Many of us have taken steroids, whether we knew it or not. Cortisone, prednisone and hydrocortisone have a variety of uses ranging from stopping a poison ivy itch to preventing organ rejection in transplant patients. For most of us, brief prescriptive use helps us feel better by managing symptoms that interfere with our physical ability to function. As beneficial as they can be to some, using steroids still requires lifestyle changes to reduce side effects and prevent long-term consequences.
How do they work?
Steroids mimic the hormones our body produces in the adrenal glands. Below are some common adrenal hormones and what they do:
- Hydrocortisone: regulates how the body converts fats, proteins and carbohydrates to energy; helps regulate blood pressure and cardiovascular function
- Corticosterone: regulates immune response and suppresses inflammatory reactions
- Aldosterone: maintains the right balance of salt and water; helps control blood pressure
- Epinephrine/Adrenalin: increases the heart rate and spikes blood sugar levels
- Norepinephrine: works with epinephrine to control the stress response; causes blood vessels to constrict and raises blood pressure
Why are they prescribed?
Steroids can help decrease inflammation and reduce immune system activity. When a major organ is transplanted, they can also be used to prevent inflammation. This will keep the body from destroying the new organ. In lower doses, steroids can provide relief from pain and stiffness. It is commonly prescribed for severe cases of asthma, and other chronic conditions.
Unfortunately, they are not without their side effects. People taking oral steroids are at risk for the following:
- Acne
- Blurred Vision
- Cataracts or glaucoma
- Difficulty sleeping or insomnia
- Easy bruising
- High blood pressure
- Increased appetite, weight gain
- Increased body hair growth
- Lower resistance to infection
- Moodiness
- Muscle weakness
- Nervousness/restlessness
- Osteoporosis
- Stomach irritation or bleeding
- Sudden mood swings
- Swollen, puffy face
- Water retention/swelling
- Worsening of diabetes
Steroids and nutrition
Steroid therapy has the potential to interfere with the normal absorption and utilization of calcium, potassium, sodium, protein and vitamins C and D. If you’re starting a steroid regimen, you’ll need to discuss your dietary needs with your doctor. He or she may want you to add more foods that contain calcium, potassium and vitamin D to your diet. Here are a few other dietary concerns:
- Use of sodium/salt
- Adding protein source(s)
- Avoiding simple carbohydrates (sweets, breads/pasta/potatoes), soda and fried foods
People who begin a new regimen should expect to feel more hungry, so it’s important to focus on low-calorie foods and controlling portion sizes. On the other hand, you should also avoid having an “empty stomach.”
How to handle mood changes
Steroids can make us feel more agitated, stressed and irritable. In some people, steroids can create a mild sense of happiness and well-being. Recognizing the possibility for personality changes will help manage them if/when they do happen. Discuss any symptoms with your healthcare provider to determine if a change in dosage or administration method would be helpful.
With self-awareness and a little effort, you can be stable on steroids for whatever interval of time they are needed for your health.
