Side effects of cortisone

What side effects can cortisone cause?

The occurrence and severity of side effects depend on the type of illness and the duration and dosage of cortisone intake.

The side effects are usually closely linked to the actual function of the cortisone in the body. Therefore, when prescribing and taking medication containing cortisone, it must be clear that it is not just a drug, but also a hormone produced by the body. The intervention in the cortisone household will therefore in any case have an impact on important metabolic processes of the organism.

As a rule of thumb, the higher the dose taken and the longer the period of intake, the more sustainably the natural hormone balance is influenced.

Read more on the topic: Taper off cortisone

When taking low-dose cortisone preparations over a short period of time, no serious side effects are to be expected.In a few cases, patients report occasional headaches, but these are not definitely related to taking the drug. However, long-term overdose can cause serious problems and sequelae.
Some patients report side effects after prolonged high-dose use of cortisol that are very similar to symptoms of a condition called Cushing's syndrome. If long-term therapy is needed, reducing the daily dose may lower the risk of developing side effects .

The following symptoms can occur with long-term use:

• They often suffer from one high blood sugar levels, this can result in a Diabetes mellitus form.
• In addition, many of these patients have a severe immunodeficiency on.
• Also a high blood pressure can occur.
• In addition, the excessive cortisone content causes one Muscle wasting of the arms and legs With simultaneous fat accumulation in the area of ​​the body trunk, also Trunk obesity called. Also Water retention are possible.
• Also the appearance of osteoporosis and the Death (necrosis) of the bones, especially of the bones, is possible in the course of a long-term cortisone overdose.
• Another side effect is the Inhibition of the natural processes during blood clotting Patients often complain about one delayed blood clotting, poorer wound healing and the Occurrence of point-like hematomas the whole body.
• Furthermore, the intake of cortisone can be a severe increase in intraocular pressure (glaucoma) and or Lens opacities (Cataract) have as a consequence.
• Since the production of gastric mucus is restricted in the course of cortisone therapy, it often comes about stomach pain and Inflammation of the lining of the stomach.
• Psychological complaints how depressions, Loss of appetite and listlessness and euphoria are possible.

When using cortisone as ointment the following side effects are possible: delayed wound healing, Steroid acne (similar to normal acne), thinning skin.

Applied as Nasal spray or to inhalation can above all bacterial and Fungal infection the airways occur. It does this by inhibiting the Immune system in this area.

The taking of alcohol during treatment with cortisone increases the risk of side effects (see: Cortisone and alcohol - are they compatible?).

Side effect on the eye

Cortisone therapy can have side effects that affect the eye.
These are two very well-known and common clinical pictures, namely glaucoma and cataract.
Cataracts, also known as cataracts, are a clouding of the lens from which 39% of men and even 46% of women suffer from the age of 75. Cortisone therapy, whether topical or systemic, can lead to such cataracts. Ultimately, only cataract surgery can be considered to treat a cataract, as there are no conservative or medicinal treatment measures. The second clinical picture that can be favored by therapy with cortisone is glaucoma, which is also known as glaucoma.

Psychosis as a side effect

A common fear among patients in relation to cortisone therapy relates to the potential consequences of the therapy for the psyche. At the moment there are more and more questions on the subject of “cortisone and psychoses” in various forums.
It is known that as a rare side effect of therapy with cortisone, especially long-term, high-dose therapy, mood changes in the sense of a depressed or euphoric mood or even depressive symptoms can occur. However, it is questionable to what extent individual factors, risks or even previous mental illnesses also play an increased role in these cases.
In the case of psychoses, the current study situation is rather vague. There are rare cases of patients who have developed psychotic symptoms during high-dose, long-term therapy with cortisone. Most of the time, however, it was temporary dementia symptoms that have completely receded. Older people were also more often affected. Some studies also showed that only patients with a previous psychiatric illness in the sense of a psychotic disorder tended to develop a psychosis when they were treated with high-dose cortisone. It is therefore not safe to assume that cortisone was actually responsible for the psychoses.

Cushing Syndrome

Cushing's syndrome describes the symptomatic expression of an excess of cortisone (hypercortisolism) in the body. This creates typical symptoms that can be combined to form a syndrome.
The majority of Cushing's syndromes are caused by long-term therapy with cortisone. There are also so-called endogenous Cushing's syndromes, which are caused by hormone-producing tumors. Typical symptoms of Cushing's syndrome are trunk obesity with a bull's neck and a full moon face, osteoporosis, weakness due to a reduction in muscle mass, high blood pressure and thinning of the skin. Psychological changes such as depressive episodes or euphoria are also possible.

