Corticosteroid Therapy Side Effects

Corticosteroid therapy has been in use for 70-plus years to treat inflammatory conditions in the body.  Corticosteroids are natural anti-inflammatory hormones produced by the adrenal glands, which are under control of the hypothalamus.  Synthetic corticosteroids (cortisone or dexamethasone) are used to treat a wide range of inflammatory musculoskeletal conditions ranging from certain types of arthritis to sports injuries.  These synthetic hormones can have undesirable adverse effects from short-term use and long-term use.  Below is a list of some of these effects categorized under short-term and long-term effects.

Side Effects of Short-Term Corticosteroid Use:

Acne

Easy bruising

Inhibition of Fibroblast growth and collagen synthesis – leading to decrease structural stability of connective tissue.  This can effect your ability to heal cuts or scrapes properly leading to noticeable scarring of the injured tissue.

Decrease Immune Function – More prone to succumb to infections like the common cold or flu.

Hypokalemia – a decrease in potassium in the blood.

Myopathy – where the muscles do not function correctly.  This is thought to be due to the decreased amount of potassium in the blood.  Muscle weakness does occur.  Most importantly, corticosteroid use is associated with an increase in serum creatinine phosphokinase which indicates muscle necrosis (death).

Glucose Intolerance – hyperglycemia (high blood sugar levels) may occur in individuals not predisposed to diabetes mellitus.  It is unclear why hyperglycemia develops with corticosteroid use.

Pancreatitis – Inflammation of the pancreas, rare effect though.

Psychologic Effects – these include mood alterations, insomnia, hyperactivity, and even psychosis.  These effects are rare and are directly related to the amount of steroid dose given.  Dementia, decreased attention, concentration, and performance may persist after withdrawal.  Withdrawal from corticosteroid use may include depression, irritability, apathy, insomnia, memory problems, and fatigue.

Neurologic Effects – Seizures have been described with corticosteroid use.  Possible causes include fluid shifts and electrolyte imbalances.

Hypertension – Increased blood pressure due to sodium retention.

Side Effects of Long-Term Corticosteroid Use:

Osteoporosis – The major affected areas are the ribs, vertebrae, and long bones like in the arms, legs, feet, and hands.  This causes a significant increase for the chance of breaks in these areas.  Corticosteroids directly inhibit bone formation by stopping osteoblast (the cells that build bone) formation.  It also decreases calcium absorption and increases the loss of calcium through urinary excretion.  As we all know calcium in essential for healthy bone density and fracture prevention especially in post-menopausal women.

GI Disorder – In rare instances corticosteroid use has been associated with peptic ulcer formation.

Ophthalmologic Effects – An increase in intraocular pressure has been noticed, better known as glaucoma.  Those with a history of diabetes are more at risk.  Cataracts have also been associated but the incidence is low.

Hyperlipidemia – High levels of triglycerides (fats) in the blood, and as we all know increased levels of fat in the blood is a leading cause of high cholesterol which in turn is a leading cause of heart disease.  Heart disease is the leading cause of death in America.

Growth Supression – Corticosteroids interfere with collagen, bone formation and nitrogen retention, all responsible for growth.  Growth hormone and insulin-like growth factor levels are also decreased.  This is very concerning to individuals who are serious about working out and body image because you cannot have muscle growth without these hormones.

Birth Defects – Corticosteroid use while pregnant has been linked to increase incidence of cleft lip and cleft palate.

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Why is a chiropractor talking about corticosteroids?  The doctors at Park Bench Chiropractic feel that you are not able to make wise decisions about you and your family’s health unless you have all the information about the different treatment plans for each specific condition.  If you would like information on how chiropractic can safely help reduce pain and inflammation without the use of drugs, feel free to contact Dr. Matt or Dr. Rob at Park Bench Chiropractic.

BuchmanAL. Side Effects of Corticosteroid Therapy. J Clin Gastroenterol 2001;33(4):289-294

Dr. Matt is a chiropractor at Park Bench Chiropractic located at 1780 N Market St Frederick, MD.  He is a member of the ACA and ICA.  He is a graduate of Appalachian State University in Boone, NC and Life University in Atlanta Ga.  Contact the office at 301-378-0334 to schedule a consultation or exam.