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Side Effects of Steroids

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: Why do patients who take steroid hormones frequently retain large amounts of water?

A: The body naturally makes its own steroids. These influence how our body systems physically operate and how certain glands/hormones function, such as blood pressure and glucose (sugar) metabolism. As you point out, when extra steroids are used, one of the side effects may be to cause our body to handle water differently and to hold onto it more (fluid retention).

This family of drugs is an important group of medicines prescribed frequently by physicians to treat many diseases and conditions. For example, steroids have been extremely beneficial in treating asthma. They are most widely used to reduce inflammation and to influence the immune system. Steroids are given in various ways such as by mouth (pills or liquid), injection (as a shot in the muscle), intravenous (directly into a vein), topical (on the skin), inhalation (into the lungs), and drops (in the eyes).

They can have significant side effects, which depend on which type of steroid is used, how much is used, for how long, when in the day they are taken, and the age of the patient. Some of the side effects include an increased amount of sugar in the blood, ulcers, increased appetite, weight gain, high blood pressure, and fluid retention. If someone takes them a long time, it can also negatively affect the eyes, heart, growth, bones, and ability to fight infection. Although the benefits of properly used steroids far outweigh the side effects, it is critical to monitor anyone using them closely.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.


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