Read more on the topic: Cushing Syndrome

Redness or flushing as a side effect of cortisone

A short-term side effect of a cortisone injection can be a kind of flush. A flush is an attack-like reddening of the upper body and face. However, this side effect will go away in a short period of time and has no worrying effects or consequences.
Apart from a flush, redness in the sense of telangiectasia can occur. These are enlargements of very small blood vessels, so-called capillaries. These occur when cortisone is applied locally to the skin and are often irreversible.

Pimples / acne as a side effect

Both systemic and local therapy with cortisone can lead to so-called steroid acne.
However, it is far less common with local therapy than with systemic cortisone therapy. It is most commonly found in patients who are receiving long-term cortisone for the treatment of autoimmune diseases, after organ transplants, or for asthma. Typically, dark red papules that look like pimples appear on the back and shoulders, but also on the face. The classic comedones, which resemble a pimple with a black tip, develop later. If it is therapeutically justifiable, cortisone therapy can be reduced somewhat for treatment.
Often, however, cortisone cannot be dispensed with for the treatment of another disease, so that steroid acne is treated analogously to dermatological acne therapy.

Liver side effects

According to current studies, long-term, high-dose therapy with cortisone can have negative effects on the liver. The underlying mechanisms are not yet fully understood, but there is evidence that cortisone interferes with the lipid metabolism of the liver.
As a result, more fat deposits develop in the liver and the risk of steatosis hepatis, a fatty liver, increases. However, you can take action yourself to reduce the risk of fatty liver disease under cortisone therapy. A low-fat diet during cortisone therapy reduces the risk of fatty liver disease.

Sweating as a side effect

Increased sweating, high blood pressure and restlessness are among the symptoms that usually only occur with high-dose and long-term cortisone therapies. Women may be more sensitive to cortisone and occasionally experience increased sweating and hot flashes.
Overall, however, sweating is one of the rare and unpleasant, but not threatening, side effects of cortisone.

Water retention as a side effect

One possible side effect of cortisone is water retention in the tissue, which is also known as edema. Cortisone affects important channels in the kidney that are responsible for the reuptake of water and electrolytes.
Cortisone promotes the re-absorption of sodium and water into the body that would otherwise have been excreted in the urine. The water accumulates in the body tissue and causes edema. With short-term cortisone therapy, however, this effect is not so great and the edema is flushed out by itself after the cortisone is discontinued.

Increase in blood sugar as a side effect

Cortisone has a so-called diabetogenic effect. It affects the metabolism of fat and carbohydrates in the body in a number of ways and can thereby increase blood sugar. Important diabetogenic effects include the formation of glucose in the liver and the inhibition of insulin release.
With long-term cortisone therapy, diabetes mellitus can be caused even in a healthy person. However, this side effect is particularly relevant for people who are already suffering from diabetes, especially for patients with type I diabetes mellitus. The blood sugar is increased as a result of the therapy with cortisone, which means that larger amounts of insulin may have to be administered.
As a diabetic, one should consult the attending physician before starting cortisone therapy so that the medical diabetes therapy can be adjusted.

Side effects after stopping cortisone

Long-term cortisone therapy should never be ended abruptly, but always tapered off. Abrupt discontinuation of high-dose, long-term cortisone therapy can lead to symptoms of adrenal insufficiency.
The externally supplied cortisone inhibits the production of the body's own adrenal cortex, so that too few adrenal cortex hormones are available if the patient is stopped suddenly. Possible symptoms are a drop in blood pressure, tiredness, exhaustion, hunger for salt and weakness.
A so-called “Addison crisis” can even occur as a complication. The results are fever and drowsiness, vomiting, diarrhea and hypoglycaemia. Furthermore, it can lead to severe dehydration and an extreme drop in blood pressure up to shock.

Read more on the topic: Taper off cortisone

Duration of side effects

Cortisone often has a worse reputation among the population than it actually deserves. As a natural hormone, cortisone takes on many important tasks in the human organism; in the treatment of many diseases, cortisone has many positive effects. Relevant and serious side effects are usually rather rare and usually do not exist even with high-dose cortisone therapy.
If side effects occur, a distinction is made between the consequences of short-term and long-term therapy. The duration of the side effects cannot, however, be specified precisely in either case, since it is highly dependent on the individual patient, his underlying illnesses and the duration and dosage of the cortisone therapy.
As a rule, most of the side effects, such as infections, wound healing disorders or immunosuppression, are of short-term nature. The condition quickly returns to normal after discontinuation of therapy.
Some side effects can last longer. This includes the thinning of the skin (skin atrophy) with locally applied cortisone. This skin damage can even be irreversible, which is why cortisone preparations are used very carefully, especially in sensitive skin regions such as the face.
In the long term, it can also lead to Cushing's syndrome, which is associated with increased fat tissue on the face, torso and neck, a decrease in muscle mass and high blood pressure. These side effects are permanent and require medical attention. However, Cushing's syndrome only occurs with long-term and relatively high-dose cortisone therapy, which is usually required for the treatment of another underlying disease.

