What Conditions Are Treated With Steroids and Their Benefits?

Steroids are used to treat a variety of conditions in which the body's defense system malfunctions and causes tissue damage. Steroids are used as the main treatment for certain inflammatory conditions, such as systemic vasculitis (inflammation of blood vessels) and myositis (inflammation of muscle). They may also be used selectively to treat inflammatory conditions such as rheumatoid arthritis, lupus, Sjögren's syndrome, or gout.

What Are the Benefits of Steroids?

When inflammation threatens to damage critical body organs, steroids can be organ saving and, in many instances, life-saving. For example, they may help prevent the progression of kidney inflammation, which can lead to kidney failure in people who have lupus or vasculitis. For these people, steroid therapy may eliminate the need for kidney dialysis or transplant.

Low doses of steroids may provide significant relief from pain and stiffness for people with conditions including rheumatoid arthritis. Temporary use of higher doses of steroids may help a person recover from a severe flare-up of arthritis.

What Conditions Are Treated With Steroid Injections?

Steroids often are injected directly into joints to treat conditions such as rheumatoid arthritis, gout, or other inflammatory diseases. They also can be injected into an inflamed bursa or around tendons near most joints in the body.

Some people report relief from osteoarthritis when steroids are injected directly into swollen or painful joints.

What Are the Expected Benefits of Steroid Injections?

Steroid injections into a specific area are generally well tolerated and are less likely than other forms of steroid drugs to produce serious side effects. Also, the injections may help avoid the need for oral steroids or increased doses of oral steroids, which could have greater side effects.

What Role Do Steroid Injections Play in an Overall Treatment Program?

Steroid injections can be added to a treatment program that may already include anti-inflammatory pain medications (NSAIDs), physical therapy, occupational therapy, or supportive devices such as canes and braces. Whether one or more of these treatment methods are used depends on the nature of the problem.

For example, in an otherwise healthy person, tendinitis may be adequately treated with only a steroid injection into the inflamed area. However, in a person with rheumatoid arthritis, injections are generally a small part of a multifaceted treatment approach.

When Should Steroid Injections Not Be Used?

Steroids should not be injected when there is infection in the area to be targeted or even elsewhere in the body because they could inhibit the natural infection-fighting immune response. Also, if a joint is already severely destroyed, injections are not likely to provide any benefit.

If someone has a potential bleeding problem or is taking anticoagulants (often referred to as blood thinners), steroid injections may cause bleeding at the site. For these people, injections are given with caution.

Frequent steroid injections, more often than every three or four months, are not recommended because of an increased risk of weakening tissues in the treated area.

Anabolic steroids help people with HIV put on weight and muscle mass

People with HIV who are treated with anabolic steroids to prevent AIDS wasting may realize modest gains in weight and muscle mass.

The review covered 13 studies of adults age 24 to 42 with HIV, 294 of whom received anabolic steroids for at least six weeks and 238 of whom received placebo. The average weight increase in those taking anabolic steroids was nearly three pounds.

The magnitude of weight gain observed may be considered clinically relevant. One hopes there would be greater weight gain with the long-term use of anabolic steroids; however, this has not been proven to date in clinical trials.

AIDS wasting, which leads to significant weight loss in people with HIV, causes severe loss of weight and muscle and can lead to muscle weakness, organ failure and shortened lifespan. Researchers have long sought to reverse this common, destructive effect of HIV with mixed success.

The wasting stems from loss of the body’s ability to grow muscle and from low levels of testosterone.

Anabolic steroids are synthetic substances similar to the male sex hormone testosterone that promote growth of skeletal muscle and the development of male sexual characteristics.

Although most recently in the news for their misuse by professional athletes, anabolic steroids have legitimate medical application for men with low testosterone and people with certain types of anemia. Two anabolic steroids available in the United States, nandrolone decanoate and oxandrolone, have been used to help increase weight and muscle mass in small studies of people with wasting.

Conversely, anabolic steroid use has been associated with increased rates of HIV in those who share needles or use nonsterile needles when they inject steroids.
In the review studies, anabolic steroids were administered to patients either orally or by injection. The main side effects were mild and included abnormal liver function tests; acne; mild increase in body hair; breast tenderness; increased libido, aggressiveness and irritability; and mood swings — all common side effect of anabolic steroid use.

The risks and side effects of taking anabolic steroids long-term are certainly of concern.

HIV/AIDS program director at the Group Health Cooperative in Seattle, suggests that clinicians should obtain blood testosterone levels, if an HIV-infected individual has had significant weight loss, significant fatigue or muscle wasting, and particularly if associated with a significant decrease in libido and erections. If testosterone is in the low or low-normal range then a trial of steroids could be tried. The individual and the clinician should decide what result would constitute a successful trial: weight gain of 15 pounds, a 30 percent improvement in sense of well-being or a successful erection once a week.

