Prednisone is a catabolic, prescription steroid medication. Usually used to suppress an overactive immune system or decrease inflammation, prednisone is used in treating diseases such as asthma, allergic reactions, autoimmune disorders and some cancers among many other disorders.
As a catabolic steroid, prednisone contributes to the break down of body tissues like muscle and bone. This distinguishes it from the muscle-building anabolic steroids that athletes use.
Because the immune system is suppressed, increased risk of infection will always be a possible complication of use. Other issues, side effects and complications exist and are increased when the daily dose of prednisone exceeds 10 mg or it is taken for longer than two to three weeks.
Osteoporosis occurs from prednisone after long-term use. Prednisone reduces the absorption of calcium, causing bones to lose density and strenth. Bone density scanning should be done on anyone who is using long-term prednisone. Often, osteoporosis is discovered only after a fracture that results from a minor injury that normally wouldn't lead to a broken bone.
Prednisone causes changes in the way your body metabolizes and uses glucose. As a result, high blood sugar levels and glucose intolerance can occur. Occasionally, glucose levels become high enough to require treatment with diabetes medicines.
In the short term, weight gain results from sodium and water retention. Over time, fat accumulation occurs from the metabolic and hormonal changes induced by prednisone. Fat accumulation in some people is concentrated around the face and neck, top of the back and the abdomen.
Prednisone can cause behavioral changes up to and including psychosis. More commonly, insomnia, euphoria and mania affect some patients. Mood swings and short-term memory loss are also frequently reported.
Severe psychiatric complications develop in over 5% of patients, but about one-third report more mild disturbances in mood or mental state.
The adrenal glands are normally responsible for making the body's corticosteroids. If you take steroids from an external source, the adrenals make less of their own. When prednisone is stopped, the adrenals may still be suppressed. This can result in life-threatening low blood pressure. For this reason, prednisone should never be suddenly stopped. Anyone taking prednisone for more than a week or two should have their dose carefully and gradually tapered.
While there is no doubt that prednisone is a life-saving drug, the number of likely and possible side effects probably approaches one hundred items. Some of these are merely annoying and others are life-threatening.
This summary is by no means a comprehensive list of possible problems with prednisone. These items are just a representative sample of the types of issues that can arise with this powerful medicine.
If your doctor has prescribed prednisone, be aware that there are potential issues. Short courses over a week often don't cause significant problems or require a taper to stop, but always follow the instructions of your health care provider.
If you need to be on prednisone for a longer period of time, you and your doctor will discuss the risks and benefits of such treatment. Your doctor will continue to monitor your use with blood tests and other studies as needed.
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