Oral Corticosteroids: Dos And Don’ts To Follow


Corticosteroids are powerful anti-inflammatory drugs which are used to provide symptomatic relief from inflammation, swelling, redness, and itching. These medicines are prescribed to treat a wide range of conditions such as asthma, allergies, various skin problems, and certain systemic diseases including kidney problems and arthritis. They are also used to manage potentially life-threatening illnesses such as autoimmune disorders and cancer.

However, if you are taking any of these medications or have been prescribed these by your doctor, there are few dos and don’ts you need to follow. Dr. Pradip Shah, General Physician, Fortis Hospital, Mumbai reveals a few important things you need to keep in mind while taking oral corticosteroids.

1. Limit your salt intake

Corticosteroids play a key role in regulating the fluid and electrolyte balance. Use of these drugs can promote water retention, which in turn can lead to salt retention. Excess accumulation of salt and water can cause swelling of the face and feet in few patients and lead to slight weight gain. Moreover, these drugs can also put pressure on the heart.

Hence, it is wise to keep a tab on your salt intake to lower the risk of complications associated with corticosteroids. This includes the use of table salt in cooking and other hidden sources of salt such as processed foods, soy sauce, and bread, which may be high in sodium. Here are 5 Simple Tips To Reduce Salt In Food.

2. Control your hunger pangs

It is been reported that people who are on corticosteroids feel hungry all the time. Some people even wake up in the middle of the night to satiate their hunger. The constant hunger coupled with metabolic issues and fat distribution can also lead to weight gain.

Hence, it is advised to stay away from foods such as fries and processed food which satiate your hunger only for some time. Instead, opt for foods rich in complex carbs such as whole grains, beans, oats, and load up your intake of proteins which will not only fill you up but can also curb your hunger pangs. 

3. Monitor your blood glucose and blood pressure level

Corticosteroids can increase blood glucose and raise blood pressure in people who are suffering from diabetes and hypertension respectively. You may need to increase the dose of blood pressure medications or blood sugar medication if you are on corticosteroids. So talk to your doctor beforehand if you suffer from hypertension or diabetes and are advised to take corticosteroids for any clinical condition.

Hence, it is important to monitor blood glucose and blood pressure regularly if you are on steroids. Also, ensure you follow diet and lifestyle modifications advised by your doctor to control diabetes and hypertension.

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4. Watch out for any signs of infections

Corticosteroids help you to reduce inflammation by impairing the immune function. This means that if you are on these medications, your immune system is compromised or less efficient to fight infections. Hence, it is important to watch out for any signs of infections as the body might fail to initiate an immune response and make you more vulnerable to acquiring infections. This can further worsen your condition.

5. Maintain strict personal hygiene and sanitation

People using corticosteroids have compromised immunity, which means they are highly vulnerable to infections. This is the reason why people on these medicines are advised to follow strict guidelines to maintain personal hygiene and sanitation. This includes drinking filtered water which means carrying water from home, keeping your nose and mouth covered, and avoiding close contact with people who are sick to stave off infections.

6. Go for regular bone density measurement

If you have been using steroids for a long time, then it is important to go for regular bone density scans. This is because corticosteroids can cause loss of bone density, which can lead to weak bones and increase the risk of fractures. Hence, it is advised to increase your intake of foods rich in calcium and Vitamin D. If food sources fail to fulfill the requirement, then use of calcium and Vitamin D supplements is recommended.

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7. Don’t take steroids without asking your doctor

Last but most important point to bear in mind is to never take corticosteroids on your own. Never assume that the dose of corticosteroids will be the same as that you had last time or what your friend or family member is prescribed. The dose has to be adjusted based on the individual symptoms and condition which means not to take corticosteroids without visiting your doctor. Also, do not take any higher or lower doses of these medications without asking your doctor. Follow your doctor’s recommendations clearly. Never stop corticosteroids suddenly, especially if you have been prescribed it for a long time. Also, never start a new course of the drug without consulting your doctor.

In addition to these points, there are some of the frequently asked questions (FAQs) about corticosteroids everyone should know the answers for.

How do oral corticosteroids work?

Corticosteroids are synthetic drugs which are closely related to the hormone cortisol. This hormone is naturally produced by the body when under stress and hence, it is also known as the stress hormone. These drugs work by blocking the activity of certain chemicals which cause inflammation. Hence, it reduces inflammation and also reduces the activity of the immune system, thereby providing relief.

Are corticosteroids and steroids the same?

Corticosteroids are commonly known as steroids. However, some people often misunderstand steroids as anabolic steroids which are used to boost strength and physical performance. Anabolic steroids are mostly used to gain weight and are not the same as steroids, which are medicines used to treat inflammation.

Do corticosteroids make you gain weight?

Weight gain is one of the common side-effects of corticosteroids. This is because corticosteroids make you hungry, lead to fat deposition in the abdomen, face, and neck; and cause fluid retention, all of which can cause a shift in your weight. Moreover, the higher the dose and the longer the treatment, the more likely you are to put on weight.

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What are the side-effects of corticosteroids?

The common side-effects of corticosteroids, when used for a short time, include an increase in appetite, fluid retention, weight gain, feeling anxious, insomnia, and gastric ulcer. When used for a long time, corticosteroids can cause high blood pressure, increase the risk of infections, fractures, muscle weakness, bruises, weight gain, and hematosis.

Can you buy oral corticosteroids over the counter (OTC)?

Oral corticosteroids should ALWAYS be taken only on prescription. It should never be taken OTC as it can lead to numerous side-effects and can damage the overall health. Moreover, the dose of the steroids need to be strictly monitored, so never share your steroids or start a new course of steroids without consulting your doctor. Never take these medicines because your friend or family member is taking them for similar symptoms.

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There are different therapies of corticosteroids such as an ultra shot one that requires just one dose or steroids which can be taken for three days or a week or six weeks or a year. In some cases, steroids can also be a part of maintenance therapy which might be life-long to manage certain conditions. The dosage depends on the types of steroids and the condition, so never buy steroids over the counter.

(The article is reviewed by Dr. Lalit Kanodia, General Physician)

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