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Hydrocortisone is a medication used to treat inflammatory, autoimmune, hormonal, and other conditions. It is commonly used to treat rheumatic diseases, which are painful inflammatory conditions that affect joints, tendons, ligaments, bones, and muscles. Side effects of hydrocortisone include muscle pain, weakness, and tenderness, as well as joint pain. In addition, stopping hydrocortisone medication suddenly can cause withdrawal symptoms such as fever, muscle and joint pain, and discomfort. Therefore, it is important to consult a doctor before stopping this medication.
| Characteristics | Values |
|---|---|
| Lack of Hydrocortisol | May cause extreme tiredness, weakness, loss of appetite, weight loss, an upset stomach, vomiting, drowsiness, joint and muscle pain, changes in skin color, and craving for salt |
| Adrenal Gland Problems | May cause darkening of the skin, diarrhea, dizziness, fainting, joint pain, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting |
| Muscle Problems | May cause muscle pain, weakness, and tenderness |
| Bone Problems | May cause bone pain, slow growth in children, and an increased risk of osteoporosis |
| Withdrawal Symptoms | May cause fever, muscle and joint pain, and overall discomfort |
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What You'll Learn
Withdrawal symptoms
While hydrocortisone is a synthetic form of cortisol, the steroid withdrawal syndrome is a set of symptoms that can occur when someone stops taking steroids. Therefore, stopping the use of hydrocortisone can lead to withdrawal symptoms.
Steroid withdrawal syndrome can produce a wide range of signs and symptoms, some of which are not well recognized. These include:
- High fever
- Moderate anorexia
- Nausea
- Lethargy
- Headache
- Diarrhea
- Dizziness
- Confusion
- Fast heartbeat
- High blood pressure
- Irritability
- Muscle tremors or twitching
- Vomiting
- Swelling of the feet or lower legs
- Unusual tiredness or weakness
In addition, stopping hydrocortisone may cause serious adrenal gland problems, such as adrenal crisis.
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Adrenal gland problems
Adrenal glands produce hormones that perform a variety of functions, such as regulating blood pressure and helping the body react to physical and emotional stressors. Examples of hormones produced by the adrenal glands include adrenaline, norepinephrine, cortisol, and aldosterone.
Adrenal gland disorders occur when the glands produce too much or too little of these hormones. Addison's disease, for instance, is caused by an underproduction of cortisol, leading to symptoms such as fatigue, weight loss, loss of appetite, nausea, and joint and muscle pain. Cushing's syndrome, on the other hand, is caused by an overproduction of cortisol, often due to long-term use of steroid medications.
Other adrenal gland disorders include congenital adrenal hyperplasia, a genetic disorder that results in an underproduction of cortisol; aldosterone-producing adenoma, a benign tumour that leads to high blood pressure; and adrenal cancer, an aggressive form of cancer that often spreads to other organs.
Certain medications, such as hydrocortisone, can also impact adrenal gland function. Not taking enough hydrocortisone or stopping it suddenly can lead to adrenal gland problems, including adrenal crisis. Side effects of hydrocortisone may include joint pain, muscle pain, nausea, vomiting, unusual tiredness, weakness, and skin discolouration. It is important to consult a doctor if experiencing any of these symptoms or planning to discontinue hydrocortisone use.
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Thinning of bones
While there is no direct link between low hydrocortisol and thinning of bones, low doses of hydrocortisone replacement therapy have been associated with improved bone remodelling balance in hypopituitary male patients. In addition, bone mineral density is not significantly reduced in adult patients on low-dose glucocorticoid replacement therapy. However, it is important to note that hydrocortisone is a type of corticosteroid, and corticosteroid medications have been linked to bone loss and osteoporosis when taken orally or intravenously in high doses or for extended periods. This is because corticosteroids primarily affect bones by decreasing bone formation and potentially increasing bone resorption when an individual first starts taking the medication.
Osteoporosis is a condition characterised by thin, weak, and easily breakable bones. Prolonged use of hydrocortisone may increase the risk of osteoporosis. Patients taking this medication should inform their doctor if they experience any bone pain or have an increased risk of osteoporosis. Monitoring bone density levels is recommended for patients taking corticosteroids.
Certain factors can increase the risk of corticosteroid-induced osteoporosis. For example, postmenopausal women who are not taking hormone replacement therapy (HRT) are at higher risk. Smoking can also accelerate bone loss, possibly by lowering oestrogen levels in women and reducing calcium absorption in the intestine. Excessive alcohol consumption, defined as more than two drinks per day, can also negatively impact bone formation and calcium absorption.
