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Guide Health: Steroids – essential for life

We’ve all heard about anabolic steroids and sports, but what are corticosteroids?

Steroids are a group of organic compounds that we produce in our bodies, just like many other species. As molecules, steroids are similar in their structure. Specifically, each steroid consists of a group of four chemical rings with various side chains.

In the body, steroids have a variety of functions. They help to regulate your metabolism and your electrolyte and water balance, and they are also important in the functioning of your cardiovascular system, kidneys, skeletal muscle and even your nervous system. Without steroids, your body would certainly not function well.

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You probably have heard of anabolic steroids and you may know that these steroids, including testosterone, have been banned in professional sports. However, female sex hormones like estrogen and progesterone also have the steroid structure.

Cholesterol and vitamin D have steroid structures too. Another group of steroids are corticosteroids, so named because they are commonly produced in the adrenal cortex, again with the same steroid structure.

Corticosteroid pharmaceuticals are available as both topical creams and ointments as well as in oral tablets and injections. They have the capacity to prevent the development of inflammation, including local heat, redness, swelling and tenderness. They do this at the cellular level, but it should be noted that they do not treat the cause of the inflammation, only the symptoms.

Hydrocortisone and betamethasone creams and ointments are two common examples of topical corticosteroids. They are used for rashes and skin conditions like eczema or psoriasis.

Ideally, these products should be applied thinly and not for long periods of time as thinning skin can result from overuse. One daily application is usually sufficient as the steroid remains active on the skin. They should not be applied to areas of tender skin such as the face. As well, applying them in the direction of hair growth will be more effective.

Oral corticosteroids include prednisone, dexamethasone and hydrocortisone. You may recognize prednisone for short-term treatment of poison ivy rash. Prednisone is also used by transplant recipients to reduce the potential for organ rejection and for treatment of chronic inflammatory conditions like rheumatoid arthritis. To be the most effective, prednisone is best taken first thing in the morning.

Hydrocortisone tablets are used to treat Addison’s disease, which is the poor functioning of the adrenal cortex. The activity of the adrenal cortex was described first by Addison in 1855 and thus the insufficiency disease was named after him.

Dexamethasone is often used to reduce inflammation associated with wisdom teeth removal. More recently, favourable results have been seen when dexamethasone is given to patients hospitalized with COVID-19. With COVID-19 the lungs become inflamed and breathing is difficult, often requiring a respirator.

Dexamethasone reduces this inflammation making breathing easier and speeding-up recovery. It is six times more potent than prednisone and has a much longer half life at 36 to 72 hours, making it the preferred corticosteroid.

So, yes, it’s true. Steroids are probably some of the substances of which you were not aware, but you depend on them for your overall good health and they are excellent choices for certain medical conditions!

About the author

Contributor

Marie Berry is a lawyer/pharmacist interested in health and education.

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