Side effects of steroids
Steroids for autoimmune hepatitis (AIH)
Steroids can have a number of side effects. The risk of getting some of these will increase depending on the dose and how long you take them.
It's important to know:
If you develop any severe infection (including chicken pox, measles or shingles) while taking steroids, please tell your doctor immediately.
Common side effects
Common side effects of steroids include:
- higher risk of infections, including colds, flu and more serious infections like pneumonia and sepsis
- salt and fluid retention, which can lead to raised blood pressure and ankle swelling.
- changes to your hormones, which can cause weight gain, diabetes or raised blood sugar levels
- gut problems, such as stomach pain, stomach ulcers or feeling sick (nausea)
- joint, bone and muscle problems, such as osteoporosis (weak bones), muscle and joint pain or muscle weakness
- cosmetic changes, including acne, rounded ‘moon face’, growth of unwanted body hair, thinner skin or stretch marks
- changes in mood or mental health, including experiencing highs and lows in your mood
- sleep disturbances
- problems with growth in children and young people
Other, less common side effects include:
- eye problems, such as glaucoma, cataract or other problems with vision
- more severe effects on mood, including depression and thoughts of suicide
When to seek help
Call a doctor or contact 111 straight away if you:
- feel feverish or generally unwell, or think you have an infection
- come into contact with someone with chickenpox, shingles or measles
- have worrying changes in your mental health or mood, such as feeling depressed, confused, irritable or anxious
Call 999 or go to A&E if:
- you have thoughts about harming yourself or ending your life
Serious allergic reaction
It's possible to have a serious allergic reaction.
Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
Adrenal crisis
Steroids can stop your body from making the hormone cortisol. Cortisol is an essential hormone to live well.
If there is not enough cortisol in your body, you can become unwell and this can be life-threatening if not treated. This is known as adrenal crisis.
Symptoms of adrenal crisis
Signs and symptoms of an adrenal crisis are:
- low blood pressure
- feeling dizzy, lightheaded
- fever or high temperature
- shivering and feeling cold
- feeling sick (nausea) or being sick (vomiting)
- feeling very weak
- extreme tiredness, drowsiness or confusion
- aching muscles or joints
- tummy ache
- severe diarrhoea (runny poo)
Contact us if you start to feel unwell after a steroid dose reduction.
If you are unwell, show your steroid emergency card to the person treating you and tell them that you are at risk of adrenal crisis.
To prevent adrenal crisis:
- follow the steroid sick day rules, available from the Society for Endocrinology's website. They explain when and how to take more steroids if you feel unwell, or if you are having a procedure such as surgery
- make sure you have enough of the steroid medicine to take when you feel unwell
- do not stop your steroid treatment suddenly or skip doses
- only reduce your steroid dose as advised by a doctor or pharmacist
Material number: 5186/VER1
Date published: June 2021
Review date: June 2024
