length of time. This is also called 'red skin syndrome' or 'topical steroid withdrawal' (TSW). After the withdrawal period is over the atopic dermatitis can cease or is less severe than it was before. In children the short term use of steroids by mouth increases the risk of vomiting, behavioral changes, and sleeping problems. Dysphonia: Inhaled corticosteroids are used for treatment of asthma as a standard treatment. This can cause local adverse effects like vocal cord dysfunction.
use of corticosteroids has numerous side-effects some of which may be severe severe amoebic colitis fulminant amoebic colitis is associated with high case fatality and can occur in patients infected with the parasite entamoeba histolytica after exposure to corticosteroid medications neuropsychiatric steroid psychosis and anxiety depression therapeutic doses may cause a feeling of artificial well-being ("steroid euphoria") the neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline therapeutically the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night the feeling of being energized will interfere with sleep an extensive review is provided by flores and guminabenjamin h flores and heather kenna gumina the neuropsychiatric sequelae of steroid treatment urlhttp//wwwdianafoundationcom/articles/df_04_article_01_steroids_pg01html cardiovascular corticosteroids can cause sodium retention through a direct action on the kidney in a manner analogous to the mineralocorticoid aldosterone this can result in fluid retention and hypertension metabolic corticosteroids cause a movement of body fat to the face and torso resulting in "moon face" "buffalo hump" and "pot belly" or "beer belly" and cause movement of body fat away from the limbs this has been termed corticosteroid-induced lipodystrophy due to the diversion of amino-acids to glucose they are considered anti-anabolic and long term therapy can cause muscle wasting (muscle atrophy) besides muscle atrophy steroid myopathy includes muscle pains (myalgias) muscle weakness (typically of the proximal muscles) serum creatine kinase normal emg myopathic and some have type ii (fast-twitch/glycolytic) fibre atrophy endocrine by increasing the production of glucose from amino-acid breakdown and opposing the action of insulin corticosteroids can cause hyperglycemia insulin resistance and diabetes mellitus skeletal steroid-induced osteoporosis may be a side-effect of long-term corticosteroid use use of inhaled corticosteroids among children with asthma may result in decreased height gastro-intestinal while cases of colitis have been reported corticosteroids are often prescribed when the colitis although due to suppression of the immune response to pathogens should be considered only after ruling out infection or microbe/fungal overgrowth in the gastrointestinal tract while the evidence for corticosteroids causing peptic ulceration is relatively poor except for high doses taken for over a month the majority of doctors still believe this is the case and would consider protective prophylactic measures eyes chronic use may predispose to cataract and glaucoma clinical and experimental evidence indicates that corticosteroids can cause permanent eye damage by inducing central serous retinopathy (csr also known as central serous chorioretinopathy csc) this should be borne in mind when treating patients with optic neuritis there is experimental and clinical evidence that at least in optic neuritis speed of treatment initiation is important vulnerability to infection by suppressing immune reactions (which is one of the main reasons for their use in allergies) steroids may cause infections to flare up notably candidiasis pregnancy corticosteroids have a low but significant teratogenic effect causing a few birth defects per 1000 pregnant women treated corticosteroids are therefore contraindicated in pregnancy habituation topical steroid addiction (tsa) or red burning skin has been reported in long-term users of topical steroids (users who applied topical steroids to their skin over a period of weeks months or years) tsa is characterised by uncontrollable spreading dermatitis and worsening skin inflammation which requires a stronger topical steroid to get the same result as the first prescription when topical steroid medication is lost the skin experiences redness burning itching hot skin swelling and/or oozing for a length of time this is also called 'red skin syndrome' or 'topical steroid withdrawal' (tsw) after the withdrawal period is over the atopic dermatitis can cease or is less severe than it was before in children the short term use of steroids by mouth increases the risk of vomiting behavioral changes and sleeping problems dysphonia inhaled corticosteroids are used for treatment of asthma as a standard treatment this can cause local adverse effects like vocal cord dysfunction