Dr. Randy Horwitz fills us in on the different types of corticosteroid treatments now available. There are more options to choose from than there used to be. He describes various corticosteroids and differences between them, e.g., oral corticosteroids, inhaled corticosteroids and prednisone. He also indicates their side effects.
Dr. Horwitz is an integrative medical consultant. His special interest is in complementary and alternative therapies for asthma, immunological and allergic diseases, hepatitis and heart disease.
(Transcribed from video interview)
Dr. Horwitz:
There are different types of corticosteroids and we used to just have oral corticosteroids and we still use that quite a bit. Many people are on prednisone or Solu-Medrol – these are pills that you take that are corticosteroids and patients with severe asthma are often on this for months at a time. There are also inhaled corticosteroids which are the next generation.
The side effects of oral corticosteroids; osteoporosis. You can get immunosuppressed. You can get cataract, so all kinds of issues with long-term use. So they developed inhaled corticosteroids which give the anti-inflammatory action where it’s needed in the lung tissue and most of the time this is not systemically absorbed to a large degree so you can get hoarseness, you can get oral thrush or yeast infections that can be treated as well, but you don’t get the systemic effects and so the important thing to remember is when you are using an oral corticosteroid, press your provider to make sure that you are always in motion.
We were taught in allergy fellowship that you should never have a stagnant dose of a corticosteroid. You should either be bursting to treat an exacerbation or you should be on a taper. You should never be complacent about your corticosteroid dose, and with inhaled corticosteroids you want to be sure that rinse your mouth very well and again, push for the lowest possible dose because if you don’t push, many practitioners will just leave you where you are. For protection it’s useful, but you’ve got to be the impetus to lower that dose – the lowest possible dose that provides protection.
About Dr. Randy Horwitz, Ph.D., M.D.:
Dr. Randy Horwitz, Ph.D., M.D., received a B.S. degree in biochemistry from the University of Illinois, and a Ph.D. in Immunology and Molecular Biology from the University of Florida. He received his medical degree from the University of Illinois, and completed his residency in Internal Medicine at University Hospitals (Case Western Reserve University) in Cleveland.
Visit Dr. Horwitz at http://integrativemedicine.arizona.edu/about/directors/horwitz
Video:
https://www.empowher.com/asthma/content/what-should-asthmatic-patients-know-about-corticosteroids-dr-horwitz-video