To mitigate the risk of osteoporosis, individuals taking corticosteroids long-term may need to adjust their diet. For instance, postmenopausal women not on HRT and those at risk of steroid-induced osteoporosis should aim for 1,500 mg of calcium and 800 IU of vitamin D daily. Men under 65 should consume 1,000 mg of calcium daily, while men over 65 should aim for 1,500 mg. Good sources of calcium include dairy products like milk and yogurt, certain cheeses, broccoli, canned salmon with bones, orange juice, and tofu.
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Muscle problems
Hydrocortisone may cause muscle problems, including muscle pain, weakness, and tenderness called myopathy. If you get an unusual muscle ache that's not from exercise or other physical activity, talk to your doctor. You may need a blood test to find the cause.
If you suddenly stop taking hydrocortisone, your body may not have enough natural steroids to function normally. This may cause extreme tiredness, weakness, loss of appetite, weight loss, an upset stomach, vomiting, drowsiness, joint and muscle pain, changes in skin color, and craving for salt.
Symptoms of withdrawal may include fever, muscle and joint pain, and overall discomfort. Your risk is greater if you’ve taken hydrocortisone for more than a few days. When it’s time to stop, your doctor may decrease your dosage slowly to avoid withdrawal.
Hydrocortisone may increase the risk of hyperosmolarity (an imbalance of salts and other substances in your blood leading to fluid shifts), metabolic acidosis (too much acid in the blood), and stomach problems. Check with your doctor if you experience unusual tiredness or weakness, muscle tremors or twitching, nausea, or vomiting.
In children, hydrocortisone may cause bone pain and slow growth. The risk may be higher in children who take it for a long time. Tell your child’s healthcare provider if you have concerns about your child’s growth.
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Side effects in children
Hydrocortisone is a prescription medication that comes in many forms, including oral tablets, granules, injections, and topical applications. It is used to treat various conditions such as adrenocortical deficiency, inflammation, severe allergies, arthritis, and skin conditions. While it can be an effective treatment, it is important to be aware of the potential side effects, especially in children. Here are some detailed explanations of the side effects of hydrocortisone in children:
Delayed Growth and Development: Hydrocortisone can slow growth and development in children, especially with long-term use. Doctors will carefully monitor the child's growth and development, including height and weight measurements. Parents or caregivers should express any concerns about their child's growth to the doctor.
Muscle and Joint Pain: One of the notable side effects of hydrocortisone is muscle and joint pain. This can occur during treatment or as a withdrawal symptom when stopping the medication. If a child experiences muscle pain, weakness, or tenderness, it is important to seek medical advice, and possibly discontinue the medication.
Adrenal Problems: Hydrocortisone can cause adrenal issues in children, such as reduced adrenal gland function. Signs of adrenal problems include fatigue, weakness, stomach pain, headache, changes in body temperature, and vomiting. It is crucial to seek medical attention if these symptoms arise.
Other Side Effects: Hydrocortisone may cause various other side effects in children, including skin changes, increased infection risk, liver problems, and changes in mood or behaviour. Skin absorption of topical hydrocortisone can lead to serious side effects in children. Additionally, hydrocortisone weakens the immune system, increasing the risk of infections and altering the effectiveness of vaccines. It is important to consult a doctor about any unusual or persistent side effects and to carefully follow their instructions.
It is important to note that the side effects of hydrocortisone in children may vary, and not all children will experience the same issues. Parents and caregivers should closely monitor their children and seek medical advice for any concerns. The benefits and risks of using hydrocortisone should be carefully considered, and any changes in dosage or discontinuation should be done under medical supervision to avoid potential withdrawal reactions.
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Frequently asked questions
Stopping hydrocortisone medication can cause withdrawal symptoms such as fever, muscle and joint pain, and overall discomfort. It is advised to consult a doctor to decrease the dosage slowly to avoid withdrawal.
Hydrocortisone may cause muscle problems, including muscle pain, weakness, and tenderness. Other side effects include nausea, vomiting, dizziness, drowsiness, upset stomach, weight loss, loss of appetite, and changes in skin colour.
Serious side effects of hydrocortisone include blurred vision, eye pain, bone pain, and changes in vision. It may also cause serious adrenal gland problems such as adrenal crisis.
While on hydrocortisone medication, it is important to avoid drinking too much alcohol and having any immunizations (vaccines) without consulting a doctor. It is also advised to monitor any unusual muscle ache that is not related to physical activity, as it may require a blood test to determine the cause.
