Problems with Prednisone
- Aug 22, 2024
- 8 min read
Updated: May 7
The Health Destroying Effects of Prednisone: Why Inflammation is NOT the Enemy
Paul A. Goldberg MPH, DC, DACBN, DCBCN
Founder and Consultant to the Goldberg Tener Clinic
Over the five decades I’ve been in health care, one of the most challenging obstacles I’ve faced with patients has been medically prescribed corticosteroids.
Corticosteroids such as prednisone are almost universally prescribed by medical physicians of every variety… general practitioners, family practitioners, internists, dermatologists, rheumatologists, gastroenterologists, urologists, etc. Corticosteroids are prescribed for numerous conditions that involve inflammation / allergic reactions including asthma, eczema, dermatitis, ulcerative colitis, Crohn’s disease, sinusitis, iritis, ear inflammation, bronchitis, nephritis, arthritis, bursitis, neuritis, carditis, thyroiditis and virtually every other medical condition including some cancers. It is the go-to drug for medical physicians, as it will temporarily suppress a wide range of symptoms… but at what cost?
The body protects itself against infection, toxicity, injury and other insults through inflammation. Despite what those in standard and alternative medicine would have us believe, inflammation is neither the enemy nor the problem. Inflammation is in fact a constructive action created by the body with purpose. It serves as a marshaling of the body’s resources and is a key component in allowing a patient to recover from a wide variety of injuries and insults. To believe otherwise is to imagine that one of the most basic defense mechanisms of the body is a “mistake” … that the body is incompetent in its actions and that we know better. Such belief has allowed for the massive employment of not only steroids but also a plethora of other anti-inflammatory drugs.
Inflammation is a manifestation of the body attempting to normalize function, to repel invading organisms, to eliminate toxicity and to gather the body’s reparative forces to the site of injury. It is the result of adverse circumstances, not the cause of them.
Whatever might be causing a patient's inflammation needs to be identified and eliminated. This is a primary differentiating difference between our practice and standard medicine and so called "functional medicine" (see article The Facade of Functional Medicine). When the etiological factors (the causes) of a patient’s inflammation are addressed directly, the inflammation subsides as it is no longer needed. Put simply… identify and remove the causes of the inflammation and the body no longer has the need to produce it. This process of tracking down the sources of inflammation is a primary goal of the Goldberg Bio-Hygienic Recreation System™ in which my training in Hygiene, Chronic Disease Control, Public Health, and Epidemiology established the groundwork for.
Our patients know we are interested in renewing their health and vitality… not suppressing symptoms with drugs or supplements that ignore causes and often lead to further suffering.
The risks and complications of employing steroids are numerous. Their adverse effects often lead to a downward spiral in a person’s health, lessening their potential for a return to health. We have over the past fifty years seen numerous patients who have gotten on the corticosteroid train, often taking steroid drugs from different physicians. In time, a dependency on them can be created leading the patient down a dark path of chronic health issues.
The employment of steroids also makes it more difficult to determine what is currently occurring with a patient physiologically as steroids deviously mask underlying conditions. They alter the body's physiology making an accurate determination of the causes of a patient’s problems both in regard to performing an accurate physical examination and conducting laboratory testing difficult. In sum, Steroids mask underlying causes while undermining a person’s normal physiological state.
Common Side Effects of Prednisone and Other Steroids
Hormonal- By increasing the production of glucose from amino-acid breakdown and opposing the action of insulin, corticosteroids can cause hyperglycemia, insulin resistance and diabetes mellitus. We have seen patients who have developed diabetes in as little as a few months due to prednisone administration.
Gastro-intestinal: The use of prednisone and other corticosteroids has led to the formation of gastric ulcers. When there are infections present in the GI tract, steroids will exacerbate them. Steroids also lead to thinning of the gut lining which ironically can make the individual more susceptible to the very allergic reactions that they were given steroids for. Metabolic: Corticosteroids cause a loss of muscle tissue and increase body fat in the face, resulting in “moon face,” where the face becomes enlarged often making the patient resemble a chipmunk. Steroids also may lead to the development of tissue on the back referred to as a “buffalo hump”. The body loses muscle tissue due to the diversion of amino acids to glucose. Steroids are catabolic in nature i.e. they cause accelerated breakdown of tissues.
Lowered Resistance to Infection: The use of steroids leads to lowered body resistance to infections of all kinds including bacterial, fungal and yeast infections.
Skeletal Issues: Osteoporosis is a common side effect of long-term corticosteroid use. Use of inhaled corticosteroids among children with asthma may result in decreased height. We have seen patients over the years whose long-term use of steroids has resulted in vertebral body collapse. One 55-year-old woman who came to our clinic, who had been on steroids for arthritis for over fifteen years, experienced vertebral compression fractures to five dorsal and three lumbar vertebrae leading to a height loss of six inches.
Neuropsychiatric: A wide variety of psychological/emotional aberrations have been related to steroid usage including steroid psychosis, anxiety and depression. Conversely, steroid usage may cause a feeling of artificial well being referred to as “steroid euphoria.”
Eyes: Chronic use predisposes to cataracts and retinopathy.
Dependency: Extended use of steroids leads to increasing dependency upon them. The longer steroids are used and the higher the amounts employed, the weaker and more atrophied the adrenal glands become due to the degenerating effects of steroid replacement. We have repeatedly seen patients with autoimmune diseases e.g. inflammatory bowel disease and rheumatoid disorders who’ve become dependent on steroids leading to a downward spiral in their health status.
