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Side effects of cortisone

Side effects of cortisone


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Cortisone is called a devil's stuff with side effects. However, even the body itself makes a certain amount of it and this is vital. Cortisone is one of the best-known medications and the treatment of choice for some diseases. However, cortisone still has a bad reputation, especially when it comes to side effects. Everyone affected should be aware of the benefits and risks. Medicine has become an integral part of cortisone. This much-questioned drug can save lives and provide great relief, especially for chronic inflammatory diseases. However, the side effects must also be considered here, especially with long-term use.

Body's own cortisone: definition, tasks

So-called glucocorticoids are produced in the adrenal cortex in the human body. These include cortisol, cortisone and corticosterone. These substances have a protein-degrading effect in the muscles, skin and fat tissue. They also contribute to lipolysis (fat loss), whereby fatty acids are released into the blood. Under the influence of cortisone, the body is stimulated to increase the glucose concentration in the blood from amino acids in the liver through the formation of sugar, which is why this is also known as the so-called stress hormone.

Glucocorticoids have an anti-inflammatory effect. They inhibit inflammation of the wound and its scarring after an injury. Unfortunately, they also contribute to immunosuppression. This means that cortisone weakens the immune system and inhibits the lymphocytes and phagocytes. Again, this substance has an anti-allergic component because it curbs inflammation after an antigen-antibody reaction. As a side effect, the loss of bone and muscle mass should be mentioned here.

Cortisone an important medication

Many patients have mixed feelings about taking cortisone. You are afraid of the side effects. However, this drug is the drug of choice for many diseases. In the 1970s, cortisone had not been researched as much as it is today, and high doses were often administered, which then also led to more or less serious side effects. This is no longer the case these days. Cortisone is administered much more individually and especially in smaller doses. There are also a wide variety of applications on the market.

Cortisone has become a vital drug that is used primarily in the area of ​​inflammation and allergic reactions. This is administered for skin diseases (e.g. itchy rash), bronchial asthma, allergies and rheumatism. In autoimmune diseases, such as systemic lupus erythematosus (SLE), cortisone can have a life-saving effect. Also important is the use in a life-threatening anaphylactic shock, in which this medication is always used. In addition, the risk of side effects can be controlled relatively well with the right dosage and strictly limited use.

Forms of application of cortisone

Cortisone is available in various forms of use. So the external treatment exists in the form of creams, ointments and gels. Oral use is in the form of tablets. If the gastrointestinal tract is to be bypassed, but the cortisone has a systemic effect, this can be done by injection or infusion. There are also nasal drops, eye drops and inhalation sprays that contain cortisone.

Use of cortisone in diseases

Cortisone is often used for skin diseases such as neurodermatitis, psoriasis and eczema. Here the application takes place over ointments, creams and gels. Asthma and allergies are also a large area of ​​application for this medication. Inflammatory reactions in the bronchi are inhibited, which also reduces mucus production. An inhalation spray is usually prescribed for respiratory diseases. Additional oral doses are possible, but are usually only appropriate in severe cases. In rheumatic diseases, cortisone counteracts inflammation in the joints and thus stops the excessive immune system.

Side effects of cortisone

If cortisone is administered over a short period of one to two weeks, this usually does not cause any serious side effects. Only in extremely rare cases does this brief use lead to considerable impairments. If the underlying disease requires long-term therapy, an attempt is made to achieve what is known as low-dose therapy. After an initial higher dose, the amount used is reduced more and more, in very small steps, until the individual limit of the patient is reached. The lower the dosage, the lower the risk of side effects. High-dose, long-term income usually results in unpleasant side effects.

External use of cortisone in the form of gel, ointment or cream over a long period of time can lead to thinning of the skin, red veins or steroid acne. If the substance is applied over a large area or applied to particularly thin areas of the skin, such as on the face, it can also penetrate the bloodstream and have a systemic effect, i.e. cause side effects throughout the body.

If nasal or eye drops containing cortisone are used for a longer period of time, the nasal mucosa and / or the cornea may dry out. In the case of respiratory diseases, such as asthma, the substance is inhaled in the form of a spray, which can lead to coughing and hoarseness over a long period of time. These include sleep disorders, dizziness, headache, calcium deficiency, bone loss and a weakened immune system. A high blood sugar level can also result from taking cortisone.

In women, temporary infertility is possible due to the lack of ovulation. Cortisone is suspected of promoting high blood pressure and causing edema (water retention in the tissues) (such as fat legs), which in the broader sense lead to weight gain. Inflammation of the stomach and gastric ulcer are also mentioned in the list of side effects. In the worst case, use in children can lead to growth disorders.

These side effects are not a must, but possible. To prevent osteoporosis caused by long-term use of cortisone, calcium and vitamin D are administered. Regular monitoring of the blood sugar level is necessary so that developing diabetes can be diagnosed in good time. The sugar level should be checked, especially if those affected let go of increased water in connection with the intake and complain of massive thirst. A healthy, balanced, vitamin-rich diet is important in order to counteract any deficiency symptoms.

What to consider with cortisone

Care should be taken when using cortisone. Since the body produces the greatest amount of cortisone, especially in the morning hours between 6 a.m. and 8 a.m., it should also be taken during this time. This additional dose hinders much less during this period than at another time of the day and is therefore better tolerated. Asthma sufferers often have to take an additional dose in the evening to avoid nighttime asthma attacks.

Cortisone should never be discontinued without consulting the doctor who is treating it, as taking it affects the body's production and reduces it somewhat. With abrupt discontinuation, the body can suffer from deficiency symptoms that have to be coped with. Therefore, gradual weaning is absolutely sensible. Special attention should be paid to regular intake during therapy so that a sufficient active level can build up.

Cortisone is an important medication that has become indispensable in medicine. Nevertheless, the benefits and risks should be carefully weighed, especially if longer-term use is necessary. Given the massive side effects of cortisone, the use of alternatives should be carefully examined. (sw)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • C. Strehl, F. Buttgereit: Long-term therapy with glucocorticoids; in: The Internist, Volume 57, Issue 9, pages 934-939, September 2016, springer.com
  • E. Gromnica-Ihle: glucocorticoids; in: Journal of Rheumatology, Volume 75, Issue 6, pages 591–594, August 2016, springer.com
  • U. Baschant, M. Stein, J. Tuckermann: The molecular mechanisms of action of the glucocorticoid receptor in glucocorticoid-induced osteoporosis; in: Osteology, Volume 25, Issue 4, pages 262-268; 2016, thieme-connect.com
  • A. Willms, P. M. Schumm-Draeger, T. Siegmund: Glucocorticoids and Diabetes; in: The Diabetologist, Volume 12, Issue 2, pages 127-138, March 2016, springer.com
  • Merih Oray, Khawla Abu Samra, Nazanin Ebrahimiadib, Halea Meese, C. Stephen Foster: Long-term side effects of glucocorticoids; in: Expert Opinion on Drug Safety, Volume 15, Issue 4, 2016, tandfonline.com
  • Robert N. Richards: Side Effects of Short-Term Oral Corticosteroids; in: Journal of Cutaneous Medicine and Surgery, Volume 12, Issue 2, pages 77-81, sagepub.com
  • Heike Schäcke, Wolf-Dietrich Docks, Khusru Asadullah: Mechanisms involved in the side effects of glucocorticoids; in: Pharmacology & Therapeutics, Volume 96, Issue 1, pages 23-43, October 2002, sciencedirect.com


Video: What Are the Side Effects of Treatment With Corticosteroids? (May 2022).


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