Important safeguards when using oral steroids

If you do need long-term oral steroids, it's important to know the serious adverse effects you could face. Here are some of the most common—and the steps you can take to help protect your health. If your doctor prescribes daily oral steroid use for an extended time, be sure to ask whether you're taking the lowest possible dose that will still control your lung disease.

Also ask whether you can reduce your oral steroid dose by adding other medications. Last but not least, promptly report to your doctor any side effects that you think might be caused by oral steroids.

Adrenal suppression. Your adrenal glands normally make small amounts of cortisol, a hormone that is similar to oral steroids and is important for many body functions, including regulation of your blood sugar and the body's immune response.

However, when you take a steroid, your brain can't distinguish between the naturally produced steroid and the medication. As a consequence, when you use an oral steroid at moderate to high doses for a month or longer, your brain thinks you don't need as much cortisol, so the adrenal glands begin to produce much less than usual. In some cases, they stop producing the hormone altogether.

Typically, the adrenal glands can recover and begin producing normal amounts if the dose of steroid medication is slowly decreased. If you suddenly stop taking your steroid medication, you can trigger a life-threatening condition known as acute adrenal insufficiency.

To reduce your risk, always follow the doctor's instructions for discontinuing your steroid medication. It's important to be aware, however, that even if you've stopped taking steroids for several months without incident, an extremely stressful event, such as an automobile accident, could still trigger an episode of acute adrenal insufficiency.

Publication Review By: Peter B. Terry, M.D., M.A.

Published: 20 Jun 2013

Last Modified: 20 Jun 2013