Another topic that might interest you would be the side effects of cortisone as a form of therapy in children.

Side effects on the intestines from cortisone?

Short-term therapy with cortisone has no side effects on the intestine.
The cortisone has no or no negative effects on the stomach or intestines. In the population, however, there is often concern about suffering a gastric or intestinal ulcer or even bleeding during cortisone therapy. However, cortisone therapy alone does not appear to increase the risk of ulcer or bleeding.
Only the joint use with so-called non-steroidal anti-rheumatics, which include ibuprofen, diclofenac and aspirin, increases the risk of a gastric or intestinal ulcer and the associated intestinal bleeding enormously, by a factor of around 10-15.
Therefore, one should avoid taking such drugs during cortisone therapy. Since these are also available over-the-counter and do not require a prescription, there is a great risk that doctors, when prescribing cortisone, are often not aware that their patients are taking such non-steroidal anti-inflammatory drugs. Therefore, you should always inform your doctor about all medications you have taken, including over-the-counter medication.

Can cortisone cause hair loss?

Hair loss is not one of the side effects that can be caused by therapy with cortisone.
In fact, the opposite effect can occur, namely so-called hypertrichosis. This is excessive hair growth. Cortisone is even often used to treat various forms of hair loss, such as inflammatory alopecia. Hair loss due to cortisone has not yet been scientifically proven.

Is Fatigue a Side Effect of Cortisone?

Fatigue or exhaustion are not the classic side effects of cortisone. Every now and then, however, you come across isolated reports on the Internet that report tiredness after cortisone shock therapy or injections. However, these are extremely rare and it is questionable whether the tiredness is not due to other factors.

Can cortisone cause tremors as a side effect?

An involuntary tremor or even a tremor is not due to the use of cortisone.
Possible side effects of cortisone, however, can be restlessness in the sense of euphoria or high blood pressure, if taken for a long time. As a result, those affected can feel “shaky”, restless and nervous overall. Sleep can also be disturbed by such complaints.
Slight hand tremors may be caused by these other side effects, which are also very rare. A real tremor in the sense of a motor side effect, on the other hand, is not to be expected from cortisone.

Colds from taking cortisone?

Cortisone is often used because of a desired immunosuppressive effect.
Basically, when treating various diseases, such as Crohn's disease, one would like to take advantage of the fact that cortisone dampens the immune system. In the case of autoimmune diseases, this plays an important role in the development of the disease and also attacks healthy, endogenous organs. As negative side effects, however, the person concerned becomes more susceptible to infections and therefore more infections such as colds can occur.

How can I reduce the side effects of cortisone?

Whether a therapy with cortisone leads to side effects depends not only on the duration of the therapy and the dosage of the cortisone, but also on the individual basic requirements of the patient receiving the cortisone.
Previous illnesses and predispositional factors can favor side effects. Additional medication with other drugs can also lead to increased side effects. Unfortunately, there are only a few points where you can influence whether or not there are side effects.
The following are important tips that can help to minimize side effects: 1. No alcohol during cortisone therapy: Alcohol should never be consumed if drug therapy is being used. Possible interactions and side effects are not foreseeable under the influence of alcohol.The risk of side effects increases with simultaneous alcohol consumption .; 2. No non-steroidal anti-inflammatory drugs during cortisone therapy: Cortisone is often suspected of promoting gastrointestinal bleeding and ulcers of the intestines or stomach. In fact, cortisone alone is not the problem, but the combination with so-called non-steroidal anti-inflammatory drugs. These include over-the-counter drugs like Aspirin® and ibuprofen. Diclofenac is also used very often. In combination with cortisone, the risk of gastrointestinal bleeding increases by a factor of 10 to 15.
3. Physical rest: Particularly with high-dose cortisone therapy, you should be careful not to exert yourself too much physically. This does not mean that bed rest has to be observed, but one should not necessarily run a marathon after high-dose cortisone injections. Above all, you should listen to your body feeling and give your body some rest if there are signs of malaise or the like.