The reviews authors conclude that further studies are needed to determine if increase in weight leads to improved physical functioning and quality of life, and ultimately increased survival, as well as the potential for serious side effects, especially with prolonged use.

Anabolic Steroid Side Effects

If you’re thinking of using anabolic steroids you need to understand there are possible anabolic steroid side effects you may have to deal with. As with all side-effects pertaining to all drugs, many of the side-effects of steroids are largely individually based, as well as based on your own education and understanding. Many of the possible steroid side-effects can be prevented, many can be reversed once use is discontinued but you need to have a grasp of not only the possible steroid side-effects but how anabolic steroids work as well. If this isn’t a topic you’re familiar with, referring to anabolic steroids in general, be sure to brush up and do a little digging once you’re through here and then come back and read it again. If you don’t understand how anabolic steroids work the side-effects of steroids are not going to make a lot of sense.

Frequent Anabolic Steroid Side-Effects

Many anabolic steroids aromatize and this can lead to a few unwelcome steroid side-effects; most notably Gynecomastia but it is within this aromatizing effect many experience unwanted water retention as well. Your best bet for combating this nasty steroid side-effect is through the use of an aromatase inhibitor during your cycle, as well as performing a proper post cycle therapy. Many anabolic steroid users escape the “Gyno” monster during their cycle only to have it knock down the wall after the cycle due to excess estrogen buildup. Make sure you use adequate medications such as Clomid or Nolva after your cycle to not only prevent these types of steroid side-effects but to implore proper recovery as well.

Other common steroid side-effects revolve around cholesterol and blood pressure. However, many times and by “Many” we mean most of the time these issues can be avoided by eating properly, as well as supplementing your diet with the necessary means of proper function. Almost all anabolic steroid users will experience a drop in their HDL cholesterol (Good Cholesterol) and like Gynecomastia this is avoidable or easily remedied. Many anabolic steroid users will find supplementing with fatty-acids to be their saving grace.

As it pertains to the side-effects of steroids and high blood pressure, more times than not this is due to oral anabolic steroid use; not always but more times than not. If you fall prey to this effect the solution is simple; stop using oral anabolics. If you have blood pressure issues without oral anabolic use then unfortunately anabolic steroid use may not be for you. It should also go without saying; if you suffer from high blood pressure before anabolic steroid use you should forgo use until the issue is under-control.

Testicular shrinkage is one of the steroid side-effects most are familiar with. When we take anabolic steroids our natural testosterone productions comes to a stop. Due to this shortage in production our testicles shrink; they have no reason not to. If this is a concern there isn’t a lot you can do about it if you choose to use anabolic steroids; it is one of the side-effects of steroids largely accepted as inevitable for the male user. That said, once use is discontinued and your natural testosterone production begins again, your testicles will return to their normal size.

Irreversible Steroid Side-Effects

With the possible side-effects of steroids we’ve discussed so far, all are avoidable or reversible but there are those that once they’re there, they’re there to stay. Perhaps the most common is that of hair-loss; if you are someone who was going to go bald anabolic steroid use can speed up the process and once you lose your hair, short of a transplant there’s no getting it back. However, if you are not susceptible to baldness, generally you are in the clear. The most prevalent irreversible side-effects of steroids fall within usage of female anabolic steroid users. While females are susceptible to many of the same steroid side-effects as men, they are also prone to some unique unto their own; such as dreaded masculine effects. These steroid side-effects are reversible if caught early on and if abuse is not implored but once they are allowed to set in, often there is not a lot that can be done.

When speaking of irreversible steroid side-effects we would be remised if we did not bring up Gynecomastia yet again. Although it is easily preventable, if it is allowed to set up shop and not dealt with then it is there to stay. If you reach this point the only way you can have it removed is to physically have it surgically removed.

The Side-Effects of Anabolic Steroids and Responsibility

When it comes down to the side-effects of steroids the end results will be up to you. Use, not abuse is the key. More often than not, horrific anabolic steroid side-effects are due to irresponsible individuals who not only abuse outright but further have no understanding or education behind anabolic steroid use. Understand one thing, although many of the steroid side-effects you hear of are blown out of proportion or are for a better word an outright lie, side-effects of steroids are real but they are also manageable and avoidable.

How do anabolic steroids interact with the immune system?

High doses of anabolic steroids reduce the amounts of immune globulin A, G, and M in the blood. These proteins, known medically as IgA, IgG, and IgM, are part of the body's humoral immune system. These antibodies that circulate in the bloodstream and attack invading bacteria. Having fewer of them may make a person more likely to develop a serious infection.

