Cortisone: What is it, Treatment Methods and Side Effects
Cortisone is a hormone-based substance that is naturally synthesized in the human body. There may be diseases caused by its deficiency. There may be patients in whom cortisone cannot be synthesized in sufficient amounts in the body. It is not possible for cortisone not to be fully synthesized in a healthy body. Cortisone replacement therapy, which has offered very effective solutions in recent years, is applied to these patients. Because the effect of cortisone is indisputably important for the immune system and the body’s self-repair. If it is not produced, the body must be given exogenously, that is, a synthetic hormone with cortisone structure from outside. The synthetic form of cortisone that cannot be synthesized in the body and is taken from outside is called cortisol. There may be misuses of cortisone and cortisol among the public, and incorrect and incomplete perceptions that cortisone has more negative effects. Of course, cortisol treatment, in addition to its negative effects, provides the patient with a very important treatment opportunity. Every medicine can have side effects, even if they are minor. The effects of cortisone treatment are also controllable as long as doctor checks are not interrupted and post-treatment recommendations are followed. Cortisone is a hormone produced in the outer part of the adrenal gland, called the cortex. Cortisone is one of the naturally occurring hormones formed as a result of a series of biochemical reactions that use cholesterol as a raw material. Two different groups of hormones are produced by the kidney. These are glucocorticoids and mineralocorticoids. In the glucocorticoid group, there are these hormone products called cortisone and cortisol. Cortisol and cortisone, which are glucocorticoids, affect the body’s protein and carbohydrate mechanisms. Cortisone is actually the inactive form of cortisol. After cortisone production, it is processed in the liver to obtain the active form, cortisol. For this reason, cortisol, which is the active form in the treatment of many diseases, is given to the body.
What Does Cortisone Do?
In the pathway directly affected by cortisone, there is the conversion of protein and fat molecules in the body into glucose. Cortisone naturally increases blood sugar in the body before treatment. During hunger, when low-calorie foods are consumed, in short, if a hunger signal somehow goes to the brain, cortisone comes into play and produces glucose from storage fats and then from storage protein molecules. In this way, cortisone normalizes low blood sugar.
Another mechanism of use of cortisone, an important invention in treatment in recent years, is based on the functioning of the immune system. In immunology, cortisol and cortisone-containing drug preparations save the lives of patients. Cortisone treatment is an indispensable invention, especially for diseases that are treated without treatment and are chronic, affecting different organs of the body. The reason for the use of cortisone in the immune system is usually the situations that require immunosuppression. In some diseases or organ transplants, cortisone can be used for life in cases where the body perceives the transplanted organ as foreign tissue.
Cortisone production increases the number of platelets, red blood cells, hemoglobin and PMNL (polymorphonuclear leukocyte) cells in the blood. The effects of cortisone make serious contributions to patient life in many different areas, from blood production to immune system repair.
The discovery of cortisone, which is taken orally, parenterally (intravenously) or in the form of a cream, for diseases, regulates the vital functions of many patients today. In this sense, there are great benefits in producing synthetic forms of cortisone. By easily administering cortisone to the body, hospital stays are shortened, it prevents the development of diseases that shorten life expectancy and leave permanent effects on the patient, and it minimizes unintentional errors in other treatment options.
Which Diseases Is Cortisone Used to Treat?
Cortisone is the primary drug used in acute conditions of many chronic and life-threatening diseases. Therefore, considering the role of cortisone in many diseases, it has effects that reduce the mortality rate of diseases compared to its side effects. Cortisone may sometimes be recommended for a short time, sometimes it may require lifelong use. In the following diseases, cortisone gives effects that increase the comfort in patient life and minimize the possibility of morbidity, the use of which is often prescribed for long periods of time:
- Cushing’s syndrome
- Addison’s disease
- Congenital adrenal hyperplasia (CAH)
- rheumatoid arthritis
- rheumatoid carditis
- Physical stress situations such as transportation
- Skin diseases such as lichen planus, erythema, keloid, chronic dermatitis, eczema, psoriasis
- Allergic and anaphylactic reactions
- shock table
- bronchial asthma
- Liver diseases such as chronic active hepatitis, cirrhosis, subacute hepatic necrosis
- Kidney diseases such as systemic lupus erythematosus (SLE), glomerulonephritis
- Acute respiratory distress syndrome (ARDS)
- Hyperkalemia, inflammatory bowel diseases
- eye inflammation
Many factors such as the development process of the diseases, the patient’s history, other treatment options, and the patient’s care during the treatment process also affect which of the treatment models is most appropriate. For this reason, although the diseases mentioned are diseases that require cortisone treatment, physician checks are essential to determine at which stage of the treatment cortisone will be taken, for how long and how it will be used. Otherwise, if the side effects of cortisone use are not taken into consideration, undesirable effects may occur.
What are the Side Effects of Cortisone?
When cortisone is prescribed or when patients are told that they must use cortisone for life, the first thing that comes to mind is side effects. However, the side effects of cortisone are tolerable considering the permanent effects of the diseases it treats on the patient. When using cortisone, it is necessary to maximize the treatment duration and minimize side effects. Doing this begins with the patient choosing a nutrition and exercise routine suitable for treatment. Because, as is known, the biggest effect of cortisone is that it has an opposite effect to insulin. In other words, weight gain is the most common and undesirable effect in patients because it increases blood sugar. The side effects caused by cortisone can be corrected with the right diet, a diet low in salt and sugar, consuming greens more frequently in meals, and adequate daily exercise. In addition, the side effects of long-term use of cortisone are as follows:
- Growth arrest and protein loss due to catabolic effect (destruction effect)
- While fat tissue increases in the trunk and upper body, there is thinning in the legs
- Eye pressure
- Abnormal mood that occurs with extreme reactions called euphoria, resulting insomnia
- Edema, hypokalemic alkalosis
- Decrease in vitamin D secretion
- Weakness, getting tired easily
- susceptibility to infections
These side effects may occur in patients in the long term or in the short term. The way cortisone is used is also very important to reduce or even prevent many of them from occurring. To get the most benefit from cortisone, the medicine should be taken in the morning on an empty stomach. If preferred, it is recommended to use it every other day instead of every day. If it is necessary to stop cortisone, it should be stopped over a few days and the dose should be reduced, rather than stopping suddenly. A diet low in salt and sugar should be preferred and plenty of water should be consumed. Calcium and vitamin D supplements can be taken with the recommendation of a physician. Care should be taken to consume a protein-rich diet. Live vaccination may be risky in these patients due to their susceptibility to infection. In addition, since there is a risk of interaction with other medications, the physician must be informed about the use of a new medication, vitamin supplement, or vaccination.
With the discovery of the use of cortisone in diseases, there is no longer the old helplessness for diseases that have emerged recently and their incidence has increased. The positive effects of cortisone treatment are at a controllable level compared to the side effects. You can immediately make an appointment and be examined to consult a specialist physician for short-term or long-term cortisone treatment and to get information about what you need to do after treatment.