Since cortisone as a drug only in dosages that are above the natural hormone levels, the body responds to the hormone excess. The side effects are therefore quasi-normal responses to the corticosteroid stimuli - as these are elevated, the effects are also increased. Side effects occur especially with prolonged treatment, while short-term use is rarely problematic.
Desirable effects of cortisone treatment
Some of the side effects are sometimes also desired effects: For example, the suppression of the immune system (immunosuppression) may be wanted, for example, in the therapy of the excessive defense in the context of an allergic reaction, but also a serious side effect, which leads to increased susceptibility to infection.
Typical side effects of cortisone
Adverse effects as a result of the direct hormonal action are:
- the so-called Cushing's syndrome with full moon face, bull's neck, facial flushing and brittle skin vessels
- Increase in blood pressure
- High blood glucose
- Increase in blood lipid levels
- increased susceptibility to infection
- increase in weight
- Water retention in the tissue
- Osteoporosis: Although cortisone does not appear to be the sole trigger, it can increase the risk if it is susceptible to attack. Therefore, it is necessary to determine the risk of osteoporosis (bone density measurement) before prolonged cortisone therapy and if necessary initiate preventive measures such as calcium supplements or the intake of vitamin D and fluoride.
Cortisone affects the regulatory system of hormones
Another group of side effects concerns the regulatory cycle of hormones. By feeding the glucocorticoid from the outside, your own hormone production falls asleep and may even lead to the disappearance of the adrenal cortex.
This condition becomes problematic if the therapy is stopped, because it takes some time until the own production gets going again. In stress situations, such a patient is then in danger because the adrenal cortex can not provide the hormone in a sufficient amount fast enough.
Conversely, there may be a so-called rebound effect - the increased recurrence of the disease symptoms, if the drug is discontinued too quickly, rather than slowly creeping out.
Guidelines for the right dosage
The now well-researched consequences of cortisone therapy have also led to the drug being used differently today than it was at the time of its discovery. The dosage depends on the severity of the individual disease and the patient's response.
As a rule, acute diseases are only treated for a short time, and chronic diseases are usually treated long-term. It strives to help chronically ill with the smallest, just effective dose.
This process is tedious and difficult because, after a successful initial treatment at a relatively high dosage, one attempts to reduce the dosage of the drug more and more. At very low dosages, however, this process can be done very slowly and in very small increments.
It also depends on the patient
The goal is always to minimize the unwanted side effects. To do this, the doctor and the patient must work together. The patient should intensively deal with his own cortisone treatment and obtain as much information as possible in order to actively participate in the therapy.
This includes, among other things, a low-salt, balanced diet, in which low-fat dairy products and fruits and vegetables play an important role. Sport and exercise also contribute to less discomfort and side effects.