(gentle music)
- The human body is very familiar with the consequences
of prednisone because naturally your body makes
the equivalent, which is called cortisol.
In fact, your body is so knowledgeable
about the consequences of too much prednisone
that it has an extremely tight system to prevent
your adrenal gland from making and secreting too much.
Your body knows that if it secretes too much cortisol,
this can be bad news.
Now I'm going to briefly review some of the important
side effects of prednisone.
It is a good idea to discuss these and any other potential
issues with your doctor when starting prednisone.
This will allow you to develop a proactive plan together,
which will minimize your overall risk.
Increased blood sugar.
Prednisone will increase fasting
and postprandial blood glucose, so if you have diabetes,
your medications may need to be adjusted
while you are on prednisone.
If you are borderline for diabetes,
prednisone may temporarily increase your sugar enough
to push you into the diabetic category
while you're on the medication.
By watching your diet very closely and minimizing
sugar and high carbohydrate containing foods,
this will help minimize this prednisone side effect.
Be sure to discuss with your doctor
how to check and manage blood sugar
when you start prednisone.
Moodiness, irritability and insomnia.
Prednisone affects everyone differently.
Some people taking prednisone may experience
a change in mood, this can range from feeling irritable
and short-tempered or sad and tearful
to euphoric and energetic.
It is best to be prepared that your mood may be affected
and discuss with your physician a plan
to manage and monitor for this effect.
Along the same lines, prednisone may affect
your sleep patters and contribute to insomnia
or sleeplessness, if this occurs,
it is best to take your dose in the morning
to minimize the impact on your nighttime sleep.
Osteoporosis and avascular necrosis.
Prednisone can impact your bone health.
Although this is generally with longterm use,
there are some effects in the short term
on your bones as well.
Steroids can contribute to osteopenia and osteoporosis.
Both of these conditions are a decrease
in bone mineral density.
Low bone mineral density is a risk factor
for bone fractures.
Osteonecrosis is a rare complication of steroids
where there is an interruption to
the blood supply to the bone.
Steroids increase the risk of this complication
especially if there is trauma, alcohol use,
or if you have certain concurrent hematologic conditions
such as sickle-cell disease.
It is important to discuss with your physician
ways to protect your skeleton while on steroids.
Medications, exercise and vitamin D supplementation
may be good options for you.
Ocular health.
Long term use of prednisone can affect your eyes.
It can accelerate or increase the risk
of cataracts and glaucoma.
If you're going to be on prednisone for more than a few days
discuss with your doctor if a referral to
and ophthalmologist or eye doctor in order to monitor
for these conditions is appropriate.
Infections, part of why prednisone is so effective
in treating inflammation is that it decreases
the immune reaction which is causing
the problematic inflammation,
but the downside to decreasing an immune reaction
is an increased susceptibility to infections.
This is a dose-related side effect of prednisone.
And susceptibility to very serious infections
occurs predominantly at high prednisone doses,
around 20 milligrams or more daily.
Vigilant hand washing and avoiding sick contacts
can be helpful to minimize this risk.
Discuss with your doctor if other precautions
to prevent infections would be appropriate for you
while on prednisone.
The prednisone dose and duration of treatment
are important factors when thinking
about these steroids side effects.
The higher the steroid dose,
and the longer the steroid treatment duration,
the more we consider these side effects.
But remember, you doctor has prescribed prednisone
as a treatment for an important reason
and to treat a serious condition.
And as with many medications, the risks
and benefits need to be carefully weighed and discussed.
Although these are common side effects of prednisone,
they do not occur in every patient or all of the time.