Alternate Names :
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
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.
* Reid IR and Ibbertson HK. Calcium supplements in the prevention of steroid-induced osteoporosis. Am J Clin Nutr. 1986;44:287-290.
* Homik J, Suarez-Almazor ME, Shea B, et al. Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev. 1998;(1). DOI: 10.1002/14651858.CD000952.
* 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.
* Davis RH, Parker WL, and Murdoch DP. Aloe vera as a biologically active vehicle for hydrocortisone acetate. J Am Podiatric Med Assoc. 1991;81:1-9.
* Teelucksingh S, Mackie ADR, Burt D, et al. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Lancet. 1990;335:1060-1063.
* Tamura Y, Nishikawa T, Yamada K, et al. Effects of glycyrrhetinic acid and its derivatives on delta-4-5-alpha- and 5-beta-reductase in rat liver. Arzneimittelforschung. 1979;29:647-649.
* Chen MF, Shimada F, Kato H, et al. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn. 1190;37:331-341.