Side Effects of hydrocortisone: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Major research findings

Hydrocortisone is an important steroid hormone that has been used for many years to treat a variety of conditions, including inflammation, allergies, and autoimmune diseases. 4 However, hydrocortisone, like other steroids, can have side effects. 4 One of the most common side effects is adrenal insufficiency, which occurs when the body doesn't produce enough cortisol. 4 A recent study found that adrenal insufficiency is a common side effect of lenvatinib treatment for thyroid cancer. 2 This finding is important because adrenal insufficiency can cause fatigue, weakness, and other symptoms. 2 Another study found that hydrocortisone use in children and young people can have long-term consequences. The study authors recommend close monitoring for adverse effects and the use of the lowest possible dose. These studies highlight the need for more research on the long-term effects of hydrocortisone use.

Reasons for side effects

The side effects of hydrocortisone are related to its mechanism of action. Hydrocortisone works by suppressing the immune system and reducing inflammation. 4 This effect can have unintended consequences for the body, leading to side effects. 4

Common side effects

Metabolic abnormalities

Long-term use of hydrocortisone can lead to metabolic abnormalities such as abnormal sugar metabolism, lipid metabolism, and electrolyte metabolism. 4 Specifically, this can include increased blood sugar levels, increased cholesterol levels, and decreased potassium levels. 3

Endocrine system

Hydrocortisone can cause adrenal insufficiency. 4 Adrenal insufficiency is a condition where the body does not produce enough cortisol, a hormone that helps regulate many functions in the body. 4 Therefore, adrenal insufficiency can lead to fatigue, poor appetite, weight loss, and low blood pressure. 4 Long-term use of hydrocortisone can also lead to Cushing's syndrome. 4 Cushing's syndrome is a condition where the body produces too much cortisol. 4 Excess cortisol can lead to obesity, high blood pressure, diabetes, and osteoporosis. 4

Digestive system

Long-term use of hydrocortisone can lead to digestive problems such as peptic ulcers and gastritis. 4

Mental and neurological system

Long-term use of hydrocortisone can lead to mental and neurological problems such as depression, insomnia, and irritability. 4

Other

Long-term use of hydrocortisone can lead to other side effects such as osteoporosis, cataracts, and glaucoma. 4 In addition, oral hydrocortisone can cause hypertension and hypokalemia. 21 This is because hydrocortisone promotes sodium reabsorption and potassium excretion. 21 Furthermore, topical application of hydrocortisone can cause skin thinning and telangiectasia. 21

Side effects countermeasures

Metabolic abnormalities

Diet and exercise therapy can be effective in preventing metabolic abnormalities. 4 If your blood sugar is high, consider a low-carbohydrate diet. If your cholesterol is high, limit your intake of animal fat and eat more vegetable fat. 4 Regular exercise can also help to improve metabolism. 4

Endocrine system

To prevent adrenal insufficiency, it is important to reduce the dosage of hydrocortisone. 4 If you experience symptoms of adrenal insufficiency, see a doctor immediately. 4 To prevent Cushing's syndrome, it is important to reduce the dosage of hydrocortisone and undergo regular health checks. 4

Digestive system

To prevent digestive problems, it is important to reduce the dosage of hydrocortisone and take antacids. 4

Mental and neurological system

To prevent mental and neurological problems, it is important to reduce the dosage of hydrocortisone and reduce stress. 4

Other

To prevent osteoporosis, it is important to consume plenty of calcium and vitamin D and exercise regularly. 4 To prevent cataracts and glaucoma, it is important to visit an ophthalmologist regularly. 4

Comparison of studies

Common points of studies

Many studies have shown that long-term use or high-dose use of hydrocortisone can lead to various side effects. 4 2 21 It is also common for hydrocortisone administration to lead to adrenal insufficiency. 4 2

Differences in studies

The administration methods and side effect occurrence frequencies differ among studies. 4 2 21 For example, the frequency of side effects differs between oral and topical administration. 21 In addition, the side effect occurrence frequency varies depending on the dosage and administration duration of hydrocortisone. 4

Precautions for real-life application

Hydrocortisone is an effective medication for treating various illnesses, but it is important to understand the risk of side effects. 4 Follow your doctor's instructions for taking hydrocortisone and do not stop taking it or change the dosage without your doctor's approval. 4 It is also important to undergo regular health checks while taking hydrocortisone. 4 This will allow for the early detection and treatment of side effects. 4

