The major side effects of steroids vary depending on whether the type is a corticosteroid (used for inflammation and autoimmune diseases) or an anabolic steroid (used for muscle building), and the dosage and duration of use.
Common side effects
Patients on moderate to high doses of prednisone often notice that they bruise easily, even with only slight trauma. Pictured below is a patient with giant cell arteritis who suffered a skin laceration after she struck her leg against a chair.
Prednisone may cause gastrointestinal symptoms like: Nausea. Vomiting. Diarrhea.
Nausea, vomiting, or diarrhea. Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy" Trouble urinating, pain or burning, constant urge or frequent urination. Bloody, cloudy, or foul-smelling urine, or black, tarry stools.
Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor right away if you have blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.
Prednisone is usually detectable in blood for up to 22 hours, in urine for 24 to 36 hours, and in saliva for 12 to 24 hours. In hair follicles, its metabolites remain for up to 90 days. The drug is metabolized in the liver into prednisolone and excreted by the kidneys.
RESULTS: Steroids reduced the number of bowel movements by more than five times within one week and all patients reported improved subjective well-being at wk 1 and 4.
Side effects of oral corticosteroids: short-term use
Short-term use of OCS (about 3-5 days) can cause the following side effects: Weight gain, particularly in abdomen, face or neck. Eye problems. Muscle weakness.
Stay hydrated: Drinking lots of water and fluids helps support your kidneys as they flush out prednisone. Exercise: Physical activity helps support your metabolism and blood circulation. This helps your body process and eliminate drugs efficiently.
Skin atrophy typically presents as thin, shiny skin. Wrinkling of the skin and erythema may also be observed. In lighter skin tones, erythema presents as bright red, while darker skin tones appear more dark brown.
People with low levels of vitamin K may notice easy bruising. If you, your mom, and your sister all turn black and blue from the tiniest bump, it may be a family thing. Some people just have more fragile blood vessels, and that makes them more likely to bruise, especially on their upper arms, thighs, or butt.
How long is the immune system compromised after steroid injection? The immune system may be compromised shortly after a steroid injection, typically lasting a few days to a week. However, this can vary depending on factors such as the type and dosage of the steroid medication and individual health conditions.
Based on these findings we have something called as Rule of 2. If a patient consumed 20mg/day or more Cortisone or its equivalent, for a duration of 2 weeks or more, within 2 years then the dosage of the steroid medication should be doubled preoperatively.
Take steps to manage steroid side effects
The side effects of prednisone can also include losing touch with reality. For this reason, doctors may prescribe methylprednisolone to someone with a risk of mental health conditions instead of prednisone to reduce the risk of psychosis. Due to these side effects, doctors may avoid prescribing these corticosteroids.
Common short-term side effects include changes in appetite, mood, energy, and sleep. Long-term prednisone treatment can lead to weight gain, osteoporosis, and cataracts. Diarrhea isn't a side effect of prednisone. But other gastrointestinal symptoms are possible, like increased appetite and indigestion.
The amount of time it takes to taper off prednisone depends on the disease being treated, the dose and duration of use, and other medical considerations. A full recovery can take a week to several months.
Experts recommend taking a mild and safe over-the-counter sleep aid such as melatonin or chamomile if prednisone is causing sleep disruption or sleep deprivation.
And because long-term use of prednisone can lower the body's immune response, you may be at a higher risk for small intestinal bacterial overgrowth (SIBO), a condition that causes bacteria to overgrow in the gut, leading to symptoms like gas, diarrhea, weight loss, and nutritional deficiencies.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are your first-line defense when looking for prednisone alternatives. These medications work by blocking certain enzymes that cause pain and swelling. Common OTC NSAIDs include: Ibuprofen (Advil, Motrin) – Great for general inflammation and pain.
Many people enjoy the benefits of prednisone and other corticosteroids which are powerful anti-inflammatory drugs that can reduce pain and discomfort related to allergic reactions, arthritis, autoimmune conditions and more. In some cases, they even elevate mood, creating a sense of euphoria and excessive energy.
If you take oral corticosteroids for a long time, your adrenal glands may produce less of their natural steroid hormones. To give your adrenal glands time to recover this function, your provider may reduce your dose gradually.
You could go into steroid withdrawal, which can have severe symptoms. It's safer to taper off prednisone. Your doctor will gradually lower your dose. Tapering helps prevent withdrawal and stop your inflammation from coming back.
If you're taking prednisone to treat an acute condition or illness, you'll likely only need to take the medication for a few days or weeks. This is considered to be a short-term course. For chronic conditions, long-term use (30 days or longer) may be more appropriate.