Corticosteroids, also called steroids, are a common weapon in the fight against lupus, along with other medications like nonsteroidal anti-inflammatories (NSAIDS), antimalarials and cytotoxic drugs. (For more information on these types of drugs, see "Drugs Are Good Medicine! Part I" and "DAGM Part II") Corticosteroids are actually hormonal drugs, mimicking the body's own adrenal gland function. However, the synthetic versions are much more powerful and are given in much higher doses than the body can produce on its own. (Corticosteroids are not the same as the anabolic steroids which feature so prominently in athletic scandals.)
Corticosteroids affect lupus because they suppress the immune system, reducing the risk and/or severity of flares and avoiding damage wreaked by the lupus patient's immune system attacking the kidneys, skin, blood vessels, etc. Unfortunately, these strong drugs have side effects and consequences that all lupus patients must discuss with their physicians before starting therapy.
With an immune system that is purposely stifled, the body is extremely vulnerable to any number of infections, such as strep throat, UTIs, or even a reactivated infection like herpes or TB. Great care must be taken to reduce the risk of these infections, so as to avoid any health complications and perhaps having to stop the therapy.
Some of the most common side effects of corticosteroids include:
- Increased appetite and weight gain
- GI irritation and ulcers
- Delayed wound healing
- Menstrual irregularities
- Hair growth, especially on arms, face and legs
- Fat deposits on face and upper body (Also called "moonface" and "buffalo hump")
- High blood pressure
- Osteoporosis
While high doses or long-term therapy increase the risk of side effects, stopping therapy too abruptly carries its own dangers. I can't stress this enough: NEVER stop taking any form of corticosteroids without discussing it with your physician first!
While you are taking corticosteroids, your body's adrenal gland, realizing that there are plenty of hormones around, stops making the usual amounts of cortisone that it usually does. If you stop taking those steroids suddenly, the adrenal gland won't have time to immediately start up and make enough to keep your body functioning and you can suffer acute adrenal insufficiency, a serious and potentially fatal development. If the steroids aren't weaned off slowly over a period of time, you run the risk of lupus flares or worsening symptoms. Additionally, if a person on long-term steroid therapy is going to undergo surgery or childbirth, or has any sort of trauma, they may need additional doses to compensate for the stress to the body.
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