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Is the Brain Structure Affected By Steroid Use? Study Says Yes

An image of a doctor looking at brain scansIt's typical for healthcare providers to prescribe patients steroids for alleviating the symptoms of various inflammatory conditions. However, steroids have their benefits and drawbacks. While they can effectively offer relief, they can also cause unpleasant side effects. Researchers recently found the problem of the brain structure affected by steroid use. The brain can be affected by long-term steroid use.

What Are Steroids?

Steroids are compounds that the body naturally produces, typically in the form of hormones. These hormones help the cells and organs of the body to function as they should. Steroids are also available in synthetic form, manufactured by pharmaceutical companies. These are not the same as anabolic steroids that are associated with muscle mass increase.

Corticosteroids are the type discussed here. These steroids are formulated to produce the same effects as the body’s main anti-stress hormone, cortisol. This hormone plays a key role in neutralizing inflammation in the body. Corticosteroids are sometimes referred to as prescription steroids.

Physicians often prescribe these to help alleviate inflammatory issues, decrease immune system activity, or restore balance to the body’s hormone levels.
Hydrocortisone is the most common form of man-made corticosteroid employed in cases of adrenal fatigue and adrenocortical insufficiency. Also, it’s typically used in instances of acute asthma and shock and for topical applications.

Types of Steroids

Some steroid medicines include cortisone, methylprednisolone, and prednisone. Prednisone is the most commonly used form of steroid for treating certain rheumatologic diseases, such as rheumatoid arthritis and lupus.

How Steroids Are Administered

Steroid medications can be given in a few different ways. The different forms vary in how easily they dissolve or the length of time they remain in the body. Steroids can be administered locally and applied to the precise area where a problem exists. For example, you might receive a joint injection for local joint pain.

On the other hand, steroids can be administered systemically, throughout the body system. An example of systemic steroid remedies includes medication that is delivered directly into a vein (intravenously or IV).

Delivery methods include an inhaler, cream, liquid, nasal spray, pill, or a shot.

Conditions Steroids Help

Doctors frequently recommend steroids for conditions such as:

  • Bronchial Asthma
  • Eczema and other skin issues (like rashes)
  • Chronic obstructive pulmonary disease (COPD)
  • Crohn's disease and ulcerative colitis
  • Multiple sclerosis (MS)
  • Systemic lupus erythematosus (SLE)
  • Allergic reactions
  • Rheumatoid arthritis

Known Side Effects of Steroids

Outside of the brain structure affected by steroid use, long-term use of glucocorticoids can lead to the development of particular side effects, including:

  • Changes in blood sugar
  • Changes in blood pressure
  • Appetite stimulation
  • Agitation
  • Mood fluctuation
  • Increase in body weight
  • Anxiety
  • Feelings of depression
  • Nausea
  • Puffiness
  • Sleep disturbances

While steroids work, they can also cause problems, interacting and interfering with the body's normal functions.
It’s important to note that if corticosteroids are taken for a long time in higher doses, they can wreak havoc on your health. They can trigger osteoporosis, eye issues, changes in hair and skin, cause an increased risk of diabetes, and also stunt growth in children.

Is Brain Structure Affected By Steroid Use?

An image of a doctor checking several scan imagesIt would appear that brain structure is affected by steroid use. Both the function and structure of the brain can be affected. Research involving individuals suffering from Cushing’s disease and exhibiting an excessive level of natural glucocorticoid cortisol found that an extended period of exposure to glucocorticoids can impact not only how the brain performs, but also the brain's structure.

The exact mechanisms of how steroids are causing this brain damage are not entirely clear, but research has provided some suggestions.

Studies on If Brain Structure Is Affected by Steroid Use

Recent studies have shown that the long-term use of prescription steroids affects the brain structure. Glucocorticoids, also referred to as prescribed steroids or corticosteroids, are medications employed in addressing various conditions.

According to findings from researchers at Leiden University Medical Center in the Netherlands, prescribed steroids negatively impact the brain by causing structural and volume changes in the white and grey matter of the brain.

White matter is found in the deeper tissues of the brain and contains bundles of nerve fibers (axons) that are coated with myelin, a whitish-colored, fatty protein. It plays a role in neuronal connections and signaling in the brain. White matter is responsible for conducting, processing, and sending nerve signals.

Grey matter is a type of brain tissue that’s largely found in the cerebellum, cerebrum, and brain stem. It contains mostly neuronal cell bodies and unmyelinated axons. This brain tissue is responsible for processing information in the brain, receiving information, and regulating outgoing information.

