What does a steroid do? Who need steroid?

​အောက်ဆုံးထိ ဆွဲကြည့်​​ပေးကြပါ ခင်ဗျာ

What are steroids?

Steroids are a man-made version of chemicals, known as hormones, that are made naturally in the human body. Steroids are designed to act like these hormones to reduce inflammation.

They’re also known as corticosteroids and are different to anabolic steroids used by bodybuilders and athletes.

Steroids won’t cure your condition, but they’re very good at reducing inflammation and will ease symptoms such as swelling, pain and stiffness.

Usually inflammation is the body’s natural reaction to infection or bacteria. Your immune system produces extra fluid to fight infections or bacteria, which causes swelling, redness and heat in the affected area. You might have noticed this if you have had a cut or wound on your skin.

In some conditions, such as rheumatoid arthritis, the immune system produces inflammation in the joints or other parts of the body by mistake, which can cause permanent damage if left untreated. Steroids can be used to reduce this immune reaction.

How do steroids work?

Steroids work by decreasing inflammation and reducing the activity of the immune system. Inflammation is a process in which the body’s white blood cells and chemicals can protect against infection and foreign substances such as bacteria and viruses. In certain diseases, however, the body’s defense system (immune system) doesn’t function properly. This might cause inflammation to work against the body’s tissues and cause damage. Signs of inflammation include:

• Redness.
• Warmth.
• Swelling.
• Pain.

Steroids reduce the production of chemicals that cause inflammation. This helps keep tissue damage as low as possible. Steroids also reduce the activity of the immune system by affecting the way white blood cells work.

How are steroids beneficial?

When inflammation threatens to damage critical body organs, steroids can be organ-saving and in many instances, lifesaving. For example, steroids may prevent the worsening of kidney inflammation, which could lead to kidney failure in people who have lupus or vasculitis. For these patients, steroid therapy might eliminate the need for kidney dialysis or transplantation.

Low doses of steroids might provide significant relief from pain and stiffness for people with rheumatoid arthritis. Short-term use of higher doses of steroids might help a person recover from a severe flare-up of arthritis.

Uses

Steroids can be taken in a number of ways for many different types of arthritis and related conditions, as shown in the table below.

How is the steroid taken?	What does it do?	What conditions is it used for?	What is a common name for this type?
By mouth – tablets, liquids, dissolvable tablets, also known as oral steroids	Reduces inflammation throughout the whole body.	Rheumatoid arthritis, lupus, gout, other types of inflammatory arthritis or autoimmune conditions.	prednisolone, betamethasone, dexamethasone
By injection – into a joint, muscle, the blood or spinal area	Reduces inflammation in the area of the body where the injection is given.	Rheumatoid arthritis, lupus, gout, other types of inflammatory arthritis or autoimmune conditions.	methylprednisolone, triamcinolone,hydrocortisone
By eye – as drops or ointments	Reduces inflammation in the eyes.	Uveitis	prednisolone
Applied to the skin as a cream or gel, also known as topical steroids	Reduces inflammation on the skin.	Psoriatic arthritis and psoriasis.	hydrocortisone, mometasone, betamethasone,clobetasol

Steroids are usually only given for a short time to quickly treat flare-ups of your condition. Depending on which condition you have and what dose you’re prescribed, you may notice an improvement in your symptoms within a few days.

How are they taken?

Steroids are taken in different ways, and the dosage may vary depending on the condition you have. The table below gives an idea of how often you might need to take steroids.

You should always take medication as prescribed by the person treating you.

Tablets, liquids and soluble tablets

• Usually once a day.
• Preferably in the morning.
• Either with or after food to prevent stomach problems.

Creams and gels

• Usually once or twice a day for a few weeks.
• Your doctor might suggest taking them less often but for a longer period.
• Should only be used on affected areas of the skin.

Eye drops and ointments

• May need to be taken regularly throughout the day.
• Usually one drop in each eye each time you take it.

You will be given the lowest possible dose for the shortest possible time, to reduce the risk of side effects. Your dose will probably be reduced gradually as your symptoms improve, or your doctor might suggest a weaker medication.

It’s important that you don’t stop taking steroids without speaking to the person treating you first.

If you’ve taken steroid tablets for more than a few days, they can cause side effects known as withdrawal symptoms if you stop suddenly. You might be given a small dose, known as a maintenance dose, for a long time to make sure your symptoms don’t return.

Side-effects and risks

The chance of side effects depends on the dose, type of steroid and length of treatment. Some side effects are more serious than others. Common side effects of systemic steroids include:

• Increased appetite.
• Weight gain.
• Changes in mood.
• Muscle weakness.
• Blurred vision.
• Increased growth of body hair.
• Easy bruising.
• Lower resistance to infection.
• Swollen, “puffy” face.
• Acne.
• Osteoporosis (bone weakening disease).
• Onset of, or worsening of, diabetes.
• Onset of, or worsening of, high blood pressure.
• Stomach irritation.
• Nervousness, restlessness.
• Difficulty sleeping.
• Cataracts or glaucoma.
• Water retention, swelling.

These side effects are the most common side effects. All possible side effects are not included. Always contact your doctor if you have questions about your personal situation.

Does everyone have side effects?

Not all patients will develop side effects. How often any side effect occurs varies from person to person.

If steroid use is brief (from a few days to a few weeks), it is possible that none of the listed side effects will occur. The side effects listed here generally do not occur when occasional steroid injections are given for arthritis, tendonitis or bursitis. However, if steroid use involves high doses and is prolonged (for a few months to several years), an increase in the number of side effects might occur. The prolonged use of high dose steroids is justified only for severe illnesses that represent serious risks to the patient.

How can the side effects of steroids be minimized?

To minimize the side effects of steroids, healthcare providers follow several guidelines:

• Use steroids only when necessary.
• Watch the patient closely to detect early signs of serious side effects.
• If possible, use local steroids for local problems.
• Use the smallest dose needed to control the disease.
• Reduce the dose gradually as long as the disease remains under control.
• Monitor blood pressure and blood sugar often and treat if necessary.
• Monitor bone density and prescribe medications and supplements to help bone health.

There are other ways to prevent certain side effects, and these need to be discussed individually with your healthcare provider.

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