Steroid Withdrawal (cont.)
David S. Kaminstein, MD
Doctor Kaminstein is a Board Certified Gastroenterologist, who is presently not in active medical practice due to disability. Before disability, Dr. Kaminstein practiced Gastroenterology/Hepatology in West Chester, PA for over 15 years.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
Research conducted by Edward Calvin Kendall at the Mayo Clinic in the medical use of cortisone lead to a Nobel Prize in 1950. The drug simulated cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such corticosteroid drugs (prednisone, prednisolone, and others) have since benefited many, and are commonly used to treat many conditions including allergic reactions, asthma, rheumatoid arthritis, and inflammatory bowel disease. But they are not without serious drawbacks. The two major problems related to continuous, long-term steroid treatment are drug side effects and symptoms due to changes in the balance of normal hormone secretion. The latter typically results from taking doses greater than our body's natural production (about 7.5 mg of prednisone per day). Once we begin to decrease or discontinue the dose, however, withdrawal symptoms occur. Thus, steroids are typically given for the shortest possible time possible. Short-term steroid use is commonly without significant side effect, andis often a crucial treatment for a variety of issues, including allergies and asthma. Moreover, short-term use does not induce steroid withdrawal.
What are steroid withdrawal symptoms?
Steroid withdrawal symptoms can mimic many other medical problems. Weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea (which can lead to fluid and electrolyte abnormalities), and abdominal pain are common. Blood pressure can become too low, leading to dizziness or fainting. Blood sugar levels may drop. Women also may note menstrual changes. Less often, joint pain, muscle aches, fever, mental changes, or elevations of calcium may be noted. Decrease in gastrointestinal contractions can occur, leading to dilation of the intestine (ileus).
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