Everything You Need to Know About Corticosteroids

In contrast to anabolic steroids (used by “bodybuilders”), corticosteroids are used in inflammatory conditions for their anti–inflammatory effects. They have a rapid onset of action, and profoundly affect many parts of the immune system as well as most other body systems. Corticosteroids are a cornerstone of treating most types of vasculitis, and are often used in combination with other immunosuppressive medications. Corticosteroids are a class of steroid hormones that are naturally produced in the adrenal glands. Corticosteroids can come with serious side effects, including high blood pressure, weight gain, and increased risk of infections.

Because corticosteroids turn down your immune system, taking them makes you more likely to get infections. Patients are at increased risk for many types of infections, from minor fungal infections in the mouth (“thrush”, caused by Candida) to life–threatening infections such as Pneumocystis carinii pneumonia. The higher the steroid dose and the longer the duration of therapy, the greater the risk of infection.

Abdominal striae (“stripes”), as pictured below, frequently occur in patients who take high doses of steroids for long periods of time. This usually improves as the corticosteroid dose is reduced. Corticosteroids can be life-saving medications and improve the quality of life for many dogs. By working closely with your veterinarian, you can safely administer these drugs and provide your dog with the high quality of care he needs and deserves. If you have any questions or concerns about your dog's medications, please contact your veterinarian.

Monitor bone density and prescribe medications and supplements to help bone health. Monitor blood pressure and blood sugar often and treat if necessary. Steroids reduce the production of chemicals that cause inflammation. Steroids also reduce the activity of the immune system by affecting the way white blood cells work.

Low doses of steroids might provide significant relief from pain and stiffness for people with rheumatoid arthritis. Short-term use of higher doses of steroids might help a person recover from a severe flare-up of arthritis. When possible, local steroid treatments are prescribed instead of systemic steroids to reduce the risk of side effects.

Methods of analysis overlap both of the above areas, emphasizing analytical methods to determining if a steroid is present in a mixture and determining its quantity. Cortisol, corticosterone, aldosterone, and testosterone are produced in the adrenal cortex. The mevalonate pathway (also called HMG-CoA reductase pathway) begins with acetyl-CoA and ends with dimethylallyl diphosphate and isopentenyl diphosphate . In eukaryotes, steroids are found in fungi, animals, and plants. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. MedlinePlus links to health information from the National Institutes of Health and other federal government agencies.

In many of these cases, the diabetes resolves once the steroid is discontinued. These control electrolyte and total body water levels, primarily by causing sodium retention in the kidneys. Possession of illegally obtained steroidscarries a maximum penalty of one year in prison and a minimum $1,000 fine.

We recommend following the corticosteroid therapy withdrawal guidelines outlined in thePJ Nicholoff Steroid Protocol . The recommended starting dose of daily prednisone is 0.75 mg/kg/day. The recommended starting dose of daily deflazacort is 0.9 mg/kg/day. Your neuromuscular specialist may increase or decrease the dose based on growth, weight, and other side effects experienced.

Alert your neuromuscular team in the event of a medical emergency or admission to help ensure that your/your child’s comprehensive care continues. A stress dose is an extra dose of steroids that helps your body to deal with significant stressors. The table below, from the PJ Nicholoff Steroid Protocol, will help you to recognize which stressors might require a stress dose of steroids. When in doubt, it is generally safer to give a stress dose than to not give a stress dose . If you do make the decision to stop taking steroids, it is important that you do so under the supervision of a medical provider who can advise a slow taper, or reduction of dosing.

However, if you’re experiencing cancer-related fatigue, we prescribe a lower dose of steroids that you may take once or twice a day for a short period of time to help improve your quality of life. If oral corticosteroids are missed on days when they are normally given for more than 24 hours, IV doses should be given. Be sure to share thePJ Nicholoff Steroid Protocol with your doctor and create a plan together about what to do in case of a missed dose. Missing doses of daily steroids for more than 24 hours for any reason can also cause a life-threatening adrenal crisis. If you or your child goes to the emergency room or is hospitalized for any reason, it is extremely important you notify the providers that you are on steroids and if you have missed a dose. Additionally, it is important to be mindful of conditions that may impact the amount of steroid being absorbed, such as vomiting for more than 24 hours (food poisoning, stomach bug, etc.).