Corticosteroids, also known simply as steroids constitute an important group of drugs used for a number of diseases especially of immunological or allergic origin. They are used to suppress immune responses of the body in these conditions. For the same reason, they are required in patients with transplantation of organs.

Unfortunately, steroids are commonly misused for conditions for which they are not required. On the other hand, some patients tend to avoid their use when they are required. Problems are likely to arise in both situations.

Steroids are natural hormones produced in the body by adrenal (also known as supra-renal) glands. There are three types of steroid hormones produced by adrenal cortex:

  • Mineralocorticoids
  • Glucocorticoids
  • Sex-hormones

Steroids used for treatment of diseases are the synthetic drugs based on the chemical structure of natural hormones.

Short-term use of steroidal drugs is generally required for acute, severe attacks of asthma, acute worsening of chronic obstructive pulmonary disease (COPD), acute allergic reactions of skin and eyes, drug reactions, insect bites and several other disorders. Longer use may be needed for interstitial lung diseases, rheumatoid arthritis and other connective tissue diseases, certain types of eczema, urticarial and eye diseases, etc.

Steroids are also required for local use for skin and eye problems as creams, ointments and drops. For asthma and other respiratory problems they are frequently required as inhalers for their local action in the respiratory tract.  Local use is generally safe though minor local problems may sometimes occur.

Importantly, steroids should never be used without advice and prescription of your qualified doctor.

One should always know about their use whenever they are required for longer periods. Long-term use can produce several side-effects and other problems which should be adequately monitored. Following complications may occur:

  • Gastro-oesophageal reflux: Acidity, heart-burn and abdominal discomfort.
  • Facial swelling; later swelling over feet and abdomen.
  • Worsening of blood pressure.
  • Worsening of blood sugar levels and diabetes control.
  • Weakening of bones due to calcium depletion.
  • Gain in weight due to increased appetite and fluid retention.
  • Redistribution of body fat over the back of neck and abdomen; early cataract in the eyes, other eye problems; acne over face and other parts of body.

There are some other side effects as well, but relatively uncommon.

It is important to know that steroids, when medically indicated need not be avoided. Side-effects should be monitored and controlled with supplementary drugs. Other corrective steps may be required in some cases which should be undertaken on advice of your consultant.

The misuse of steroids is common especially by medical quacks who add the steroidal drugs in every prescription. Some such quacks are known to dispense steroids as unlabelled tablets or powders. This is a highly risky proposition. It must be avoided at all costs.