Any steroid hormone made in the adrenal cortex (the outer part of the adrenal gland). They are also made in the laboratory. Corticosteroids have many different effects in the body, and are used to treat many different conditions. They may be used as hormone replacement, to suppress the immune system, and to treat some side effects of cancer and its treatment.

Corticosteroids are also used to treat certain lymphomas and lymphoid leukemias.

Corticosteroids are the most effective anti-inflammatory therapy for asthma and other chronic inflammatory and immune diseases. Recently new insights have been gained into the molecular mechanisms whereby corticosteroids suppress inflammation.

Corticosteroids are steroid hormones that are either produced by the body or are man-made.

Systemic corticosteroids refer to corticosteroids that are given orally or by injection and distribute throughout the body. It does not include corticosteroids used in the eyes, ears, or nose, on the skin or that are inhaled, although small amounts of these corticosteroids can be absorbed into the body.

Naturally occurring corticosteroids, hydrocortisone (Cortef) and cortisone, are produced by the outer portion of the adrenal gland known as the cortex (hence the name, corticosteroid). Corticosteroids are classified as either:

1. glucocorticoids (anti-inflammatory) which suppress inflammation and immunity and assist in the breakdown of fats, carbohydrates, and proteins, or as
2. mineralocorticoids (salt retaining) that regulate the balance of salt and water in the body.

Synthetic corticosteroids mimic the actions of naturally occurring corticosteroids and may be used to replace corticosteroids in people with adrenal glands that are unable to produce adequate amounts of corticosteroids, however, they more often are used in higher-than-replacement doses to treat diseases of immunity, inflammation or salt and water balance.

Examples of synthetic corticosteroids include:

• bethamethasone, (Celestone)
• prednisone (Prednisone Intensol)
• prednisolone (Orapred, Prelone)
• triamcinolone (Aristospan Intra-Articular, Aristospan Intralesional, Kenalog)
• methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol)
• dexamethasone (Dexamethasone Intensol, DexPak 10 Day, DexPak 13 Day, DexPak 6 Day).

Some glucocorticoids also in addition to their anti-inflammatory actions have salt retaining properties but they are used mostly for their anti-inflammatory effects. Fludrocortisone (Florinef), a synthetic mineralocorticoid has strong salt retaining effects with significant anti-inflammatory actions, and is used mostly for it’s salt retaining capabilities.

Corticosteroids belonging to the glucocorticoid class influence the body system in several ways, but they are used mostly for their strong anti-inflammatory effects and in conditions that are related to the immune system function such as:

• arthritis (for example, rheumatoid arthritis),
• colitis (ulcerative colitis, and Crohn’s disease),
• asthma,
• bronchitis,
• some situations involving skin rashes,
• allergic or inflammatory conditions involving the nose and eyes.

Glucocorticoid corticosteroids are used to treat systemic lupus, severe psoriasis, leukemia, lymphomas, idiopathic thrombocytopenic purpura, and autoimmune hemolytic anemia. These corticosteroids also are used to suppress the immune system and prevent rejection in people who have undergone organ transplant as well as many other conditions.

Fludrocortisone (Florinef), a potent systemic oral mineralocorticoid corticosteroid is used to treat Addison’s disease and diseases that cause salt loss as in congenital adrenal hyperplasia. It also is used commonly to treat conditions of low blood pressure (hypotension) although this is not a Food and Drug Administration (FDA) approved indication.

What is the Side Effects of Corticosteroids ?

short-term and/or low-dose corticosteroid use results in few side effects. But taking corticosteroids long-term can result in severe side effects, including:

• Adrenal insufficiency — a condition in which the body cannot adequately respond to physical stress
• Atherosclerosis
• Bone death
• Cataracts and glaucoma
• Elevated blood pressure
• Elevated blood sugar
• Fluid retention
• Gastrointestinal bleeding
• Mood changes
• Osteoporosis
• Suppression of the immune system
• Trouble sleeping
• Weight gain
• Damage to local tissues

Corticosteroids