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Glucocorticoids

Overview

Many health problems involve inflammation. Glucocorticoids are effective in stopping damaging inflammation caused by many immune system disorders. These drugs also have many other uses. However, they also come with side effects. These can be severe, especially if you use these drugs too long.

What are glucocorticoids?

Glucocorticoid drugs are man-made versions of glucocorticoids, steroids that occur naturally in your body. They have many functions. One is to interrupt inflammation by moving into cells and suppressing the proteins that go on to promote inflammation. They also help your body respond to stress and regulate how your body uses fat and sugar.

Because glucocorticoids have so many functions, man-made or synthetic glucocorticoids have been developed to help treat many different conditions.

List of glucocorticoid drugs

What glucocorticoids treat

Synthetic glucocorticoids can be more potent than the naturally occurring steroids. They are used to treat many conditions.

Autoimmune disorders

Autoimmune diseases can cause extensive damage from inflammation when the body mistakenly attacks itself. Autoimmune diseases include:

  • multiple sclerosis
  • rheumatoid arthritis
  • inflammatory bowel disease
  • ulcerative colitis
  • psoriasis
  • eczema

Glucocorticoids can reduce how active immune cells are. This helps reduce the internal damage from these diseases. They suppress inflammation from autoimmune reactions. This can reduce pain, swelling, cramping, and itching.

Allergies and asthma

Allergies and asthma are conditions in which your immune system responds to normally harmless substances. In these conditions, substances such as pollen or peanuts can cause an aggressive inflammatory reaction. Symptoms can vary and include:

  • itching
  • itchy, watery eyes
  • lightheadedness
  • redness, hives, or rash
  • sneezing and stuffy or runny nose
  • swelling of your face, lips, or throat
  • trouble breathing

Glucocorticoids can treat this overreaction by stopping the inflammation and calming immune cell activity.

Adrenal insufficiency

If you have adrenal insufficiency, your body can’t produce enough cortisol. This can be a result of a condition such as Addison’s disease or surgical removal of your adrenal glands. Glucocorticoids can be used to replace cortisol that your body can no longer make.

Heart failure

Short-term use (less than 7 days) of glucocorticoids can help treat heart failure by increasing your body’s ability to respond to certain diuretics. However, this isn’t a common use.

Cancer

Glucocorticoids can be used in cancer therapy to reduce some of the side effects of chemotherapy. They may also be used to kill some cancer cells in some cancers, including:

  • acute lymphoblastic leukemia
  • chronic lymphoblastic leukemia
  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
  • multiple myeloma

Skin conditions

Skin conditions ranging from eczema to poison ivy are treated with glucocorticoids. These include over-the-counter and prescription topical creams that you apply to your skin and medication that you take by mouth.

Surgery

Glucocorticoids may be used during sensitive neurosurgeries. They reduce inflammation in delicate tissues. They are also administered right after an organ transplant to help prevent the immune system from rejecting the donor organ.

Side effects

Glucocorticoids may sound like miracle drugs, but they do have side effects. Some of these side effects can be very damaging. This is why these drugs aren’t prescribed for long-term use.

These drugs can:

  • increase your blood sugar level, which can trigger temporary and possibly long-term diabetes
  • suppress your body’s ability to absorb calcium, which can lead to osteoporosis
  • increase your cholesterol and triglyceride levels
  • increase your risk of ulcers and gastritis
  • delay wound healing, which requires a certain amount of inflammation
  • suppress your immune system and make you more prone to infections
Psychological effects of glucocorticoids can include mood changes, memory problems, and even psychosis.

Long-term use of glucocorticoids can cause a loss of muscle tissue. It can also result in Cushing’s syndrome, which can lead to:

  • a fatty hump between your shoulders
  • round face
  • weight gain
  • pink stretch marks
  • weakened bones
  • diabetes
  • high blood pressure
  • thin skin
  • slow healing
  • acne
  • irregular menstrual cycles
  • decreased libido
  • fatigue
  • depression

If you have used glucocorticoids for more than a few weeks, your doctor will most likely taper your dosage slowly rather than have you stop taking it all at once. This helps to prevent withdrawal effects. Your body naturally makes glucocorticoids, but when you start taking them as medication, your body reacts by making less of it on its own. When you stop taking glucocorticoids, your body needs time to start making more of its own at normal levels again.

Talk to your doctor

Glucocorticoids can be useful drugs for many different treatments. However, it is important to balance the need for glucocorticoid therapy against the side effects. If your doctor prescribes glucocorticoid treatment for you, tell them about any side effects you have. It’s also important to take the drugs exactly as directed, including when you’re stopping them. Your doctor may wean you off of your medication slowly to prevent withdrawal.

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