Steroid – The double-edged Sword

The word steroid is very commonly used and very easily misunderstood by patients and public. There are many medical conditions where steroids are a life saving drugs. Steroid refer to a group of drugs which are similar to the hormones secreted by adrenal glands. These hormones play very important roles in variety of biological functions in body.

The internal steroids are secreted in an appropriate amount and help our body to control blood sugar and blood pressure, maintain bone density, fight stress and control inflammation. The last two functions are very important to understand the use of steroid. Many diseases cause harm to our body by producing uncontrolled inflammation which leads to tissue and organ damage. Most of the infectious diseases (diseases caused by bacteria, virus, fungus, parasite) are fought by an appropriate amount of inflammation to control the infection. Sometimes this inflammation gets out of proportion and uncontrolled causing extensive damage to tissue and various organs. External supply of steroid can help to control this damage. There are many diseases which are basically inflammatory and cause tissue or organ damage by this process. An appropriate supply of external steroids can help these patients immensely.

Whenever a decision is taken to give steroid to a patient for any of the above condition, there are two most important points to consider, the dose of steroid and the duration of steroid treatment. The doses depend upon the severity of inflammation and duration depend on the cause of inflammation and its response to treatment. The duration can be few days to many months or years. Your treating doctor is the best person to decide this. It is important to adhere to the dose and duration as advised.

Whenever steroid is given for a long time (more than 3 weeks), we have to monitor therapy carefully. Patient should never stop treatment on their own as it can cause weakness, fever, nausea, vomiting or severe decrease in blood pressure. It has to be stopped slowly as per condition of patients. There is a chance of increased bacterial, viral or fungal infection during steroid therapy. Use of steroid in these conditions need careful risk assessment. Optimum dose and duration are critical to avoid harm to the patient. There is a chance of increased blood sugar and blood pressure, osteoporosis and fracture of vertebral bones, cataract and blurring of vision during steroid therapy. Both patients and doctors have to be aware of these conditions, continuously asses and monitor steroid therapy carefully. Steroid is like a double-edged sword causing benefit and harm simultaneously. We have to be extremely careful on choosing a steroid therapy and a competent doctor can guide you on this. A proper medical advice and monitoring is important during the whole treatment process.

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