Glucocorticoids Side Effects

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Glucocorticoids Side Effects: If systemic steroids have been prescribed for one month or less, side effects are rarely serious. However the following problems may arise:

  • Sleep disturbance
  • Increased appetite
  • Weight gain
  • Psychological effects, including increased or decreased energy

  • Rare but more worrisome side effects of a short course of corticosteroids include: mania, psychosis, heart failure, peptic ulceration, diabetes and aseptic necrosis of the hip.

    Side effects from a longer course of systemic steroids:

    Nearly everyone on systemic steroids for more than a month suffers from some adverse effects. These may include any of the following problems, which are not listed in any particular order of importance.

    • Reduction of your own cortisol production. During and after steroid treatment, the adrenal gland produces less of its own cortisol, resulting from hypopituitary-pituitary-adrenal (HPA) axis suppression. For up to twelve months after the steroids are stopped, the lack of steroid response to stress such as infection or trauma could result in severe illness.
    • Osteoporosis (thinning of the bones) particularly in smokers, postmenopausal women, the elderly, those who are underweight or immobile, and patients with diabetes or lung problems. Osteoporosis may result in fractures of the spine, ribs or hip joint with minimal trauma. These occur after the first year in 10-20% of patients treated with more than 7.5mg prednisone daily. It is estimated that up to 50% of patients using oral corticosteroids will develop bone fractures.
    • Reduction in growth in children, which may not catch up when the steroids are discontinued
    • Muscle weakness, especially of the shoulder muscles and thighs.
    • Rarely, avascular necrosis of the femoral head
    • Precipitation or aggravation of diabetes mellitus
    • Increase in circulating blood fat.
    • Redistribution of body fat: moon face, buffalo hump and truncal obesity.

    • Salt retention: leg swelling, raised blood pressure, weight increase and heart failure.
    • Shakiness and tremor.
    • Eye disease, particularly glaucoma (increased intraocular pressure) and posterior subcapsular cataracts.
    • Psychological effects including insomnia, mood changes, increased energy, excitement, delirium or depression.
    • Headaches and raised intracranial pressure.
    • Increased susceptibility to internal infections, especially when high doses are prescribed (e.g. tuberculosis). Avoid oral live polio vaccination. It is safe to have other routine immunisations.
    • Peptic ulceration, especially common in those also taking anti-inflammatory medications.
    • There are also side effects from reducing the dose; these include tiredness, headaches, muscle and joint aches and depression.


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    ...less medical jargon in a 'Quick Glance' format!