What are the side effects of long-term steroid use?
Corticosteroids, glucocorticoids or simply steroids, are prescribed for a variety of conditions such as asthma, arthritis, lupus or eczema (these are not the same type of steroids used for building muscles). They are usually synthetic forms of cortisol, a natural hormone produced by your adrenal glands. Steroids reduce activity of the immune system and therefore help reduce inflammation. Depending on the condition they are treating, steroids may be given by injection, taken orally as a tablet, given as drops in the eyes or ears, applied as a cream, ointment or gel to the skin, or inhaled through a nasal spray or inhaler device. Steroids given locally - as an injection into a joint, topically as a cream or ointment, inhaled or as eye drops for example - produce fewer side effects than those that act systemically (working throughout the body). Systemic steroids include tablets taken orally or injected into a vein or muscle.
Any medication can have side effects and steroids are no exception. The long-term side effects of steroids depend on a number of factors, including the dose of the prescription and how long you take it. With steroids, the higher the dose and the longer you are taking them, the greater the risk of side effects. Taking short courses of steroids repeatedly can also increase your risks. For these reasons - and because a number of side effects are associated with taking steroids - your doctor or specialist will prescribe them with caution and monitor your health while you take them. You will be given steroids only as necessary and in the lowest dose possible, and local steroids will be used for local problems if possible.
The benefits provided will be considered along with the risks. Sometimes steroids are given short-term, from a few days to a few weeks, to provide immediate improvement in a condition or to reduce flare-ups, and sometimes low doses can be taken long-term without side effects. Long-term use of steroids, from a few months to several years, is usually reserved for people facing serious health risks such as kidney failure without them. It may be necessary to prescribe high doses to save lives.
The possible side effects of long-term use of steroids include:
Increased risk of infection: Your immune system will become less effective with long-term use of steroids, making you more susceptible to infections. You may be advised to have an annual flu jab. A child taking steroid tablets for asthma who is exposed to chickenpox and is not already immune, may be given an injection for protection against chickenpox.
Weight gain: Your metabolism can be affected by taking steroids, leading to an increase in appetite as well as fatty deposits in your abdomen. While taking steroids, be careful of your calorie intake and exercise regularly. Weight gain often reverses 6 months to a year after stopping steroids.