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Hydrocortisone is a prescription medication used to treat a wide range of conditions, including asthma, allergies, arthritis, lupus, skin conditions, and cancer. It is a corticosteroid, a class of medications that work by reducing inflammation and swelling, slowing down an overactive immune system, or replacing cortisol, a hormone that helps the body respond to stress. While hydrocortisone can be effective in managing these conditions, it is important to be aware of its potential side effects, which include muscle weakness. Proximal limb and girdle muscles may experience weakness and wasting, known as corticosteroid myopathy, which is generally reversible upon discontinuation of the medication. Other side effects of hydrocortisone include increased thirst, urinary changes, weight gain, mood changes, dizziness, nausea, and vomiting. It is crucial to consult a doctor before taking hydrocortisone and to report any adverse reactions to them.
| Characteristics | Values |
|---|---|
| Muscle weakness | Yes |
| Muscle wasting | Yes |
| Cause of muscle weakness | Long-term use of hydrocortisone |
| Other side effects | Extreme tiredness, loss of appetite, weight loss, upset stomach, vomiting, drowsiness, joint and muscle pain, changes in skin color, and craving for salt |
| Other risks | Weak bones (osteoporosis), high blood sugar, weak adrenal gland, depression, lowered immune system |
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What You'll Learn
Adrenal crisis
The adrenal glands, located on top of the kidneys, produce cortisol, a glucocorticoid hormone that maintains blood sugar regulation, suppresses immune response, and is released in response to stress. Adrenal crisis occurs when there is insufficient cortisol production, which may be due to primary adrenal failure, secondary suppression of the hypothalamic-pituitary-adrenal axis, or other factors like infections, trauma, surgery, adrenal gland or pituitary gland injury, or medication discontinuation.
The symptoms of adrenal crisis are often non-specific and can include fatigue, nausea, abdominal pain, vomiting, dizziness, hypotension, weakness, sweating, diarrhoea, back pain, and syncope. These symptoms can rapidly progress to obtundation, metabolic encephalopathy, shock, circulatory collapse, and death if left untreated.
The treatment for adrenal crisis involves the prompt administration of intravenous or intramuscular hydrocortisone, fluid resuscitation, and preventative strategies. For those with underlying conditions like Addison's disease or hypopituitarism, it is crucial to recognise the signs of stress that may trigger an adrenal crisis and be prepared to administer emergency injections of glucocorticoids or increase the dosage of oral glucocorticoids.
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Corticosteroid myopathy
Corticosteroid-induced myopathy, or steroid myopathy, is a toxic non-inflammatory myopathy caused by chronic high to moderate systemic corticosteroid use. It was first described in 1932 by Harvey Cushing as a symptom of Cushing syndrome. It is a highly prevalent condition, typically affecting the pelvic girdle muscles, and is associated with muscle weakness and atrophy without pain. The chronic form of the condition occurs after prolonged use of corticosteroids, while the acute form is less common and occurs abruptly during high-dose corticosteroid treatment.
The condition is believed to be caused by an excess of either endogenous or exogenous corticosteroids. Excess endogenous corticosteroid production can be caused by adrenal tumours, while excess exogenous corticosteroids can result from steroid treatments for conditions such as asthma, chronic obstructive pulmonary disease, polymyositis, connective tissue disorders, and rheumatoid arthritis. Corticosteroids have a direct catabolic effect on muscle, decreasing protein synthesis and increasing the rate of protein catabolism, leading to muscle atrophy.
The diagnosis of corticosteroid-induced myopathy requires a high degree of clinical suspicion and is confirmed when muscle weakness improves after tapering or discontinuing corticosteroid treatment. Treatment for the condition includes corticosteroid withdrawal, switching to non-fluorinated glucocorticoids, or alternate-day dosing. Physical therapy, including resistance and aerobic exercises, has been shown to be effective in preventing and treating steroid-induced myopathy, improving muscle strength, and modulating muscle atrophy.
Hydrocortisone is a corticosteroid used to treat symptoms of low corticosteroid levels and other conditions with normal corticosteroid levels, such as arthritis, severe allergic reactions, lupus, and certain conditions affecting the lungs, skin, eyes, kidneys, blood, thyroid, stomach, and intestines. It can also be used to treat the symptoms of certain types of cancer. Side effects of hydrocortisone include muscle weakness, loss of muscle mass, osteoporosis, tendon rupture, and growth suppression in children and teens. Long-term use of hydrocortisone may lead to an increased risk of severe side effects, including muscle weakness, and should be carefully monitored by a doctor.
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Long-term use osteoporosis
Hydrocortisone is a corticosteroid used to treat conditions such as arthritis, severe allergic reactions, lupus, and certain cancers. While it can be effective in managing these conditions, long-term use of hydrocortisone may lead to a condition known as corticosteroid-induced osteoporosis.
