Adrenal cortical steroids

Corticosteroids (adrenal cortical steroids) are natural hormones made by the adrenal cortex which are important in maintaining good health. There are two types of corticosteroids, the glucocorticoids and the mineralocorticoids.

Glucocorticoids e.g. cortisol and cortisone, are important for how the body responds to stress and also how it uses carbohydrate, fat and protein. Naturally occurring and synthetic glucocorticoids have very powerful anti-inflammatory effects and are used to treat conditions that involve inflammation. Glucocorticoids also decrease the body's immune response so are used to treat conditions when the immune system is over-reacting.

Mineralocorticoids e.g. aldosterone are necessary for regulation of salt and water in the body.

How they work

Natural corticosteriods are hormones which travel to different parts of the body to pass on messages to respond to the body’s changing needs. The corticosteriod messages act in body systems including stress response, immune response, inflammation levels, salt and water balance, and the breakdown of carbohydrates and protein.

The glucocorticoids activate the body’s anti-inflammatory response so are used to reduce swelling and pain caused by inflammation. Glucocorticoids also work to decrease the immune response and are therefore used to regulate the immune system when it is over-active in conditions like allergic reactions or autoimmune conditions.

Mineralocorticoids have their effect on the body’s salt and water balance so are used to correct any salt and water imbalance or as a supplement if the natural levels of aldosterone levels are low.

What they treat

Man made (synthetic) corticosteriods are used to treat a large number of conditions and symptoms. Corticosteriods are used as a replacement therapy when the body is not naturally producing enough of its own of natural corticosteriods. They are also used to treat conditions where there is inflammation, autoimmune conditions or allergy symptoms. Corticosteriods can be taken orally as a systemic treatment to treat the body as a whole or it can be applied to the affected area for a local effect as creams, inhalations, nasal sprays, eye drops, ear drops or injections. Examples of conditions they treat are

• allergies
• asthma
• COPD
• dermatitis
• ulcerative colitis
• Crohn’s disease
• multiple sclerosis
• nephrotic syndrome
• adrenal insufficiency
• inflammation
• Addison’s disease
• rheumatic conditions such as arthritis, fibromyalgia and lupus.

Side Effects

Side effects from corticosteriods are dependant on the dose and how long they are taken. Low doses for a short period have less side effects than when they are taken at a high dose for a long period of time. Some side effects include

• fluid retention or swelling of feet and legs
• high blood pressure
• increase blood sugar levels
• increased risk of infection
• insomnia
• muscle weakness
• gastric upset
• puffy face
• change in mood
• thinning of skin
• increase in bruising