[Kim Jaeho's Life Story]<223> The Sweet Temptation of Steroids

Steroids are drugs frequently used when symptoms such as swelling, itching, pain, or red spots caused by inflammation are severe, as seen in conditions like asthma, arthritis, lupus, and allergies. Steroids are highly effective in reducing inflammation and alleviating these symptoms, which often tempts doctors to prescribe them when patients visit, and patients who have used these drugs tend to be tempted to use them again.

When our body is infected by microorganisms, injured, or exposed to irritating substances, the immune system, including white blood cells, works to eliminate or heal these threats, protecting our body from infections, diseases, and injuries. This defense mechanism is called inflammation. Inflammation is an essential process necessary for healing problems in tissues or cells (refer to Life Story episode 191) and is not a disease.

Inflammation manifests through three processes: dilation of capillaries to increase blood supply to the damaged area, increased delivery of blood and proteins to cells, and an increase in neutrophils, a type of white blood cell that digests microorganisms. These processes are accompanied by inflammatory symptoms such as swelling, itching, pain, and red spots. These symptoms naturally disappear once the cause of inflammation is eliminated, but if the cause persists, the inflammation becomes chronic.

Chronic inflammation causes significant discomfort and is difficult to resolve if its cause is not eliminated. The causes of chronic inflammation vary, including microbial infections, wounds, and irritating substances. It can also arise from autoimmune diseases where white blood cells mistakenly attack normal cells as pathogens. Steroids are among the drugs used to alleviate inflammatory symptoms when the exact cause is unknown.

When we face a threat, the two adrenal glands located on top of each kidney secrete a hormone called cortisol, which acts as an alarm system signaling urgent danger. Cortisol plays a crucial role in maintaining health across various areas, including metabolism and immune responses. Steroids are chemically synthesized substances designed to mimic the structure of cortisol and are commonly referred to as corticosteroids.

Steroids are widely used to reduce inflammation in many diseases where inflammatory reactions occur. They are also used to suppress immune cells attacking normal cells in cases of organ transplantation or autoimmune diseases. Steroids come in various forms, including tablets, liquids, injections, creams or gels, eye drops, and ointments.

Because steroids are structurally similar to cortisol, they bind to hormone receptors on immune cells inside the body and inhibit the production of chemicals that cause inflammation. This reduction in inflammation can easily be mistaken for curing the disease. However, steroids do not eliminate the cause of inflammation, so even if inflammatory symptoms decrease, the inflammation itself is not cured.

Therefore, if efforts are not made to identify and remove the cause of inflammation, the effectiveness of steroids will diminish, and inflammatory symptoms are likely to recur. Repeated use of steroids to treat these symptoms increases the risk of various side effects.

The side effects of steroids vary depending on their form and are more common with high doses or long-term use. Most side effects occur with oral steroids and include increased appetite and weight gain, sleep disturbances, glaucoma and cataracts, high blood pressure, muscle weakness, increased body hair growth, worsening diabetes, delayed wound healing, stomach ulcers, osteoporosis and fractures, depression, and growth retardation in children, among many others.

On the other hand, steroids suppress immune system activity, so long-term use can significantly lower immunity, increasing the risk of infections and sepsis, which requires special caution.

Steroids have an attractive effect of temporarily alleviating severe inflammatory symptoms of unknown cause, but there are important points to remember when using them.

Just as cold medicine taken for a cold does not kill the virus but alleviates symptoms such as runny nose, cough, high fever, and headache, steroids can temporarily reduce inflammatory symptoms and provide relief. However, they are not drugs that cure inflammation. Even when used temporarily, efforts to improve poor lifestyle habits that cause chronic inflammation must be made, and steroids should never be used long-term.

Jaeho Kim, Independent Researcher