Steroid Drug Withdrawal
Medical Author: David S. Kaminstein, MD, FACP, FACG
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
Introduction
Research conducted by Edward Calvin Kendall at the Mayo Clinic in the medical use of cortisone lead to a Nobel Prize in 1950. The drug simulated cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such corticosteroid drugs (prednisone, prednisolone, and others) have since benefited many, and are commonly used to treat many conditions including allergic reactions, asthma, rheumatoid arthritis, and
inflammatory bowel disease. But they are not without serious drawbacks. The two major problems related to continuous steroid treatment are drug side effects and symptoms due to changes in the balance of normal hormone secretion. The latter typically results from taking doses greater than our body's natural production (about 7.5 mg of prednisone per day). Thus, steroids are typically given for the shortest possible time possible. Once we begin to decrease or discontinue the dose, however, withdrawal symptoms may occur.
What are steroid withdrawal symptoms?
Steroid withdrawal symptoms can mimic many other medical problems.
Weakness,
fatigue, decreased appetite, weight loss,
nausea,
vomiting,
diarrhea
(which can lead to fluid and
electrolyte abnormalities), and
abdominal
pain are common. Blood pressure can
become too low,
leading to dizziness or fainting. Blood sugar levels may drop.
Women also
may note menstrual changes. Less often,
joint pain, muscle
aches, fever,
mental changes, or elevations of calcium may be noted. Decrease
in
gastrointestinal contractions can occur, leading to dilation of
the
intestine (ileus).
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