Steroid injection can carry many kinds of bacteria and viruses past the protective skin and into the blood, causing infection. The use of syringes without strict sanitary and sterile conditions
can transmit infectious hepatitis, a life-threatening disease. Needle-sharing can lead to AIDS and other blood-borne diseases. There are two documented cases of AIDS transmission traced to needle-sharing in the gym.

By contrast, anabolic steroids increase the activity of the natural killer cells. Another of the body's defenses against infection, natural killer cells are specialized white blood cells that attack specific viruses and bacteria and help to prevent tumor formation. Increased natural killer cell activity could be helpful to the body.
However, overactive natural killer cells could also attack the body's own tissues, leading to diseases that are known medically as "autoimmune diseases."

Do Anabolic Steroids Cause Fungal Meningitis?

The recent fungal meningitis outbreak has been linked to contaminated methylprednisolone acetate (MPA) injections produced by the New England Compounding Center (NECC). The contaminated corticosteroid injections have resulted in 590 cases and 37 deaths. It has been a tragedy for the families involved. For anti-steroid crusaders, it has simply provided another tool to unfairly demonize anabolic steroids.

Various news media and anti-steroid organizations have erroneously included the risk of fungal meningitis as a possible side effect of anabolic steroids.

The Bay County Sheriff’s Office (BCSO) is the most recent agency to add to the unwarranted hysteria among users of black market anabolic steroids.
BCSO Captain Faith Bell cited the NECC case as the reason BCSO investigators were concerned about fungal contamination according to WMBB-TV in Panama City, Florida.
Potential to spread the fungus and bacteria was our main concern. In this case, that people would be injecting this stuff and within a short window of time be dead.
Whether out of willful ignorance or careless fact-checking, the irresponsible statements by the BCSO has contributed to the societal hysteria regarding anabolic steroids.
The truth is that there is essentially zero risk of non-medical anabolic steroid users contracting fungal meningitis.
MPA is a synthetic corticosteroid and NOT an anabolic steroid.
MPA are introduced directly into the central nervous system (CNS) via epidural injections.
Anabolic steroids are introduced into the muscular system via intramuscular injections.
The risk of fungal meningitis is rare.
The current outbreak was solely the result of a contaminated MPA solution being injected into the central nervous system.
Individuals injecting anabolic steroids intramuscularly are not at risk of being dead “within a short window of time” from fungal meningitis.
It is still important to note that there are significant risks associated with the potentially-contaminated injections of UGL anabolic steroids of unknown quality.
But fungal meningitis is not one of them.
The media has utterly failed to make any corrections or clarifications with regard to this matter.

Topical Steroids for Eczema Treatment

Topical steroids are used in addition to emollients for treating eczema. Topical steroids reduce skin inflammation. A short course will usually clear a flare-up of eczema. Side-effects are unlikely to occur with short courses.
What are topical steroids and how do they work?

Topical steroids are creams, ointments and lotions which contain steroid medicines. Topical steroids work by reducing inflammation in the skin. They are used for various skin conditions including eczema. (Steroid medicines that reduce inflammation are sometimes called corticosteroids. They are very different to the anabolic steroids which are used by some bodybuilders and athletes.)


What types of topical steroids are there?

There are many types and brands of topical steroid. However, they are generally grouped into four categories depending on their strength - mild, moderately potent, potent and very potent. There are various brands and types in each category. For example, hydrocortisone cream 1% is a commonly used steroid cream and is classed as a mild topical steroid. The greater the strength (potency), the more effect it has on reducing inflammation but the greater the risk of side-effects with continued use.

Creams are usually best to treat moist or weeping areas of skin. Ointments are usually best to treat areas of skin which are dry or thickened. Lotions may be useful to treat hairy areas such as the scalp.
When and how are topical steroids used?

As a rule, a course of topical steroid is used when one or more patches of eczema flare up. The aim of treatment is to clear the flare-up and then to stop the steroid treatment.

It is common practice to use the lowest strength topical steroid which clears the flare-up. So, for example, hydrocortisone 1% is often used, especially when treating children. This often works well. If there is no improvement after 3-7 days, a stronger topical steroid is usually then prescribed. For severe flare-ups a stronger topical steroid may be prescribed from the outset.

Sometimes two or more preparations of different strengths are used at the same time. For example, a mild steroid for the face and a moderately strong steroid for patches of eczema on the thicker skin of the arms or legs. A very strong topical steroid is often needed for eczema on the palms and soles of the feet of adults because these areas have thick skin.

