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FAQs About Steroids for Asthma

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What are corticosteroids (‘steroids’)
Does the body make steroids?
What are some steroid medicines?
What are some important considerations when your dosage changes?


What are corticosteroids (‘steroids’)?

Corticosteroids (steroids) are medicines that are used to treat many chronic diseases. Corticosteroids are very good at reducing inflammation (swelling) and mucus production in the airways of the lungs. They also help other quick-relief medicines work better.

The steroids (corticosteroids) used to treat chronic lung diseases are not the same as anabolic steroids, used illegally by some athletes for bodybuilding. Corticosteroids do not affect the liver or cause sterility.


Does the body make steroids?

Corticosteroids are similar to cortisol, a hormone produced by the adrenal glands in the body. Cortisol is one of the body's own natural steroids. Cortisol is essential for life and well-being. During stress, our bodies produce extra cortisol to keep us from becoming very sick.

Normally the adrenal glands release cortisol into the blood stream every morning. The brain monitors this amount and regulates the adrenal function. It cannot tell the difference between its own natural cortisone and that of steroid medicines. Therefore, when a person takes high doses of steroids over a long time, the brain may decrease or stop cortisol production. This is called adrenal suppression. Healthcare providers generally decrease a steroid dosage slowly to allow the adrenal gland to recover and produce cortisol at a normal level again. If you have been on steroids long-term do not stop taking them suddenly. Follow your doctor's prescription.


What are some steroid medicines?

Steroid medicines are available as nasal sprays, metered-dose-inhalers (inhaled steroids), oral forms (pills or syrups), injections (shots) and intravenous (IV) solutions. Healthcare providers at National Jewish Health rarely use steroid shots for the treatment of chronic lung disorders. With severe episodes or emergencies, high-dose steroids are often given in an IV. As the symptoms improve, the medicine is changed from IV to oral forms and then slowly decreased.

Inhaled steroids and steroid pills and syrups are often prescribed for people with a chronic lung disease.


What are some important considerations when your dosage changes?

As the control of your disease improves, or if serious side effects develop, your healthcare provider may decrease your steroid dose by tapering the dose to prevent "breakthrough" symptoms and to allow the adrenal glands time to function again. If you have been taking steroids long-term do not stop your steroids abruptly. Follow your healthcare provider's recommendations.

As your body adjusts to a lower steroid dose, you may notice some withdrawal side effects. These may include an increase in breathing difficulty due to worsening of your disease, fatigue, weakness, depression and muscle and joint pain. If breathing difficulty occurs, or if any of the above symptoms are severe, notify your healthcare provider. The non-respiratory side effects usually disappear within a few weeks or months.

If your steroid dose has recently been decreased or stopped and you have a serious illness, surgery or injury, you may require a short steroid burst. During this time, your adrenal glands may not be functioning at full capacity and cannot handle stress to the body. This is important if you have taken routine steroid pills within the last year or completed a burst within the past two weeks. Inform all of your healthcare providers that you have been on steroid treatment.

Some people do not react normally to steroid medicine. Special testing may be required and the medicine dose may need to be adjusted.

Frequently people have concerns about taking corticosteroid ("steroid") medicine. Please discuss concerns that you have about steroid use with your healthcare provider. Discuss all medicines and herbal supplements with your healthcare provider to make sure they don't interact with the steroids you take. It is important to follow your healthcare provider's directions when taking steroids.


This information has been approved by David Tinkelman, MD  (August 2012).