Steroids
Side Effects From Long-Term Use Of Steroids
Side effects that may be caused by the long-term use of steroids include avascular necrosis of bone, osteoporosis, cataracts, and muscle weakness.
Avascular necrosis of bone , usually associated with high doses of prednisone taken over long periods of time, produces pain, an abnormal bone scan, and an atypical X-ray appearance. It occurs most often in the hip, but it can also affect the shoulders, knees, and other joints. Avascular necrosis of bone is quite painful. Relief from pain often requires either a core bone biopsy or total surgical joint replacement.
Steroids cause osteoporosis , or thinning of the bones. Osteoporosis can lead to bone fractures, especially compression fractures of the vertebrae with severe back pain. Calcium and Vitamin D, hormones, calcitonin, nasal spray, bisphosphonates (Actonel, Fosamax) , parathyroid hormone (Forteo), or other medications may help to prevent osteoporosis.
There is also a relationship between steroids and premature arteriosclerosis , which is a narrowing of the blood vessels by fat (cholesterol) deposits.
In general, there is a close relationship between the side effects of steroids and the dose and duration of their use. Thus, a high dose of steroids given over a long period of time is more likely to cause side effects than a lower dosage given over a shorter period of time.
Steroid Dose And Usage
In general, there is a close relationship between the side effects of steroids and the dose and duration of their use. Thus, a high dose of steroids given over a long period of time is more likely to cause side effects than a lower dosage given over a shorter period of time.
| Dose | Milligrams |
| Low | Less than 10 mg daily |
| Moderate | 11 to 40 mg daily |
| High | 41 to 100 mg daily |
While steroid dosage should be kept at the lowest effective level, steroids must not be stopped suddenly if they have been taken for more than four weeks. After that time, some shrinking of the adrenal glands will occur, and they may not produce enough cortisone if the synthetic steroids are discontinued abruptly. A slow reduction in the dosage of steroids allows the adrenal glands to regain their ability to manufacture natural cortisone.
Conclusion
- Corticosteroids are extremely effective anti-inflammatory agents and can be very helpful in treating active lupus.
- Treatment with steroids should always be kept at the lowest possible effective dose and should never be stoppped suddenly.
- The hope is that effective alternative therapies will soon be developed which will not be as toxic as steroids.
- The history of most therapies shows, however, that those which are extremely effective often are associated with side effects. This is certainly the case with steroids.
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