- See:
Steroid Menu
- Discussion:
- daily doses of more than 5 to 7.5 mg of
prednisone or its equivalent should be avoided because of side effects produced by glucocorticoids, esp
diminishing of bone mineral content;
- low dose (5 to 7.5 mg PO qd) may benefit certain pts w/ little risk of morbidity;
- Bone Changes:
- bone changes following long term corticosteroid administration are same namely, severe
osteoporosis;
- steroids initially produce an increase in bone turn over and a high turnover type osteopenia, which is theorized to occur from steroid inhibition of the osteocyte-
osteoblast lining
cell system, w/ resultant increase in
PTH secretion and bone turn over;
- long term administration of steroids or long term oversecretion of cortisol results in a low turn over type osteopenia;
- some recommend that patients on long term steroids should also receive appropriate doses of
vit D and
calcium;
- also consider use of bisphosphonates (
fosamax)
- Steroid Myopathy:
- administration of high doses of steroids, particularly fluorinated steroids, over protracted periods may lead to proximal weakness;
- biopsy findings are usually limited to atrophy of
type II fibers, which cannot be distinguished from pathologic findings seen in muscle disuse such as occurs in muscles
immobilized in a cast;
Changes associated with Anabolic Steroids:
-
cholesterol:
- use of anabolic steroids causes a decrease in high-density lipoprotein levels but has no effect on low-density lipoprotein levels;
- an abnormally low high-density lipoprotein level should alert the physician to the possibility of steroid use in an athlete;
- ref:
-
Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein. Br J Sports Med 2004;38:253-259.
-
Effects of androgenic-anabolic steroids in athletes
Corticosteroid-induced osteoporosis.
