by Dr. Om J Lakhani
Also available at : https://endocrinology.co.in/FOR+PATIENTS/Basics+about+Steroids
Q. What are steroids ?
Steroids are organic compounds with four rings in a very specific molecular configuration .
They are extensively found in plants and animals
Q. What are the functions of steroids in living beings ?
Steroids have two main function in a living thing: a) They are part of the cell membrane b) they act as hormones or signalling molecules in living things
Q. Does the human body have steroids ?
Yes. The human body, just like any other living thing is full of these “steroids”
Steroids are NECESSARY for the human being to survive. Without steroids, there is no human life.
Q. Which are the common hormones in our body which are “steroids” ?
Cortisol is the most important steroid in the human body. It is formed by adrenal cortex. Again, there is no life without cortisol. Cortisol is a form of a Corticosteroid since it is formed by the adrenal cortex. It is also called a “glucocorticoid”
Beside cortisol, there are several other steroids in the human body. The sex hormones- testosterone and oestrogen are also forms of “steroids”
Q. What is the colloquial usage of the term steroids ?
What non-medical people understand as steroids are basically two things:
a) Steroid used an abused by athletes and body builders. The correct terms for these are “anabolic steroids”
b) The steroids used in clinical medicine. These include “steroids” like hydrocortisone, prednisolone and dexamethasone. Dexamethasone is currently in vogue because of its extensive use in management of COVID-19 infection
Q. Are “Steroids” safe ?
Now that depends on what steroid you are talking about.
Steroids are per se necessary for the human body to survive. So the steroids formed without your own body, are absolutely essential for survival.
However, if you are talking about steroids given from outside as medicine, just like any medicine, the correct use of the same is not only safe but also life saving.
Incorrect use of any medicine, be it a steroid or anything else is dangerous.
Q. Let me rephrase it, are “anabolic steroids” abused by sportspersons safe ?
No. They are absolutely NOT safe. They cause dangerous, long lasting and severe side effects.
The abuse of these anabolic agents is rampant in worldwide and it is an pandemic which we are failing to recognise and curb.
If you are an athlete abusing anabolic, contact your Endocrinologist ASAP.
Q. What about the use of steroids in COVID-19 ?
Generally steroids like Dexmethasone, prednisolone, methylprednisolone etc have been used In selected sick patients with COVID-19.
Several studies have found the use of Dexamethasone to be life saving in selected patients with COVID-19. [1]
If your treating doctor prescribes you “Steroids” for COVID-19, it is most likely indicated and may be lifesaving for you. Hence it is advisable NOT to interfere with ongoing treatment without having a complete knowledge about the same.
Having said that, you are always free to seek a second opinion on the topic and may seek an opinion of another qualified doctor if you need to
Q. What is the commonest side effect of dexamethasone or other steroids used in COVID-19 ?
In some patients Dexamethasone can increase the blood sugar levels even in people who may not have diabetes mellitus. In people already having diabetes, the blood sugars can get worse.
However, there is now extensively knowledge and expertise on managing steroid induced hyperglycemia.
Doctors dealing with this can look at our RCT on this topic at : https://www.ijem.in/text.asp?2017/21/6/836/219325
Q. What are the other side effects of steroids ?
We are coming up with a note on the same soon. So watch this space