History of Corticosteroids
In 1930, an extract of animal adrenocortical tissue was found to serve as a replacement for human adrenal glands that were failing. Steroids (Cortisone) were first clinically employed in the mid 1940’s. Their use was initially heralded as being curative for Rheumatoid Disorders and there was much optimism initially expressed in their application. Shortly after, the other shoe dropped as serious side effects became visible. Patients had to take larger and larger doses to obtain the same amount of symptom suppression. Side effects (noted previously) such as cataracts, adrenal atrophy, mental disorders, osteoporosis, infections, etc., became widely evident. Nonetheless, due to their dramatic initial suppression of symptoms, steroids continue to be a cornerstone of medical treatment.
Challenges for Patients On Steroids
The longer a patient has been on steroids and the larger the amount taken, the greater the health recovery challenge is. Reversing the downward health spiral that long-term steroid usage causes is neither simple nor quick. Patients must understand that perseverance and effort will be required if the downward trend is to be reversed and health is to be regained.
If a patient is on steroids when we first see them, they will be advised to come off them at a rate the prescribing medical physician deems prudent. Packages of steroids are often given in what is termed a “Medrol Pack” which starts the patient at a high dosage and lays out a prescribed plan of reduction, built into the prescription, with the patient generally reducing their use by 5 to 10 mgs per week from the initial dosage of (typically) 20 to 60 mgs of prednisone per day.
Going cold turkey from even short-term steroid usage can be hazardous. The challenge is that as steroid usage is reduced, whatever symptoms they were prescribed for will likely return, often worse than they were previously. The steroids did not “fix” the problems and in most cases have weakened the body’s immune and endocrine systems. Skin disorders often re-erupt, joint pains commonly return with vigor (sometimes excruciatingly so), colitis symptoms frequently return with a vengeance including increased cramping, bleeding and frequency of diarrhea. Whatever the steroids were prescribed for returns. The phrase enjoy now and pay like hell later is appropriate regarding the employment of steroids. In these scenarios, the medical physician will often prescribe another round of steroids further complicating the chances for a long-term improvement in the patient’s health. To remain on steroids will virtually exclude the opportunity for the person to return to a healthy life.
The frustration patients experience in seeing the return of symptoms is common as the discomfort involved in the withdrawal of steroids can be severe. Many feel hopeless not knowing where to turn. We advise them that the road back is difficult but to continue the corticosteroid train is a one-way ticket to defeat. The longer one stays on steroids, the more times prescriptions are employed, the less the opportunity becomes to return to dependable health.
The Will to Get Well… The Right Actions to Make It Happen
The Goldberg Tener Clinic develops individual protocols to help patients get through steroid withdrawal, tailored to their own case. Physiotherapy, nutrient support, extensive rest and sleep, sunlight and encouragement are all important. Corticosteroids are anti-nutrient in their actions causing both increased needs for nutrients and increased losses of nutrients simultaneously. Over time, as the GI tract undergoes impairment, absorption of nutrients can be compromised limiting the flow of nutrients needed for maintenance and repair of tissues.
The removal of the causes as to why the person was initially ill that produced the inflammation is critical. Sadly, when physicians graduate, they are generally ill-prepared for working with patients with severe inflammatory problems, leading them to simply suppress the inflammation rather than uncovering and addressing the causes of it. Corticosteroids are an easy road for the physician to take whether they refer to themselves as standard or functional in their practice. Massive doses of "supplements" employed by so called "functional" medical doctors also fails to reverse the patient’s chronic health problems or address the causes of the inflammation.
Understanding nutritional biochemistry and the causes behind inflammatory responses has long been a priority at the Goldberg Tener Clinic. We have developed our skills through a combination of academics, personal experience with illness, internships in Natural Hygiene, practice experience, teaching clinical nutrition for forty years and by developing an understanding of clinical topics related to inflammation e.g. the dynamics of the Arachidonic Fatty Acid Cycle, gut dysfunction and dysbiosis, environmental toxicology, glucose dysregulation, protein putrefaction, bowel overgrowth, carbohydrate fermentation, stress related illness, and other etiological factors contributing to inflammatory responses.
Monitoring inflammatory levels via tests such as the sedimentation rate and the hsCRP provides an objective method to track patient progress. Medical Physicians are commonly befuddled on how our patient’s inflammatory markers almost invariably improve over time even though the patients have gotten off their steroids and other anti-inflammatory drugs. Functional tests such as fatty acid, digestive and immune system analyses are often productive in pinpointing the steps we need to take to help bring the patient to recovery. Of primary importance, however, is understanding how the patient became ill initially. The employment of a detailed case history using clinical epidemiology and a hygienic review of the patient’s habits reign supreme in this regard.
The patient must understand the process. To realize the need to be perseverant and not quickly return to steroids to ease their discomforts even when those discomforts are temporarily troubling. When patients work with us in a dedicated manner…. if they decide to get off the drug train and employ the will to get well along with definitive actions… then the beacon of light leading to recovery becomes visible. Taking the right steps needed in each case, even when the journey might be arduous, the patient can achieve their own victory over chronic disease.
Below are examples of patients we have worked with who had been given steroids and are now healthy and steroid free.
