William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Steroid withdrawal facts
- Synthetic medications simulate cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such (for example, ) have since benefited many, but are not without potential side effects.
- The two major problems related to continuous steroid treatment are:
- drug side effects and
- symptoms due to changes in the balance of normal hormone secretion (withdrawal symptoms).
- The production of corticosteroids is controlled by a "feedback mechanism, " involving the adrenal glands, the and brain. known as the "Hypothalamic-Pituitary-Adrenal Axis" (HPAA).
- Using large doses for a few days, or smaller doses for more than two weeks, leads to a prolonged decrease in HPAA function.
- Steroid use cannot be stopped abruptly; tapering the drug gives the adrenal glands time to return to their normal patterns of secretion.
- Withdrawal symptoms (, , , , , , , ) can mimic many other medical problems. Some may be life-threatening.
- Tapering may not completely prevent withdrawal symptoms. Steroid withdrawal may involve many factors, including a true physiological dependence on corticosteroids.
- Patients should carry a list of all your medications in your wallet to alert medical personnel in case of emergency.
- Supplementation with corticosteroid medication may be needed during periods of (such as surgery), even up to a year after stopping corticosteroid therapy.
Medically Reviewed by a Doctor on 2/9/2015