Limitations of current research

Research on the side effects of hydrocortisone is still insufficient. 4 In particular, more research is needed on the side effects of long-term use or high-dose use. 4 It is also known that side effects of hydrocortisone vary greatly from person to person. 4 Therefore, it is important to find the appropriate dosage and administration method for each patient based on their individual constitution and condition. 4

Future research directions

To study the side effects of hydrocortisone in more detail, research is needed to elucidate the mechanisms of side effects associated with long-term use or high-dose use. 4 Research is also needed to predict the frequency and severity of side effects. 4 Furthermore, research is important for developing new drugs and treatment methods to reduce the side effects of hydrocortisone. 4

Conclusion

Hydrocortisone is an effective medication for treating various illnesses, but it is important to understand the risk of side effects. 4 If you are taking hydrocortisone, follow your doctor's instructions and undergo regular health checks. 4

Literature analysis of 21 papers
Positive Content
17
Neutral Content
2
Negative Content
2
Article Type
1
0
0
3
19
1.

Erythrodermic Presentation of Atopic Dermatitis in a Patient with Secondary Adrenal Insufficiency Caused by Oral Glucocorticosteroid Abuse.

Author: MesjaszAlicja, TrzeciakMagdalena, Sroka-TomaszewskaJowita, ZaryczańskaAnna, NowickiRoman J

AD treatment
Cushing syndrome
Glucocorticosteroid abuse
Gynecomastia
Osteoporosis
Secondary adrenal insufficiency

A 41-year-old man presented with erythrodermic atopic dermatitis (AD) and secondary adrenal insufficiency caused by oral glucocorticosteroid abuse. Despite the effectiveness of oral corticosteroids for acute AD flares, their long-term use can lead to significant side effects, including Cushing syndrome. This case highlights the importance of carefully monitoring patients on long-term oral corticosteroid therapy and considering alternative treatment options when possible.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

The Role of Glucocorticoids in Breast Cancer Therapy.

Author: Mitre-AguilarIrma B, Moreno-MitreDaniel, Melendez-ZajglaJorge, MaldonadoVilma, Jacobo-HerreraNadia J, Ramirez-GonzalezVictoria, Mendoza-AlmanzaGretel

Anti-inflammatory
Immunosuppressive
Poor prognosis
Side effects of GR antagonists

Glucocorticoids (GCs) play a significant role in breast cancer, both as a marker of poor prognosis and a therapeutic target for triple-negative breast cancer (TNBC). The review summarizes the literature on GCs in breast cancer, highlighting the clinical utility of dexamethasone as an antiemetic and the ongoing efforts to develop better GR antagonists with fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Glucocorticoids are double-edged sword in the treatment of COVID-19 and cancers.

Author: YangRuixin, YuYingyan

Treats COVID-19
Treats advanced tumors
Side effects

Glucocorticoids are vital steroid hormones with broad applications in medicine. This review discusses the use of glucocorticoids in treating patients with severe or critical COVID-19 and advanced-stage solid tumors, highlighting their benefits and potential side effects. The ongoing controversy surrounding glucocorticoid use in the medical community is also discussed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Ketamine for atypical facial pain and hormonal dysregulation: a case report.

Author: DarwishYousef, WillefordSierra, MaheshKrithika, VanStephanie

Chronic pain treatment
Hypertension
Tachycardia

Ketamine has shown promise in chronic pain treatment, but it's still considered a third-line medication. This case report examines the effects of ketamine on cortisol levels and pain management in a patient with atypical facial pain.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Study protocol: DexaDays-2, hydrocortisone for treatment of dexamethasone-induced neurobehavioral side effects in pediatric leukemia patients: a double-blind placebo controlled randomized intervention study with cross-over design.

Author: van HulstA M, VerwaaijenE J, FioccoM F, PluijmS M F, GrootenhuisM A, PietersR, van den AkkerE L T, van den Heuvel-EibrinkM M

Overcome neurobehavioral problems
Neurobehavioral side effects

Dexamethasone, a highly effective treatment for pediatric acute lymphoblastic leukemia (ALL), can induce serious neurobehavioral side effects, impacting health-related quality of life (HRQoL). Previous studies suggest that these side effects may be related to cortisol depletion of the mineralocorticoid receptor in the brain. This study aims to replicate the findings of a previous trial, which suggested that adding physiological hydrocortisone during dexamethasone treatment could alleviate these neurobehavioral problems.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Late-onset hypophysitis after discontinuation of nivolumab treatment for advanced skin melanoma: a case report.

