Side effects of cortisone

Cortisone is known as devil stuff with side effects. However, even the body itself forms a certain amount of it and this is vital. Cortisone is one of the best known drugs and the remedy of choice for some diseases. However, the cortisone is still ahead of a bad reputation, especially concerning the side effects. Benefits and risks should be clear to all concerned. Cortisone is an indispensable part of medicine. This much-questioned drug can save lives and provide great relief, especially in the case of chronic inflammatory diseases. However, even here, especially with longer-term intake, the side effects must be considered.

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The body's own cortisone: definition, tasks
Cortisone is an important drug
Application forms of cortisone
Application of cortisone in diseases
Side effects of cortisone
What to consider in cortisone

The body's own cortisone: definition, tasks

In the human body so-called glucocorticoids are produced in the adrenal cortex. These include cortisol, cortisone and corticosterone. These substances have a protein-degrading effect in the musculature, in skin and fat tissue. They also contribute to lipolysis (fat loss), whereby fatty acids are released into the blood. Under the influence of cortisone, the body is stimulated to increase the glucose concentration in the blood from amino acids in the liver by sugar rebuilding, which is why it is also referred to as a so-called stress hormone.

Glucocorticoids have an anti-inflammatory effect. They inhibit the inflammation of the wound and its scarring after an injury. Unfortunately, they also contribute to immunosuppression. This means that cortisone weakened the immune system, the lymphocytes and phagocytes are inhibited. Again, this substance has an anti-allergic component because it restrains inflammation after an antigen-antibody reaction. As a side effect, however, the reduction in bone and muscle mass is mentioned here.

Cortisone is an important drug

Many patients have mixed feelings when it comes to taking cortisone. They are afraid of the side effects. However, in many diseases, this drug is the drug of choice. In the 1970s, cortisone was not as well-researched as it is today, often high doses were administered, which then led to more or less large side effects. This is no longer the case today. Cortisone is administered much more individually and especially in smaller doses. Also, the most diverse applications are on the market.

Cortisone has become a vital drug used primarily for inflammation and allergic reactions. This is used for skin diseases (eg itching skin rash), bronchial asthma, allergies and rheumatism. In autoimmune diseases, such as systemic lupus erythematosus (SLE), cortisone may be life-saving. Also important is the use in a life-threatening anaphylactic shock, in which this drug is always used.

Application forms of cortisone

Cortisone is available in various forms. Thus, the external treatment exists in the form of creams, ointments and gels. Oral administration is in the form of tablets. If the gastrointestinal tract should be bypassed, but the cortisone act systemically, this can be done via an injection or infusion. There are also nasal drops, eye drops and inhaler sprays that contain cortisone.

Application of cortisone in diseases

Cortisone is used for skin diseases such as atopic dermatitis, psoriasis and eczema. Here, the application of ointments, creams and gels. Asthma and allergy are also a major area of ​​use for this drug. Inflammatory reactions in the bronchi are inhibited, which also reduces mucus production. In most cases, an inhalation spray is prescribed for respiratory diseases. Additional oral supplements are possible, but usually only appropriate in severe cases. In rheumatic diseases, cortisone counteracts inflammation in the joints and thus restricts the excess immune system.

Side effects of cortisone

If cortisone is administered for a short period of one to two weeks, it usually does not cause serious side effects. Only in very rare cases, even this short use already leads to significant impairment. If the underlying disease requires long-term therapy, an attempt is made to achieve so-called low-dose therapy. In this case, after an initially higher dose, the amount used more and more, in very small steps, reduced until the individual limit of the patient is reached. The lower the dosage, the lower the risk of side effects. High-dose, long-term income usually causes unpleasant side effects.

The external use of cortisone, in the form of gel, ointment or cream for an extended period of time, can lead to thinning of the skin, red capillaries or steroid acne. If the substance is applied over a large area or applied to particularly thin skin areas, such as in the face, it can also penetrate into the bloodstream and act systemically, that is, cause side effects throughout the body.

If cortisone nasal or eye drops are used over an extended period of time, it is possible to dry out the nasal mucosa and / or the cornea. In the case of respiratory diseases, such as asthma, the substance is inhaled in the form of a spray, which can lead to coughing and hoarseness over a long period of time. Oral administration or administration by infusion may, if used for a long time, cause side effects throughout the body. These include sleep disorders, dizziness, headaches, calcium deficiency, bone loss and a weakened immune system. Also, the blood sugar level may increase by the intake of cortisone, which should be avoided especially in diabetics.

In women, a temporary infertility is possible by not ovulating. Cortisone is suspected to promote high blood pressure and cause edema (build-up of tissue) (such as thick legs), which in a broader sense leads to weight gain. Likewise, gastritis and gastric ulcer are mentioned in the list of side effects. Use in children can in the worst case lead to growth disorders.

These side effects are not a must, but possible. To prevent osteoporosis due to prolonged use of cortisone, calcium and vitamin D are administered. Regular monitoring of the blood sugar level is necessary so that a developing diabetes mellitus can be diagnosed in time. Especially if the affected people in connection with the intake over increased water and complain massive thirst, the sugar level should necessarily be controlled. A healthy, balanced, vitamin-rich diet is important to counteract possible deficiencies.

What to consider in cortisone

The use of cortisone should be extremely consistent. Since the body produces the largest amount of cortisone, especially in the morning hours between 6:00 am and 8:00 am, the name should also be entered during this time. This extra dose hinders much less during this period than at any other time of the day and is thus better tolerated. Asthma sufferers often need to take an extra dose in the evening to avoid nocturnal asthma attacks.

Cortisone should never be discontinued without consultation with the attending physician, as the intake influences the body's production and reduces it somewhat. In case of abrupt discontinuation, the body may suffer from deficiency symptoms, which must first be absorbed. Therefore, a gradual discontinuation makes perfect sense. On a regular Einname is to pay special attention during therapy, so that can build up a sufficient level of effect.

Cortisone is an important drug that has become indispensable in medicine. Nevertheless, benefits and risks should be carefully considered, especially if longer-term use is needed. The use of alternatives should be thoroughly considered in view of the massive side effects of cortisone. (Sw)

Picture: Birgit H