Glucocorticoid steroids include natural and synthetic substances that affect most cells in the body. Manufactured in the adrenal gland, natural glucocorticoids include the stress hormone cortisol. Synthetic steroids such as triamcinolone can be applied directly to the skin. Corticosteroids can also be injected subcutaneously or taken orally. These chemicals play an important role in health and disease, yet they may cause adverse reactions.
Sugar Levels
Natural corticosteroids provide chemical communication between the adrenal gland and the pancreas to ensure proper levels of blood sugar. The addition of synthetic steroids can alter this natural balance. An experiment described in the journal "Arquivos Brasileiros de Cardiologia" looked at glucose regulation in rats given dexamethasone. This commonly prescribed drug reduces inflammation. Dexamethasone administration caused higher sugar levels and lower glucose tolerance. Aerobic exercise, however, reversed these effects. These data indicate that chronic use of glucocorticoid steroids must include effective countermeasures.
Skin Thinning
Inhaled corticosteroids effectively treat breathing problems like asthma. Such treatment, though, often causes adverse reactions. An investigation presented in the periodical "Pediatric Research" tested the drug budesonide in asthmatic children. Budesonide enhanced breathing, but it also caused dermal thinning. Less resistant to injury, thin skin is also slower to heal and more susceptible to infection. Fortunately, periodic and lower doses of budesonide effectively countered these changes. Thus individual dosing protocols must be established for children using glucocorticoid steroids.
Bone Resorption
Glucocorticoid administration may affect bone content and resorption. A study published in the journal "Clinical and Experimental Dermatology" evaluated bone resorption in male and female patients using corticosteroids for dermatological problems. Oral intake of glucocorticoids increased bone breakdown after only one year of use. Women showed more drug-induced resorption than men. Etidronate, a bisphosphonate which prevents excessive resorption, reversed this breakdown. These results suggest that combining corticosteroid therapies with bisphosphonate drugs ensures proper bone health.
Eye Damage
Adrenal steroid use affects the perceptual system as well. A review by D. F. Kiernan and W. F. Mieler, published in the journal "Expert Opinion on Pharmacotherapy," describes the role intraocular corticosteroids may play in treating many eye-related diseases. Such positive use, however, can have negative effects. For example, even short-term treatment of eye problems with intraocular steroids may cause cataracts and glaucoma. Thus more data are needed before such therapies can be considered safe.
Sleep and Alertness
Corticosteroid intake also alters physiological processes which involve multiple glands and organs. A study offered in the medical journal "Cancer" investigated the effects of dexamethasone on nighttime sleep and daytime alertness. This experiment looked at drug-induced changes in the fatigue scores of pediatric cancer patients. The corticosteroid negatively impacted the sleep and alertness of most children. Nighttime sleeping decreased, daytime napping increased, and fatigue scores climbed during dexamethasone treatment. Although effective, glucocorticoid steroids must be used carefully to prevent such adverse reactions.
References
- SciELO: "Arquivos Brasileiros de Cardiologia": Exercise Prevents Cardiometabolic Alterations Induced by Chronic Use of Glucocorticoids
- "Pediatric Research"; Skin Thickness in Children Treated With Daily or Periodical Inhaled Budesonide for Mild Persistent Asthma. The Helsinki Early Intervention Childhood Asthma Study; M. Turpeinen et al.; February 2010
- "Clinical and Experimental Dermatology"; Preliminary Study of Etidronate for Prevention of Corticosteroid-Induced Osteoporosis Caused by Oral Glucocorticoid Therapy; F. Furukawa et al.; May 20, 2010
- "Expert Opinion on Pharmacotherapy"; Use of Intraocular Corticosteroids; D. F. Kiernan et al.; October 2009
- Wiley InterScience: "Cancer": Dexamethasone Alters Sleep and Fatigue in Pediatric Patients With Acute Lymphoblastic Leukemia
