Steroids: When They Help, When They Are Harmful.

Date: May 02nd, 2020

Steroids: When They Help, When They Are Harmful.

Rose, an asthma patient, has been treated with steroid pills for 30 years. Jacklin Trio, a cancer patient, receives steroids to reduce the nausea, vomiting and allergies caused by chemotherapy and to improve the overall feeling. Experts explain the benefits of the drug, and when it becomes dangerous.

When John Doe returned to Ireland, the media was asking whether he had received steroid treatment for his looks to improve his appearance. From the extensive tests he underwent, the doctors concluded that he was probably injected with steroids that gave him a healthy appearance. The matter re-raised the medical dilemma regarding steroid use. Do you really have to be afraid of them? And why have these demonic myths been associated with these effective drugs that have put them out so badly?

"The fear of doctors and patients against the use of steroids is justified," believes Prof. “Sarah Conders”, director of an internal ward at St. James's Hospital and chairman of the medical services department of general health.

"Steroids are very good drugs, but only for short-term use - a few days or weeks, two to three weeks at most. This period takes full advantage of their positive potential and minimizes damage. Prolonged use can have serious and even dangerous side effects. The drug is well-used, effective and short-term. In contrast, some give it to patients for long periods, while other doctors who fear the side effects avoid using it."

What are steroids? "This is a group of compounds that share a certain biochemical ring," explains Prof. Sarah. "Steroids play an important role in metabolism in mammals in general and humans in particular. Until recently, they thought there could be no steroid life, but experiments have found that some types of mice produce alternative compounds, although they are barren mice.

"Steroids are mostly produced in the adrenal gland (adrenal glands), and steroid compounds are also produced in organs such as the liver, testes, and ovaries. There are two types of steroids: those that cause sodium in the body and maintain blood pressure, and those that regulate sugar metabolism."

According to Prof. Sarah, steroids are often used extensively. "Doctors give patients with arthritis, asthma and allergies long-acting steroids," she says, "while the treatment should be short, and then replaced with another”. Continuous steroid therapy will cause side effects such as facial swelling, hair loss, acne, extreme obesity , hypertension, diabetes, osteoporosis, etc. Today, more and more people are trying to suppress the immune system, not using steroid-containing drugs, in order to save patients from the side effects.

"The steroids can cause mental and physical addiction," Prof. Sarah points out, "so they should be discontinued gradually."

Steroids and asthma

32 years ago, at the age of 24, Rose suffered a severe asthma attack and was admitted to a respiratory intensive care unit at St. James's Hospital in Dublin. "I've never smoked and my family has no asthma patients, so it came as a surprise to me," she recalls. "The day before the seizure because of me being hospitalized, attached to an oxygen mask, I felt a slight discomfort in breathing. Later I had wheezing in my chest, but I was a fresh, busy mother and ignored the symptoms. In the end, I collapsed."

From the day she was released from the hospital, she regularly takes steroid pills on the recommendation of the attending physician. "Thanks to them, I live a normal life," says Rose. “Work 10 hours a day at a high-tech company, run housekeeping, travel abroad, and more. But I also pay a price, and moreover: my face is puffy like a balloon and the skin of my hands is sagging and old”. Although she is taking the drug regularly, she suffers from a particularly severe asthma attack every 3-4 years, which requires hospitalization in the respiratory intensive care unit, where doctors temporarily increase the dose of steroids injected into her body. 

"Giving steroids in pills, rather than inhalers, for asthma patients is bad and dangerous," warns Prof. Jonathan Hourihane, director of the Allergy, Asthma, and Immunology institute at Slievemore Clinic. "For years, doctors have been wrong to think that giving steroids overwhelmingly is the ultimate solution to asthma. In recent years, medical studies have realized - albeit unfortunately not as a whole - that steroid overdoses can be dangerous. And they are given steroids, which can cause long-term damage, such as growth retardation, obesity, and bone loss in adulthood."

Steroids and Cancer

Steroids and cancer

About five years ago, Stephany, 48, became ill with breast cancer. Two years ago, the disease got worse and became metastatic. Stephany received chemotherapy and steroids. "I became bald as a result of chemotherapy," she says, "and the steroid contribution to my appearance was the swelling of my face. For seven months I looked like a balloon." The treatment was discontinued after the disappearance of metastasis, and Stephany returned to her usual size.

Over the last year, more metastatic MRI reviews have been discovered, and she is currently in the midst of aggressive chemotherapy, combined with steroids. "Again, the same symptoms are repeated," she says, "a swollen face, a bloated stomach. But this time I did not panic, because I already knew that not long after the treatment is over the face will return to normal dimensions, and the swelling of the abdomen will go as well." 

"Some cancer patients receiving chemotherapy are also treated with steroids," explains Dr. Liam O'Mahony, director of the oncology service in Portiuncula Hospital, "which, along with another drug, reduces nausea and vomiting among patients. The steroids are also given to reduce and even prevent the allergic effects caused by chemotherapy. Some cancer patients use steroids to improve their overall feeling and appetite".

Diseases of deficiency or excess

Edison Syndrome: Lack of steroids due to adrenal gland dysfunction or partial gland destruction due to immune destruction, tumors, or glandular blood flow. The syndrome may also have patients with autoimmune diseases - asthma, lupus and more - who have been taking high-dose steroids for a long period of time, and the treatment was abruptly discontinued. The syndrome is manifested by low blood pressure, weakness, etc. In extreme cases, there may also be deaths.

Cushing's Disease: Excess of excessive kidney steroids, due to excessive glandular stimulation or unnecessary hormone disorder.

According to Prof. Sarah, this phenomenon can also affect patients with autoimmune diseases such as allergy, asthma, lupus, arthritis, bowel disease (especially colitis), immune liver disease, and organ transplant, due to high-dose steroids. The steroids in these patients suppress the immune system and help overcome the symptoms of the disease or the rejection effects of a transplanted organ.

Anabolic steroids

As the iron curtain rose over Eastern Europe, scientists found that many athletes there were taking anabolic steroids to improve physical ability, a phenomenon that spread further to Europe and the United States. Florence Griffith, a talented American runner, died at age 39, probably due to taking steroids. Wenson, who broke a world record at the Seoul Olympics, was caught using this material.

"Anabolic steroids", explains Prof. Sarah, "are compounds derived from the male sex hormone, testosterone. Some have hair growth or muscle growth and bone tissue properties, which is why many athletes, especially weightlifters, wrestlers, and bodybuilders. These short-term steroids are minimal, but the long-term damage is the same as regular steroids, so their use is completely banned."