Prednizone side effects

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The adrenal glands manufacture glucocorticoids (steroids). Glucocorticoids are responsible for a number of functions including maintenance of blood pressure, metabolism of sugar, protein, and fat, response to stress, and many other tasks.

Glucocorticoids manufacture by the body are referred to as endogenous steroids- meaning the body makes these steroids.

When steroids are taken in from the outside either by mouth, intramuscularly or intravenously, they are referred to as exogenous steroids. Taking glucocorticoids orally or intravenously can reduce the ability of the person’s own adrenal glands to manufacture glucocorticoids.

Without the ability to increase steroid production in the face of stressors such as injury, infection, and surgery, a patient can go into shock.

The chances of the adrenal glands being suppressed increase as the dose of “outside” steroid exceeds the average daily equivalent output of the adrenal glands which is about 5.0-7.5 mg prednisone, therapy continues for more than a few weeks or months, doses are given late in the day or in split doses, or long-acting corticosteroid preparations are used.

Taking steroids on an alternate day (every other day) schedule lessens the chance of adrenal insufficiency but does not eliminate it.

Other side-effects include:

• Increased risk of bacterial or opportunistic infections such as fungi, tuberculosis, pneumocystis carinii
• Elevated blood sugar
• Fat distribution changes leading to moon face, buffalo hump
• Elevated blood lipids
• Aggravation of hypertension
• Electrolyte abnormalities such as low blood potassium
• Fluid retention leading to edema
• Easy bruisibility
• Increased body hair
• Increased sweating
• Purple stretch marks (called "striae")
• Impaired wound healing
• Glaucoma
• Cataracts
• Muscle wasting
• Stomach ulcers
• Pancreatitis
• Atherosclerosis
• Osteonecrosis (bone death)
• Psychosis
• Insomnia
• Bowel perforation
• Masking of infection

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