Prednisone is a synthetic glucocorticoid (a steroid hormone released during periods of stress) commonly used for inflammatory conditions. Glucocorticoids (stress hormones) are released by a pair of special glands on top of the kidneys, known as the adrenal glands. During periods of significant stress, these steroid hormones can be doubled or even tripled by normal adrenal glands, depending on the degree of the stress.
Prednisone and other medications in this class of synthetic glucocorticoids are important in various inflammatory and non-inflammatory medical conditions. However, both brief and prolonged periods of exposure can be associated with some undesirable side effects. Furthermore, apart from the duration of exposure, the prescribed dose by a physician can influence the severity of side effects one might experience.
The side effects of prednisone and other synthetic glucocorticoids can vary from mild to severe, depending on the dose and duration of use.
Weight gain
Prolonged exposure to high doses of steroids (a dose higher than 10mg a day for more than 30 days) is associated with significant weight gain. Steroids promote both water retention and increased storage of fat, contributing to weight gain. Prednisone also increases appetite and results in a caloric surplus, which consequently leads to weight gain.
Neuropsychiatric symptoms
Prednisone in very high doses (excess of 40mg daily) can cause many mental health problems, including delirium, depression, and mania (sometimes referred to as steroid madness). These undesired side effects typically resolve within a few days to a week of discontinuing treatment.
Sleep disturbance
Some people have difficulty initiating or staying asleep while on prednisone. This side effect is further exaggerated if this medication is inadvertently taken close to bedtime. It is worth noting that the lowest level of naturally occurring glucocorticoids (steroids) occurs around bedtime. Boosting the level of steroids close to bedtime can disrupt the normal sleep-wake cycle (circadian rhythm), resulting in sleep disruption.
Nausea
The commonest side effect of prednisone is nausea. A good way of mitigating this side effect includes eating small meals throughout the day instead of large scheduled meals. If nausea persists, an anti-nausea medication may be required.
Additional side effects
Other side effects of steroids include worsening diabetes control (by increasing blood sugar released by the liver), elevated blood pressure (due to salt and water retention), headaches, and occasional dizziness. Finally, in very high doses, prednisone can cause various changes in the skin, consistent with a medical condition known as Cushing’s syndrome. Cushing’s syndrome is a disease resulting from increased steroid hormone (glucocorticoid) production by the adrenal glands. In high doses, prednisone can cause easy bruising, facial flushing (reddening), and thickened purplish stretch marks, features characteristic of Cushing’s syndrome.
Conclusion
The good news is that most people who are on prednisone don’t have too many side effects. For example, if you’re taking it for asthma, you’re probably not going to get symptoms of depression or mania. And if your doctor prescribes it to control inflammation in your body (like in rheumatoid arthritis or lupus), then nausea and vomiting won’t be an issue either, although weight gain would be a more likely side effect.
It’s important to remember that while certain risks are associated with taking this medication, they’re generally outweighed by the benefits of doing so—especially when managing potentially debilitating autoimmune diseases like lupus or rheumatoid arthritis!
The opinions expressed here represent the views of a practicing hormone specialist (endocrinologist) and must not substitute the advice of your health care provider. This blog post is written for a non-medical audience interested in learning more about hormonal disorders. The author has no commercial conflicts of interest to declare. Also, read our privacy policy.
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