You should use topical steroids until the flare-up has completely gone and then stop it. In many cases, a course of treatment for 7-14 days is enough to clear a flare-up of eczema. In some cases, a longer course is needed.

Many people with eczema require a course of topical steroids every now and then to clear a flare-up. The frequency of flare-ups and the number of times a course of topical steroids is needed varies greatly from person to person.

After you finish a course of topical steroid, continue to use emollients every day to help prevent a further flare-up. See separate leaflet called 'Emollients  for Eczema' for more details.
Short bursts of high-strength steroid as an alternative

For adults, a short course of a strong topical steroid may be an option to treat a mild-to-moderate flare-up of eczema. A strong topical steroid often works quicker than a mild one. Short-duration treatment to prevent flare-ups.

Some people have frequent flare-ups of eczema. For example, a flare-up may subside well with topical steroid therapy. But then, within a few weeks, a flare-up returns. In this situation, one option that might help is to apply steroid cream on the usual sites of flare-ups for two days every week. This is often called weekend therapy. This aims to prevent a flare-up from occurring. In the long run, it can mean that the total amount of topical steroid used is less than if each flare-up were treated as and when it occurred. You may wish to discuss this option with your doctor.

Drugs that can Harm the Immune System

The flu is rarely deadly. It's flu that becomes pneumonia that kills. Prescription and over-the-counter drugs should be seriously considered on the list of things that could potentially make people more susceptible to having a flu that morphs into a deadly pneumonia.

Steroids
All steroid drugs, from corticosteroids to anabolic steroids, suppress the immune system that defends against bacterial and viral infections such as pneumonia.

Chronic stress creates greater susceptibility to infection because it raises cortisol levels. Cortisol is a steroid hormone released by the adrenal glands that has many side effects when it’s chronically high. One side effect is that it reduces inflammation. At first glance that sounds good, but at the same time it suppresses the immune system. Chronically high cortisol also disrupts blood sugar balance, often leading to high insulin, obesity and sometimes, diabetes.

The most common route of steroid drug use, particularly in children, is through asthma inhalers.
Most asthma inhalers contain some form of synthetic steroid. These steroids help reduce the airway inflammation associated with asthma, but at the same time can reduce the ability of the lungs to fight bacterial and viral infections.

Steroid drug abuse among high school and college athletes is common. The National Institute on Drug Abuse estimates that 1 – 6% of high school athletes use steroid drugs to enhance their performance. This amounts to potentially hundreds of thousands of teens with suppressed immune systems who are more susceptible to viral and bacterial infection.

Steroid drugs such as prednisone are widely prescribed for people with painful inflammatory diseases such as arthritis, and for autoimmune diseases such as multiple sclerosis and lupus. They are also prescribed for those with organ transplants to suppress a rejection response by the immune system.

Even the regular use of cortisone creams for arthritis can raise cortisol levels enough to suppress the immune system.

 PPI Heartburn Drugs that Suppress Stomach Acid
Proton pump inhibitors or PPIs such as Nexium, Prevacid and Prilosec powerfully block the secretion of stomach acid. This has the effect of reducing heartburn and nausea, but it also blocks one of the body’s main defenses against bacteria and viruses. According to a 2004 study published in the Journal of the American Medical Association (JAMA), 70% of the hospitalized patients in the study received a PPI or other stomach acid-suppressing drug within hours of being admitted. The study showed that patients who were given PPIs had a 30% higher risk of developing pneumonia.

Statin Drugs to Lower Cholesterol
A medical group in Switzerland found that organ transplant patients who were taking statin drugs (e.g. Lipitor, Mevacor, Pravachol) did better than those who weren’t taking the drugs. Laboratory studies showed that statins did indeed suppress parts of the immune system, and the authors concluded, “This unexpected effect provides a scientific rationale for using statins as immunosuppressors, not only in organ transplantation but in numerous other pathologies as well.”

SSRI Antidepressants
The selective serotonin reuptake inhibitor antidepressant drugs (SSRIs) such as Prozac, Zoloft and Paxil increase serotonin levels and in so doing also give the immune system a boost. This boost can be the good news or the bad news. According to researchers at Georgetown University Medical Center, this boost can push the immune system into autoimmune disease, where the body starts attacking itself. These types of immune system over-reactions are also implicated in the “cytokine storms” that can create deadly inflammation in the lungs.

Opioid Drugs
Both short term and long term use of the pain killing opioid drugs such as hydrocodone, oxycodone, fentanyl, codeine and morphine block the immune system’s ability to attack viral and bacterial invaders. Some pain killing drugs such as Tramdol combine an opioid with acetaminophen (e.g. Tylenol), further compromising the immune system with acetaminophen’s toxic effects on liver function.