With steroids, though, comes the possibility of side effects.
“High-dose steroids are used to speed recovery" after an MS flare-up, also known as a relapse, says Matthew McCoyd, MD, an assistant professor and residency program director of neurology at the Loyola University Medical System in Maywood, Illinois.
"Because of long-term complications like bruising, skin changes, and bone changes, we only use them for short periods of time, and it is rare to use them more than once or twice a year."
The steroids used for MS are known as corticosteroids, which mimic hormones in the body to interrupt inflammation. They're usually well-tolerated when given to treat an MS relapse, Dr. McCoyd says, and the dose is short-term.
Nonetheless, the medication still has side effects. Once you start to taper the drug, he says, most side effects will subside.
In the meantime, though, seven side effects to watch out for include:
Sleep problems: A steroid is often given intravenously at the start of a relapse, and you may be sent home to taper the dose using an oral steroid over several more days.
“One of the most common side effects from the initial high dose of steroid is sleep disturbance, ” McCoyd says.
You may notice trouble falling asleep and sleepiness or fatigue during the day. Ask your doctor whether a sleeping aid medication can be prescribed.
Upset stomach: According to the Multiple Sclerosis Society in the United Kingdom, you may notice a metallic taste in your mouth when you start the steroid treatment, and you might feel nauseated.
Mints can help with the metallic taste. Ask your doctor to suggest an over-the-counter antacid to help control indigestion and ease heartburn.
Mood disturbance: Being on a steroid can make you restless and agitated. “Agitation is a common symptom for some people, " McCoyd says.
Mood swings with steroid treatment can range from mild to serious. Be sure to tell your doctor if you have a history of depression, anxiety disorder, or bipolar disorder.
Weight gain: “Although some people may get nauseous, others find their appetite increases while on a steroid, ” McCoyd says.
Steroids also increase your body’s tendency to retain fluid, the National Multiple Sclerosis Society reports. You may notice some swelling in your ankles and a few more pounds when you get on the scale. While you're on a steroid, it's a good idea to follow a low-salt diet to cut down on fluid retention. You should also take care not to overeat.
Infection risk: One of the functions of a steroid is to turn down your body’s immune system, so you need to watch out for infections. “It is a good idea to do a blood and urine test to look for any sign of infection before starting treatment, ” McCoyd says. Make sure you avoid sick friends and family members. Let your doctor know about any fever, cough, sore throat, or other symptoms of infection. Also, the National MS Society says not to get any live vaccines until you are cleared by your doctor.
Elevated blood sugar: One of the most important adverse drug events caused by steroids is that they can increase blood sugar levels. This is not usually a problem unless you have diabetes. If you do have diabetes, you can expect a spike in blood sugar that will show up in your blood and urine sugar testing, the National MS Society says. People with diabetes need to keep their doctor updated on any changes in blood sugar during steroid treatment.
Pregnancy risks: Steroids taken during pregnancy may slow a baby’s growth after birth, according to the National MS Society. And in animals, steroids have been shown to cause birth defects. Steroids can also pass through breast milk and slow an infant’s growth, the society says.
“When the risks of steroids outweigh the benefits, you have the option of not using them, " McCoyd says. "We have this conversation with patients frequently." Recovery may take longer, but physical therapy and rest, without steroids, is an option to discuss with your doctor.