When is it ok to use steroids?

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Ask a person who would have died of an adverse drug reaction if not for steroids, what does S/he thinks of steroids. The answer would be, it is a boon.

Ask a man whose wife, suffering from arthritis and on long term steroid medication, dies due to a perforated bleeding peptic ulcer: what does he thinks of steroids. The answer would be – a curse. Steroids or anabolic steroids have been in the news for all the wrong reasons, especially with sports people and doping scandals. Most drugs used in sports are anabolic steroids or their derivatives.

Steroids are used in various forms: applied in cases of skin diseases, administered orally for arthritis, joint pains and inflammatory conditions, injectible for brain tumours or head injury, for inhalation as in cases of asthma, nasal mucosal inflammation, sinuses, airway, chronic lung diseases and so on.

In a layman’s mind, there is always a debate about pros and cons of steroids. Some of the important side-effects noted in literature include effects on endocrine glands causing insulin resistant diabetes, hypothyroidism and hypogonadism. Other adverse effects include osteoporosis, and aggravation of peptic ulcer disease. It is known to cause gastrointestinal bleeding. A major side-effect is, it decreases the immune reaction. To sum up:

Steroids if used judiciously have a great beneficial effect.

  • If the doctor is prescribing steroids then you must inform the physician of use of any other drugs / history of diabetes, any lingering infection which may flare up, or symptoms of ulcer disease like pain in upper abdomen, related to meals, history of vomiting, history of bleeding with vomiting or passing dark coloured stools .
  • In children, there are a few situations where steroids are advised. They have reduced the morbidity and mortality significantly in children afflicted with leukemia, asthma, rheumatic diseases, and other inflammatory disorders. However one needs to watch for side-effects like mood changes, increased hunger, problems falling or stay asleep, nightmares, acting withdrawn, weight gain, pain (such as muscle cramps), indigestion, growth of body hair and red/flushed cheeks.
  • As always, steroids like any other medicine, should never be used without being prescribed by a doctor.

About Mukul Saxena 33 Articles
Col (Retd) Dr Mukul Saxena has over 30 years of cross-functional expertise in healthcare, both in public and private sectors.