Because steroids mimic cortisol, they affect many organs throughout the body, leading to both short-term and long-term side effects. These side effects vary from person to person and often depend on the dose, the type of steroid, and how long you take it.
For IgAN, steroid treatment may last around six months for prednisone or methylprednisolone, or around nine months for targeted-release budesonide, says Kannan.
Short-Term Side Effects
Short-term steroid use usually means taking the medication for less than 30 days, says Dr. Gershman. Side effects can appear quickly, within days of starting treatment, sometimes after just a few doses of the medication, she says. Common short-term side effects of systemic steroids include the following:
Long-Term Side Effects
Taking steroids for several months or longer increases the risk of additional and more serious side effects. These effects develop gradually and are more likely with higher doses or repeated treatment. Possible long-term side effects include the following:
- Osteoporosis (bone thinning)
- Diabetes or worsening blood sugar control
- Suppression of the adrenal glands, meaning your body may stop producing cortisol
- Weakened immune system and higher infection risk
- Cushing’s syndrome (a condition that causes symptoms such as fat deposits in the face, known as “moon face,” and purple or pink stretch marks on the belly, breasts, and hips)
- Skin thinning
- Easy bruising
- Eye problems, including glaucoma and cataracts
Keep your care team updated on any side effects you notice. Above all, never stop taking steroids suddenly. Suddenly stopping steroids can cause withdrawal symptoms like severe fatigue and weakness. It can also cause a potentially life-threatening condition called adrenal insufficiency, in which your adrenal glands decrease cortisol production. Your healthcare provider will help you gradually lower your dose to give your body time to adjust before stopping it.
Tips for Managing Side Effects
Both Kannan and Gershman suggest a few changes to help manage the side effects of systemic steroids. These include taking steroids in the morning to reduce insomnia and taking them with food to prevent upset stomach.
“It’s also a good idea to check your blood pressure and blood sugar at home while taking steroids, since they can become elevated,” says Gershman. This is especially important if you already have diabetes or prediabetes. You can monitor your blood pressure with a home blood pressure cuff and check your blood sugar with a glucose meter at home. Both are available over the counter at most pharmacies.
Kannan recommends sticking to a low-sodium diet to help reduce fluid retention and swelling. For your bone health, she suggests doing weight-bearing exercises and keeping up with your calcium and vitamin D intake, if your care team recommends these supplements.
Your healthcare provider may adjust your dose or treatment plan if side effects become difficult to manage.
When to Call Your Healthcare Team
Stay in close contact with your care team during steroid treatment. Kannan recommends notifying your healthcare provider if you notice any of the following:
- Signs of an infection, such as a fever or a persistent cough
- Severe mood changes or feelings of depression
- Uncontrolled or very high blood sugar levels
- Severe stomach pain
- Black, tarry stools
- Rapid swelling
- Shortness of breath
- Changes in your vision or severe muscle weakness
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