What are the potential short-term and long-term side effects of oral steroid usage?

After oral steroid usage, it is possible to experience such adverse short-term effects as increased appetite, tissue fluid accumulation, mood swings, pimples, difficulties with sleeping, and elevated blood pressure caused by the rapid hormone changes inside the body. 

The potential long-term effects are more serious and potentially irreversible bone loss, abnormality in metabolism, and weakening of the immune system- which is not as easy to cure as the short-term effects. 

Furthermore, gastrointestinal complications, cardiovascular impacts, endocrine disruption side effects, and musculoskeletal health problems such as muscle weakness and bone density loss are probably common, so before you start oral steroid therapy, you should be cautious about the risks and benefits.

Short-Term Side Effects of Oral Steroid Usage:

These acute side effects of oral steroid usage do arise immediately after the dosage starts and it may lead to weight gain, oedema, and to some mood swings. It is a hormonal imbalance that most of their effects can be attributed to, which happens to be a result of the fast switching of hormone levels in the body and the increase in the production of cortisol and testosterone levels. 

Other than the typical short-term side effects such as acne, insomnia, and an increase in blood pressure are another kind of effects. Though these effects in the majority of cases tend to be well tolerated and not permanent, they can make the user strikingly uncomfortable in the high doses or when the usage is prolonged.

Long-Term Side Effects of Oral Steroid Use:

Long-term steroid therapy can be associated not only with immediate but also with late side effects that can be worse, and sometimes difficult to heal. Such causes could be subtle and affect various organ systems, including the metabolic, cardiovascular, or respiratory systems. 

• how long do oral steroids take to work?

Some of the worst long-term implications of steroid usage are osteoporosis and low bone density. Hence broken bones become more common in the affected individuals. Lengthening use of steroids can also cause metabolism disorder, which results in insulin and a high risk of diabetes. On the other hand by long-term steroid consumption, the immune system is suppressed and the risk of infection growth and the healing processes may be delayed.

Gastrointestinal Effects:

Oral medications with steroids often irritate the stomach and intestines, and subsequently, these steroids can induce gastrointestinal side effects like nausea, vomiting and dyspepsia (indigestion). The solidly common side effects are from specific steroid formulations, most of all those which have a higher chance of leading to the acidity of the stomach. In the worst case, steroid usage may have the risk of growing peptic ulcers or gastrointestinal bleeding. The patients taking oral steroids are advised to take them along with food, if any, or to divide the dosage into small parts to ease the way for the steroid to the gastrointestinal system.

Cardiovascular:

Accordingly, being on oral anabolic steroids is closely linked with cardiovascular adverse effects, such as hypertension (high blood pressure), dyslipidemia (abnormal lipid levels), and the increased risk of cardiovascular events like heart-stroke attacks. These adverse effects could be associated with such factors as lipid metabolism altering, the creation of oedema and dysfunction of blood vessels. Those with prior cardiovascular conditions or predisposing factors are prone to adverse reactions. Monitoring blood pressure, lipids levels, and cardiovascular health is one of the major issues connected to patients undertaking continuous oral steroid therapy.

Cardiovascular Effects:

Those participating in oral anabolic steroids experience cardiovascular complications like hypertension (increase in blood pressure), dyslipidemia (abnormal lipid levels build-up), and heart strokes since this is mostly the case. These terrible consequences have probably taken place due to the following reasons, i.e. -interrupting lipid metabolism, triggering oedema and blood vessels’ dysfunction. Individuals with existing cardiovascular disease or conditions which could trigger unwanted consequences are more likely at risk. Staying on top of the ways blood pressure, lipids levels, and cardiovascular health are affecting the patients is one of the things that has to do with using oral steroids for a long time.

Endocrine Effects:

Oral steroid use causes an imbalance in the body’s hormonal system, which is the core reason for many endocrine side effects. Impairment of the HPA axis—a system consisting of the hypothalamus, pituitary gland, and adrenal glands responsible for cortisol secretion—is also among the most frequently observed endocrine-related consequences. 

A prolonged administration of oral steroids may cause the adrenal glands to develop a decreased sensitivity to the secretion of cortisol that is normally released from the adrenal gland; thus, resulting in adrenal insufficiency after discontinuation of steroid therapy. Also, oral steroids are known to suppress the endogenous (body’s) hormonal production and can consequently lead to the symptoms of hypogonadism (low testosterone levels) in men and women. Other endocrine-related adverse reactions might include cycle interference, lower fertility in young patients and growth depression in paediatrics as well.

Musculoskeletal Effects:

Nevertheless, steroids like oral steroids are sometimes used for musculoskeletal conditions such as musculoskeletal inflammation and pain. However, there are also these side effects when administered to the musculoskeletal system. The beneficial effects of corticosteroids which are prolonged, are two-sided- muscle weakness and atrophy (muscle wasting) and they are more likely to get tendon injuries. This can be, for example, the consequence of the muscle tissue being broken down by steroids or of the insufficient process of collagen in the tendons. Another concerning aspect related to steroid use is long-term steroids are a well-known risk factor for osteoporosis (where the bones become weak and fracture risk increases). For patients who are on long-term oral steroid therapy, the doctors might prescribe supplemental calcium and vitamin D as well as a bone density test to prevent or successfully manage the risks associated with osteoporosis.

Psychological Effects:

Taking medicine in an oral form may result in mood and behaviour changes that ultimately cause a negative emotional impact, such as aggressiveness, fear of the future and even depression. While some of these effects may be worsened by the pharmacologic activities of steroids in the brain’s neurotransmitter systems, for instance, the serotonergic and dopaminergic pathways, others may be ameliorated by their actions. It is reported that mood instability is more likely if high doses of steroids are administered or promoted for longer use. Those symptoms may include temper changes and even some psychotic behaviour in the susceptible users. Patients using oral steroids should be continuously evaluated for mood changes or suicidal dysfunction, and therapy or special intervention is needed in case of long-term and serious psychiatric implications.

Immune System Effects:

When oral steroids are used rather to damp down the immune system in cases where autoimmune diseases and organ transplantation are encountered they can further affect the general immune function. Longer exposure to steroids will have the same effect on the immune system, increasing the possibility of infections and making the wound-healing process less efficient.

Frequently Asked Questions

1- What is the most common oral steroid?

The most well-known oral steroid is usually known as prednisone, which is widely used in the treatment of inflammatory conditions as well as its immunosuppressive properties.

2- Why would someone take oral steroids?

In addition, individuals may take oral steroids for different purposes, such as to reduce inflammation, suppress the immune systems (like in autoimmune disorders), treat allergies, and for part of cancer treatment among other uses.

3- What are the three main types of steroids?

Corticosteroids: They contain substitutes for the hormones your body’s adrenal glands normally produce. They blunt inflammation responses and modify immune reactions.

Anabolic steroids: Synthetic products of testosterone, they are used to acquire muscle and improve sports performance but it may be accompanied by considerable disadvantages.

Androgenic steroids: Generally we relate this with anabolic-androgenic steroids which are responsible for male traits and muscle mass growth.

4- What is the best oral steroid to take?

The “optimal” oral steroid for a patient can differ in his/her disease, additional conditions, and treatment objectives greatly. Prednisone is being used in a variety of places because of its effectiveness in treating a wide range of diseases but doctors should always advise the best alternative in line with the individual needs and circumstances.

Tim Head

all author posts