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February 9, 2010
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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).



Next: Going off steroids »

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  • prednisone, Deltasone, Liquid Pred - Defines the medication prednisone (Deltasone, Liquid Pred) a drug used for suppressing the immune system and inflammation. Article includes descriptions, uses, drug interaction, and side effects.
  • Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
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Steroid Drug Withdrawal

Unusual symptoms of asthma

Patients suffering from episodes of asthma do not always have the typical symptoms of asthma such as shortness of breath, chest tightness, and wheezing (symptoms of airway narrowing). Instead, patients can have symptoms that may not appear to be related to asthma. These "unusual" asthma symptoms include

  • rapid breathing,
  • sighing,
  • fatigue and inability to exercise properly,
  • difficulty sleeping,
  • anxiety and difficulty concentrating,
  • chronic cough without wheezing,
  • protracted cough after an upper respiratory illness,
  • recurrent diagnosis of walking pneumonia, and
  • noises emanating from the chest usual during exhalation.

To complicate matters, symptoms of asthma are not consistent and often vary from time to time in an individual. In some patients, symptoms are influenced by diurnal factor...

Read the Asthma Complexities article »











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