Corticosteroid drugs (also known as glucocorticoids) act like the naturally occurring adrenal hormone cortisone in the body. They are strong anti-inflammatory and immune-suppressant medications used in many inflammatory and autoimmune conditions, such as ]]>rheumatoid arthritis]]> , ]]>asthma]]> , ]]>inflammatory bowel disease]]> , and ]]>systemic lupus erythematosus]]> . Corticosteroids are also prescribed to suppress transplant rejection.
Drugs in this family include:
- Betamethasone (Celestone)
- Cortisone acetate (Cortone Acetate)
- Dexamethasone (Decadron, Dexameth, Dexone, Hexadrol)
- Hydrocortisone (Cortef, Hydrocortone)
- Methylprednisolone (Medrol)
- Prednisolone (Delta-Cortef, Pediapred, Prelone)
- Prednisone (Deltasone, Liquid Pred, Meticorten, Orasone, Panasol-S, Prednicen-M, Sterapred DS)
- Triamcinolone (Aristocort, Atolone, Kenacort)
- And others
One of the most serious side effects of long-term corticosteroid use is accelerated osteoporosis. Although we don't fully understand how this works, corticosteroid interference with calcium and vitamin D is known to play a major role.
Calcium and vitamin D supplements are definitely beneficial for fighting ordinary ]]>osteoporosis]]> ; in addition, there is good evidence that they also protect against osteoporosis brought on by corticosteroids. ]]>1]]> A review of 5 trials enrolling a total of 274 participants found that calcium and vitamin D supplementation significantly prevented bone loss at the lumbar spine and forearm in corticosteroid-treated individuals. ]]>2]]> For example, in a 2-year double-blind placebo-controlled study of 130 individuals, supplementation with 1,000 mg of calcium and 500 IU of vitamin D daily actually reversed steroid-induced bone loss, causing a net bone gain. ]]>3]]>
Possible Supportive Interactions with Topical Corticosteroids
Aloe]]> and ]]>licorice]]> are two herbs sometimes used topically for skin problems. Preliminary evidence suggests that each one might help topical corticosteroids, such as hydrocortisone, work better. ]]>4,5]]>
Supplementation Possibly Helpful
Long-term, high-dose corticosteroid treatment can cause diabetes. This may be at least partly caused by chromium deficiency. A very preliminary study found treatment with corticosteroids caused increased loss of chromium in the urine. ]]>11]]> Another preliminary study found that individuals with corticosteroid-induced diabetes could improve blood sugar control by taking chromium supplements. ]]>12]]>
Possible Harmful Interaction
The supplement ipriflavone is used to treat osteoporosis. A 3-year, double-blind trial of almost 500 women, as well as a small study, found worrisome evidence that ipriflavone can reduce white blood cell count in some people. ]]>13,14]]> For this reason, anyone taking medications that suppress the immune system should avoid using ipriflavone except under physician supervision.
Possible Harmful Interaction
When taken by mouth, the herb licorice appears to enhance some actions of oral corticosteroids, but interfere with others. ]]>6-8]]> Because of the unpredictable nature of this interaction, individuals using oral corticosteroids should avoid licorice.
3. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D 3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 125: 961-968, 1996.
15. Roy BD, Bourgeois JM, Mahoney DJ, et al. Dietary supplementation with creatine monohydrate prevents corticosteroid-induced attenuation of growth in young rats. Can J Physiol Pharmacol . 2002;80:1008-1014.
Last reviewed April 2009 by EBSCO CAM Review Board]]>
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