Corticosteroids are a family of drugs which include both the adrenal
steroid hormone cortisol (hydrocortisone) and synthetic drugs (prednisone
etc.) that are related to cortisol.
They are usually taken by mouth to treat autoimmune and inflammatory
diseases including asthma and other lung conditions, bursitis, skin
disorders, tendonitis, ulcerative colitis, etc. In addition, they are
used to treat severe allergic reactions and prevent rejection after
organ transplant. Inhaled by nose, they are used to treat symptoms of
seasonal allergies. They are often combined with antibiotics to treat
ear, eye and skin infections.
Partial list by type and brands include:
Beconase, Beclovent, Vancenase, Vanceril, QVAR
Decadron, Decadron Phosphate Turbinaire, etc.
Cutivate, Flonase, Flovent, Advair
Cortef, Hytone, etc.
Deltasone, Orasone, etc.
Delta-Cortef, Pediapred, etc.
Aristocort, Azmacort, Nasacort, Etc.
Note: The side effects listed here are generalizations only, and
should be viewed as guidance only. You should consult your Primary
Care Provider and your Pharmacist for the side effects for any
specific drug which you are using, since each has different specific
In general, the Corticosteroids may possibly cause dizziness,
nausea, indigestion, increased appetite, weight gain, osteoporosis,
edema, bruising, slow healing, headaches, convulsions, acne, rash,
psychic disorders (steroid psychosis, weakness or sleep
disturbances. In addition, the use of certain corticosteroids may
mask the signs and symptoms of infection.
As a general rule, the inhaled Corticosteroids have less severe
Note: See the 5 interaction categories below for additional
information on side effects.
Interactions -- Dietary Supplements:
Folic Acid - Some possible loss of this B Vitamin with
corticosteroid use. Folic acid plays a role in cell division, and
can reduce the risks of heart attacks and birth defects.
Magnesium - The loss of this essential nutrient mineral with
corticosteroid use may be increased. Muscle relaxation, blood
clotting, and the manufacture of ATP (the body's main energy module)
may be effected. Some nutritional doctors suggest 3-400 mg of
magnesium daily for long term use (over two weeks).
N-Acetyl CySteine (NAC)
- one study indicated further
improvement with 600mg - 3 times daily with prednisone for treatment
of fibrosing alveolitis, a rare lung disease.
- Some possible increased loss in urine with
corticosteroid use. This mineral plays a role in sodium balance,
plus blood pressure control and hypertension. Since the loss is not
significant for most people, it can usually be offset by using more
potassium rich fruits, such as bananas. NOTE: Diuretic use
combined with corticosteroid use may aggravate this loss
considerably. Consult your health care provider for guidance
Vitamin A - Corticosteroid use often results in impaired
wound healing. One study indicated that 80% of the people treated
with vitamin A had improved wound healing capabilities. Since
theoretically, Vitamin A might also reverse some of the benefits of
corticosteroids, definitely consult with your health care provider
before starting Vitamin A supplements.
Vitamin B-6 Some possible increased loss is possible with
corticosteroid use. This vitamin's principal uses are heart disease
prevention, morning sickness, asthma and PMS. Some nutritional
Doctors recommend 25-50mg daily replacement to prevent deficiency
if using corticosteroids for long term (over 2 weeks).
Vitamin B-12 - Some increased loss is possible with
corticosteroid use. The principal use is for pernicious anemia, with
lesser possible influence for infertility, asthma, diabetic
neuropathy, MS, depression, and osteoporosis. Also possibly needed
for potassium deficiency. Consult your health care provider for
guidance regarding this.
Calcium and Vitamin D - There is a reduction in the body's
ability to activate Vitamin D when taking corticosteroids, thus
increasing the risk of bone loss as well as cataracts. The list of
other possible benefits of Calcium and Vitamin D is extensive
ranging from cancer prevention to heart disease to mental
conditions. People taking corticosteroids on a long term basis (2 or
more weeks) should ask their health care provider to be tested for
vitamin D deficiency and to possibly be put on calcium and vitamin
D supplements. Note: Calcium is an essential nutrient that is
obtainable only from foods and supplements.
Dehydroepiandrosterone (DHEA) - Some studies have
indicated that inhaled steroids (beclomethasone) may reduce levels
of DHEA in women. This may provide a possible clue to a contributing
factor to osteoporosis, but this needs much more research.
Melatonin - Further research is needed (especially for
long term use), however, early indications are that a high
percentage of people show a reduction in the production of melatonin.
Selenium - -Corticosteroids may cause some possible loss
of this trace mineral which has antioxidant implications.
Sodium - - Corticosteroid use causes sodium retention in
the body. Consult your health care provider for guidance regarding
the restricting of salt intake.
Zinc - - - -Corticosteroids may cause some possible loss
of this important element which supports the functioning of over 300
Other Information - Corticosteroids increase the urinary loss of
Vitamin K and Vitamin C. Although the significance of this is
unclear, you should consult your Health Care Provider about these
if you are taking corticosteroids for 2 or more weeks.
Interactions -- Herbs
Aloe (aloe-vera) - When applied along with cortisone there
have been anti-inflammatory benefits according to early animal
Digitalis (digitalis purpurea) - This herb, from the
foxglove family of herbs, has similar characteristics to the
commercial drug digitalis. This use might increase the possibility
of side effects from the use of corticosteroids.
Ephedra sinica (Ma Huang) - People taking Dexamethasone
should avoid edephra and products containing ephedrine, since it
increases the clearance of the drug from the body, decreasing its
effectiveness. Consult your health Care provider on any use of
Licorice (Glycyrrhiza glabra) - Licorice has been shown to
reduce the clearance of prednisone from the body of test animals. If
this occurs with people, it will result in lengthening and possible
strengthening of the drug's activity, as well as a possible increase
in side effects.
Indications are that it might prevent the immunosuppressive
actions of cortizone.
It has been shown to increase the activity of hydrocortisone
when applied topically.
Consult your health Care provider before taking Licorice with
Interactions -- Foods - Corticosteroid can cause
stomach upset and should be taken with food.
Interactions -- Protein - Doctors often ee a high protein
diet for people taking corticosteroids to offset the protein wasting
side effects. Since there is some possible link between high protein
diets and some other medical conditions, you should consult your health
care provider before starting a high protein diet.
Interactions -- Alcohol - Corticosteroid use can cause stomach
irritation, which can be aggravated with alcohol use.
This is provided as an information resource only, with the goal of
helping to provide you with the knowledge to help you make more
informed choices and to help you work more effectively with your primary
health care provider. Nothing can replace the knowledge and services of
a qualified health-care provider, however, you can and should be
empowered though knowledge to have a major role in the selection of
medical treatment options.
The data as presented in the various forums has been collected from a
wide range of resources. This information is provided as a starting
point for assisting you in gaining the desired knowledge. All
information provided should be discussed with a qualified health care
professional before any remedy or therapy is started.