Osteoporosis is a condition characterised by weak and brittle bones that break easily. Corticosteroids like hydrocortisone can contribute to osteoporosis by reducing the body's ability to absorb calcium and increasing the rate of bone breakdown. This leads to a loss of bone density, making individuals more susceptible to fractures. The risk of developing osteoporosis increases with higher doses and longer durations of corticosteroid use.
Individuals taking hydrocortisone, especially postmenopausal women, should be aware of the potential risk of osteoporosis. It is recommended to monitor bone density levels regularly through dual-energy X-ray absorptiometry (DEXA) scans to detect any changes early on. Preventative measures, such as maintaining a healthy diet rich in calcium and vitamin D, engaging in physical activity, and avoiding excessive alcohol consumption, can also help mitigate the risk of osteoporosis.
If you are taking hydrocortisone and are concerned about osteoporosis, it is important to consult your healthcare provider. They can advise you on the necessary precautions, such as adjusting your diet, recommending supplements, or prescribing osteoporosis medications to prevent or manage bone loss. Additionally, they may suggest alternative treatments to reduce your reliance on hydrocortisone and lower your risk of osteoporosis.
It is crucial to remember that the benefits of hydrocortisone often outweigh the potential risks, especially when used appropriately and under medical supervision. Regular communication with your healthcare provider is essential to ensure the safe and effective use of this medication.
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Muscle wasting
Hydrocortisone is a corticosteroid medication that can be administered orally or through injection. It is used to treat a range of conditions, including asthma, allergies, arthritis, lupus, skin conditions, and ulcerative colitis. It is also used to treat complications arising from low corticosteroid levels in the body.
One of the known side effects of taking hydrocortisone is muscle weakness, which can occur in conjunction with muscle wasting. This is a condition known as corticosteroid myopathy, which presents as weakness and wasting of the proximal limb and girdle muscles. It is important to note that this side effect is generally reversible upon cessation of therapy.
The muscle weakness caused by hydrocortisone can also be associated with other symptoms, such as extreme tiredness, weight loss, upset stomach, vomiting, drowsiness, joint and muscle pain, and changes in skin color. These symptoms may indicate a more serious underlying condition, such as adrenal gland problems or Cushing's syndrome, and should be monitored closely.
Long-term use of hydrocortisone may also lead to other complications, including osteoporosis, tendon rupture, and growth suppression in pediatric patients. It is important for patients to be aware of these potential side effects and to consult their doctors if any of these symptoms arise.
Additionally, hydrocortisone can weaken the immune system, making patients more susceptible to infections. This is particularly important to consider when it comes to vaccinations. Patients taking hydrocortisone should not receive live vaccines, such as the chickenpox or measles vaccine, as they may be at risk of contracting the infection or experiencing reduced vaccine effectiveness.
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Withdrawal symptoms
Hydrocortisone is a corticosteroid used to treat symptoms of low corticosteroid levels and other conditions in patients with normal corticosteroid levels. It is typically administered as a shot into a muscle or vein, or in tablet form.
- Extreme tiredness and weakness
- Loss of appetite and weight loss
- Upset stomach, nausea, and vomiting
- Dizziness and fainting
- Joint and muscle pain
- Changes in skin colour
- Craving for salt
- Confusion, sweating, and a fast heartbeat
- Depression
- Infertility or sex drive issues
- Bone density loss
- Growth suppression in children and teens
Topical steroid withdrawal symptoms are also possible, and typically affect the skin and face. Symptoms include:
- Redness and itchiness of the skin
- Flares, or repeat periods of symptoms
- Non-skin symptoms, such as mood changes
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Frequently asked questions
Hydrocortisone is a corticosteroid medication used to treat a variety of conditions, including asthma, allergies, arthritis, and inflammatory bowel diseases. It is available in various forms, including oral tablets, liquids, injections, and creams.
Hydrocortisone is a steroid that decreases inflammation, slows down an overactive immune system, or replaces the cortisol hormone, which helps the body respond to stress.
Yes, hydrocortisone can cause muscle weakness, especially with long-term use. This is known as corticosteroid myopathy and is characterised by weakness and wasting of the proximal limb and girdle muscles. However, this side effect is generally reversible upon discontinuation of the medication.
Other side effects of hydrocortisone include increased thirst and urination, weight gain, nausea, vomiting, joint pain, dizziness, blurred vision, high blood sugar, mood changes, and stomach bleeding. It is important to consult a doctor if any of these side effects occur.
No, it is not advisable to stop taking hydrocortisone suddenly as it can lead to withdrawal symptoms such as fever, muscle and joint pain, and discomfort. Consult a doctor to gradually taper off the medication to avoid withdrawal reactions.
