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Doctors tell you that steroids only cause side effects after many years. But new research shows that permanent damage is immediate and devastating. Here's how to avoid it.


Steroids

The sleaziest of drugs

Steroids are fast catching up with antibiotics as the most abused class of drugs in your doctor's black bag. There's no doubt that the discovery of steroids a half century ago was a major advance in medicine-a life-saver for those like the late President John F Kennedy, who suffered from Addison's disease, a disease of the adrenal glands causing insufficient hormone production. Steroids mimic the action of the adrenal glands, the body's most powerful regulator of general metabolism. John Stirling, director of the vitamin company Biocare, credits a very short course (three injections) of steroids with jump-starting his failing adrenal system after anaphylactic shock and saving his life. The problem is, like antibiotics, steroids appear to be a miracle 'cure'. Patients with crippling arthritis or asthma seem to be instantly better on steroids.

The wheeze, the swelling, the pain go away. So doctors turn to steroids as the first, rather than last, line of attack for their anti-inflammatory and anti-allergic effects.

As with antibiotics, what was once reserved for the extreme emergency is now being used on the most trivial of conditions. Steroids are now handed out as readily as antibiotics, even to babies, at the first sign of inflammation of any sort. The latest drug set to replace gripe water for babies with croup is a steroid (budesonide); hydrocortisone is included in the latest over-the-counter medication for piles. Steroids make up many OTC skin drugs, and are considered the drug of choice for asthma, eczema, arthritis, back problems, bowel problems like ulcerative colitis-indeed, for any and all inflammations or allergic reactions-and new uses are still being invented. The sole exceptionis Addison's Disease, where steroids act as a replacement therapy of cortisone, much as insulin is given to diabetics.

Far from being a wonder drug 'cure all', steroids cannot cure one single condition. All they do is suppress your body's ability to express a normal response. In a few instances, this type of suppression will give the body a chance to heal itself. But more often, the effect is immediate, devastating and permanent damage. And we are only now realizing just how quickly damage can occur. Despite what doctors say, that steroids only have side effects after many years of use, there is no such thing as a safe dose.

Studies show that steroids cause permanent, debilitating effects after a single dosage. 'Steroids are probably the most sleazy of modern day medications,' says John Mills, former professor of medicine at the University of California, San Francisco and chief of infectious diseases at San Francisco General Hospital. .......

CONTINUED..WHAT DOCTORS DON'T TELL YOU, VOLUME 7 NUMBER 2, MAY 1996.

Long-term damage: quick and dirty

Steroids don't take years to damage your system, as doctors maintain. Permanent, crippling damage can occur weeks after you've begun treatment.

Osteoporosis can occur within a matter of months. Steroids cause 8 per cent reduction in bone mass after four months (Ann Int Med, November 15, 1993), the equivalent of the effect on your bones of having your ovaries removed. Even low doses of inhaled steroids (400 micrograms per day) reduce bone formation (The Lancet, July 6, 1991).
Low doses (10-15 mg prednisone) for a year can cause cataracts (Surv Ophthalmol, 1986; 31: 260-2).
Topical steroids may begin to cause eye damage or raise pressure after two weeks. Extensive visual loss can be caused by a 1 per cent hydrocortisone ointment, which is available OTC (BMJ, August 20-27, 1994).
Rub-on steroids have caused Cushing's syndrome in children as soon as a month after treatment has begun (Arch Dis Child, 1982; 57: 204-7).
Inhaled steroids slowth growth in children after six weeks (Acta Ped, 1993; 82: 636-40. See also, The Lancet, December 14, 1991).


Sudden death on steroids

Steroids, even in low doses, can kill or maim. The common thread in the following cases was that the drugs weren't used for long periods but had a swift and devastating effect.
Steroids gave James Hart osteoporosis in three months and killed him inside of one year. In July 1994, James Hart was diagnosed as having fibrosing alveolitis, a lung disease. A body-dye scan at the time showed that he was otherwise healthy, with every other organ besides the lung in good shape. Up until that spring, he'd been a keen golfer, playing a full round twice a week. He was given oxygen therapy at home, plus 12 tablets of 5 mg of prednisolone per day. The drug was intended to give his body a boost, to help him gain weight. Within a month, however, James's weight increased dramatically, bloating out of all proportion. His skin became very thin and his arms and hands were discoloured purple, bruising at the slightest touch. Although the steroids weren't alleviating the lung problem to any degree, and the dosage was halved within a month, James suffered terrible mood swings, and soon developed a misshapen neck and back, usually termed buffalo hump, a well-known side effect of steroids.

Five months after he'd started on steroids,James was crippled and incapacitated, with pain to his back and ribs; eventually, his family discovered he had a broken vertebrae and damaged rib-cage due to osteoporosis. He was no longer able to go to the toilet on his own, and a month later, he'd contracted diabetes and developed a liver problem.

By early June 1995 he could no longer eat due to mouth and gum ulcers, which were slow to heal. A month later-exactly a year after he'd started on steroids-James died of liver, pancreatic and kidney failure. When he was dying, his family could not even hold his hands, because it would damage his skin and cause blood vessels to leak. On his death certificate, the lung disease was not considered the major cause of his death.

Steroids killed nine-year-old Lexie McConnell after only five and a half weeks. In August 1993, Lexie was diagnosed as having toxoplasmosis. The consultant put her on 80 mg per day of prednisolone. Immediately, she suffered severe side effects-huge weight gain, terrible pains, holes in her tongue and black stools. After nearly a month, at her parents' pleading, the doctors quickly lowered the dosage to 60 mg, 40 mg, 20 mg. In excruciating pain, Lexie was taken to a hospital, where it was discovered she'd contracted chickenpox. Four days later, she died. A few years later, another eye specialist declared that a simple course of antibiotics could have cleared up her infection (see Viewpoint).


Books

Coping With Prednisone and Other Cortisone-Related Medicines : It May Work Miracles, but How Do You Handle the Side Effects?
by Eugenia Zukerman, Julie Ingelfinger

Amazon.com: When flutist Eugenia Zukerman developed a rare lung disease and began taking the powerful drug prednisone as part of her treatment, she was subjected--with little choice and less preparation--to a barrage of side effects: intense mood swings, bloating, changes in her hair and skin, gastrointestinal problems, and more. Physician (and sister) Julie was shocked to discover how few materials were available to help patients cope with this difficult medication. Together, the distinguished sisters created a highly readable, easy-to-understand, and complete guide through the treatment experience.

    Available from Amazon.com - $15.37 Hardcover, 176 pages Published by St Martins Pr (Trade) Publication date: August 1, 1997 Dimensions (in inches): 8.54 x 5.70 x .81 ISBN: 0312155026

Our 75th Issue of WDDTY . . .

A new, easier-to-read design with more information on alternative treatments
Announcement of our WDDTY non-profit foundation
The WDDTY red card system.Parkinson's without drugs.
Cancer Special: the truth about what works and what doesn't.
Thyroid treatments without replacement therapy.