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The Effects of Corticosteroids on the Adrenal Glands

Posted Dec 02 2008 12:00am
When I was 24, I was diagnosed with asthma. I was given a lot of different medications throughout the years, which included a multitude of various short-acting inhalers such as Albuterol, Proventil, Ventolin. Oral bronchodilators: Theo-Dur (theophylline). Long-acting bronchodilators: Serevent. And more recently, another oral inhaler: Advair. Having asthma made me more prone to lung infections and I've had many of those. Bouts of bronchitis and even bronchial pneumonia, were not that uncommon during the dry, cold winter or in times of severe stress. Each time I got really sick, my doctor put me on Prednisone- a drug I hated more than any other I have ever taken in my life. It did crazy things to me then, and now it seems likely that it continues in attacking my endocrine system. Luckily, I am almost asthma free, I rarely get an attack or experience symptoms...I now have another issue to deal with: Conn's Syndrome.

Prednisone is a corticosteroid, as are most of the above mentioned drugs. Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. They are involved in a wide range of physiologic systems such as stress response, carbohydrate metabolism, immune response, regulation of inflammation, protein catabolism, blood electrolyte levels, and behavior. While prednisone can be a great healing drug for many conditions, the side effects can be pretty heinous. The short term effects include: euphoria, insomnia, mood changes, personality changes, psychotic behavior, or severe depression, fluid retention and high blood pressure. The long term effects are: osteoporosis, diabetes, lowered sex drive, glaucoma and cataract formations, and adrenal glands problems such as Cushings Syndrome. Doctors do not recommend stopping the use of prednisone before seven days because it can have bad consequences such as bringing on symptoms of Addison's disease (another adrenal gland condition). Doses are reduced gradually over a few days with short term use and over a few weeks/months with long term use.

While Conn's has not been mentioned as a long term side effect, I still wonder if there is a correlation. There has been stress on my adrenal glands that's for sure. But I'm not a doctor and I don't know of all tricky terminology that would help explain my theory. I plan on asking my endo at our next appt. At this point, all I know is prednisone/corticosteroids help asthmatics like me everyday, and I am thankful for that. But sadly, after years of them being prescribed to me at the drop of a hat, I have to wonder if they are playing any role in my adrenal crisis.

Short Term Effects of Corticosteroids:
* Elevated pressure in the eyes (glaucoma)
* Fluid retention, causing swelling in your lower legs
* Increased blood pressure
* Mood swings
* Weight gain, with fat deposits in your abdomen, face and the back of your neck

Long Term Effects of Corticosteroids:
* Cataracts
* High blood sugar, which can trigger or worsen diabetes
* Increased risk of infections
* Loss of calcium from bones, which can lead to osteoporosis and fractures
* Menstrual irregularities
* Suppressed adrenal gland hormone production-such as Cushings Syndrome
* Thin skin, easy bruising and slower wound healing

1.20.09 Update:
My G.P. feels there is no relation to corticosteroids and Conn's. I'm not entirely convinced and plan on asking my endo for more info later.
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