Author: AntoniouSofia, BazazoGeorgios, RöcklLudwig, PapadakisMarios, BergChristian

Cancer immunotherapy
Hypophysitis

This case report describes a patient with nivolumab-induced hypophysitis, a rare side effect of the anti-programmed cell death protein 1 antibody. The hypophysitis manifested several months after treatment discontinuation, highlighting the importance of long-term monitoring for autoimmune-related side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Anesthesia Overdose Versus Rapid Cooling for Euthanasia of Adult Zebrafish.

Author: FerreiraJorge M, FélixLuís, JorgeSara, MonteiroSandra M, OlssonI Anna S, ValentimAna M

Anesthesia overdose

This study compares the efficacy and side effects of different euthanasia methods for adult zebrafish, including anesthetic overdose with various drugs and rapid cooling. The study finds that rapid cooling is the most humane method, offering a quick and effective approach with minimal impact on postmortem analyses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

To prescribe or not to prescribe? Perceptions of radiation therapists prescribing medications for common radiation therapy side effects.

Author: ZokvicAlyssa, FarrellTom, QuanKimmen, HoEmily, SmokeMarcia

Radiation toxicity management
Timely medication prescription

Radiation therapists should prescribe medications to manage radiation toxicities in patients undergoing radiation therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Safety Assessment and Potential Risks of the Glucagon Stimulation Test in the Diagnosis of Secondary Adrenal Insufficiency.

Author: AchTaieb, AbdelkrimAsma Ben, HasniYosra, SaadGhada, KacemMaha, ChaiebMolka, ZaoualiMonia, MaaroufiAmel, AchKoussay

GH and ACTH assessment
Abdominal cramps
Hunger
Nausea
Vomiting

The Glucagon Stimulation Test (GST) is a reliable alternative to assess the hypothalamic pituitary adrenal axis, but should be used cautiously, especially in the elderly, due to minor side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Carfilzomib-induced life-threatening lung injury in refractory multiple myeloma.

Author: GhasoubRola, BenkhadraMaria, KassemNancy, AlshurafaAwni, ElsabahHesham

Respiratory side effects

Carfilzomib is a proteasome inhibitor used to treat multiple myeloma. While carfilzomib is associated with respiratory side effects, severe pulmonary toxicity is rare and only reported in a few case reports.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Corticosteroids for treatment of COVID-19: effect, evidence, expectation and extent.

Author: PatelVijay K, ShirbhateEkta, PatelPreeti, VeerasamyRavichandran, SharmaPrabodh C, RajakHarish

COVID-19 treatment

The World Health Organization (WHO) announced the COVID-19 occurrence as a global pandemic in March 2020. There is no clinically accepted therapeutic drug(s) available yet for the treatment of COVID-19. The treatment of SARS-CoV-2 patients is based on the experience gained from SARS-CoV and MERS-CoV infection during 2003.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Effects of estradiol- and ethinylestradiol-based contraceptives on adrenal steroids: A randomized trial.

Author: KangasniemiMarika H, ArffmanRiikka K, HaverinenAnnina, LuiroKaisu, HustadSteinar, HeikinheimoOskari, TapanainenJuha S, PiltonenTerhi T

Adverse effects related to COCs

This study compared the effects of two types of combined oral contraceptives (COCs) containing either estradiol valerate (EV) or ethinylestradiol (EE) on cortisol and other adrenal steroid hormones. The study found that COCs containing EE affected adrenal function by altering steroid and corticosteroid-binding globulin (CBG) synthesis. However, the effects of COCs containing natural estrogens, such as EV, on adrenal function remain unclear.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Hypertension and Severe Hypokalemia Associated With Oral Ingestion of Topical Hydrocortisone Cream.

Author: SahaArunava, BalakrishnanSuryanarayanan, TrivediNitin, AbrahamGeorge M

Adrenal insufficiency
Hypokalemia
Systemic toxicity

Ingesting topical hydrocortisone cream can lead to life-threatening side effects, as demonstrated by a case of a patient who developed hypokalemia and adrenal insufficiency after consuming OTC hydrocortisone cream.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

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