COLORADO, USA — Prednisone is often used to treat a number of autoimmune or inflammatory diseases like lupus, rheumatoid arthritis, asthma and even treat those who have had an organ transplant.
According to a survey from 2017, prednisone was the 22nd most-prescribed drug in the U.S. with about 25 million prescriptions written for prednisone in 2017.
During a Twitter controversy where Ashley Judd’s “puffy” appearance was criticized by both men and women alike, including a presumably negative comment by actor Dean Cain, a conversation arose about the health risks of chronic prednisone use.
Many chronic prednisone users began sharing pictures of themselves before and after prednisone use after Ashley tweeted:
9Health Expert Dr. Payal Kohli answers common questions about what might happen with chronic prednisone use.
What are the risks of chronic prednisone use?
Prednisone can cause many changes both internally and externally, as well as mentally. With respect to external changes, prednisone can cause weight gain, thinning hair, acne, rounded or “moon” facies, “buffalo” hump, purple striae (or purplish discolorations on abdomen), facial hair growth.
When you gain weight on steroids, you don’t just increase your weight, you get redistribution of body fat to places that are undesirable, including the face, neck, back and abdomen, creating “fat pads” in undesirable locations.
- Physical/external: weight gain, thinning hair, acne, rounded or “moon” facies, “buffalo” hump, purple striae, facial hair growth
- Physiological/internal: high blood pressure, high sugar, increased risk for cataracts, thinning bones, easy bruising, salt and water retention, growth suppression, gastric ulcers, increased infection
- Mental/psychological: insomnia, nervousness/anxiety, or mania/excessive energy, excess hunger and mood swings.
Internally, prednisone can cause high blood pressure, high sugar, increased risk for cataracts, thinning bones, easy bruising, salt and water retention, growth suppression and gastric ulcers. Because prednisone suppresses the immune system, there is an increased risk for infections. Mental changes include insomnia, nervousness/anxiety, or mania/excessive energy, excess hunger and mood swings.
Why do these physical changes occur?
Prednisone is a steroid hormone and is four times more potent than the stress hormone cortisol. Many of the physical changes with respect to fat pads and fat redistribution seen with prednisone are the result of this hormone binding to fat cell receptors. Other changes occur because of prednisone suppressing the sex hormones (estrogen and testosterone) in the body.
Can the side effects be reversed by going off prednisone?
Some are reversible and others are more permanent. The time it takes for the side effects to reverse depends on the dose and the duration of the steroid hormone that was used. Permanent side effects include glaucoma, cataracts and bone loss/osteoporosis. But, if you are on prednisone, DO NOT STOP it on your own because that can also be dangerous. Instead, discuss with your doctor how to minimize the duration and dose to minimize the side effects.
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