Study Observations: Brain Structure Affected by Steroid Use

The research involved a significant number of  UK Biobank cohorts, amounting to nearly 25,00 patients, recruited between 2006 and 2010. However, only about 800 people actually took steroids, while the rest were non-users. It included persons who used the inhaled form of glucocorticoid, as well as persons who used a systemic glucocorticoid. This type of steroid is taken as an injection or orally.

Also, none of the participants had a background involving hormonal, neurological, or psychiatric problems that are linked to brain damage.

Researchers made several observations:

  • When compared to participants who did not use steroids, both those who were taking systemic steroids or prescription inhaled steroids had diminished white matter in the brain.
  • White matter was reduced more in participants on systemic steroids than inhaled of steroids.
  • Participants using systemic steroids had a bigger caudate nucleus— a part of the brain found in the grey matter that plays a key role critical role in functions such as learning — in comparison to participants who did not use steroids.
  • In participants who took the inhaled type of glucocorticoids, it was observed that the amygdala— a section of the grey matter that plays a critical role in how emotions are processed and regulated —  was smaller in comparison to participants who did not use steroids.

The researchers believe that these findings offer some insight into the link between prescribed steroids and psychiatric-associated issues, like mood disorders and depression. Further research may be needed to validate these findings.

Steroids and Adrenal Insufficiency

An image of a cortisol blood test tubeWhen the adrenal glands fail to produce an adequate level of steroid hormones, primarily cortisol, along with aldosterone and cortisone to a lesser extent, adrenal insufficiency develops. This condition can be assessed with the use of laboratory tests that can document and confirm low cortisol levels in the body.

The adrenal glands, which are located above a kidney, are the hub for producing crucial anti-stress hormones. The adrenal cortex secretes steroid hormones, sometimes referred to as corticosteroid hormones.

Types of Adrenal Insufficiency

Adrenal insufficiency can be placed in two categories: primary adrenal insufficiency and secondary adrenal insufficiency.

  • Primary adrenal insufficiency is sometimes called Addison’s disease. This rare condition occurs when the adrenal glands fail to secrete sufficient stress hormones.
  • Secondary adrenal insufficiency occurs when the pituitary glands fail to communicate to the adrenal glands to secrete cortisol.

Adrenal insufficiency can impact children, adults, and seniors alike. Also, different conditions can lead to varying levels of severity of adrenal insufficiency, and individuals can be impacted differently. As such, the most effective remedies may also be different from one person to the next.

A doctor may prescribe synthetic corticosteroids to mimic similar effects exerted by the natural corticosteroids secreted by the adrenal cortex. However, you may want to discuss with your doctor the research on brain structure affected by steroid use before beginning any new medication.

Steroids and Adrenal Fatigue

There are instances when steroids are recommended to help with the symptoms of Adrenal Fatigue Syndrome (AFS), like chronic tiredness, frequent allergies, irritable bowel syndrome, and skin conditions. Steroids are known to be effective at suppressing these symptoms, and in the process, they may provide temporary relief. However, long-term use of steroids can lead to a weakened or even catabolic state, when the breakdown of organs and proteins in the body occurs.

It may be tempting to take more steroids in order to get symptom relief in this state. However, symptoms are likely to return if the root causes of the condition are not addressed. This could lead to excessive or long-term steroid use.

What Can Happen: Steroids and AFS

AFS is a condition that develops when your body starts to lose its ability to fight stress, typically due to chronic or severe stress. The body’s exposure to stress forces the adrenal glands to secrete cortisol with the aim of neutralizing it. With short-term stress, this works.

However, chronic stress, whether physical, emotional, or mental, pressures the adrenals for more and more cortisol. The result is exhausted adrenals with a diminished capacity to function properly.

Steroids are useful in helping to prime the adrenal glands and stimulating them to produce hormones as they should. Steroids can often help to manage symptoms. However, AFS symptoms often return, leading patients to increase their steroid use just to reach baseline.

However, long-term use increases the likelihood of the brain structure being affected by steroid use, so it may be best to approach steroid use with caution. This is why, if you are using steroids to address some of the symptoms of AFS, be sure to talk to a doctor aware of AFS about addressing the root cause of the problem and getting off steroids as soon as your body allows.

Brain Structure Affected By Steroid Use: When to Use Steroids

An image of a man injecting himself steroidsThe evidence showing brain structure affected by steroid use means you need to use caution when deciding between different forms of steroids.

In general, it's best to avoid steroids when possible. Steroids are strong compounds, and their impact can have lasting effects on your body. The simplest and best advice is to use steroids as a last resort, and even then, use them while exercising caution.

Steroids may affect persons differently. While it may work for one person in alleviating a particular condition, it may be ineffective for another person with the same condition. For instance, if a steroid helps to alleviate your AFS symptoms, it may not produce positive results in another AFS patient. Furthermore, long-term use of steroids may not work well or at all.

Trying a wide variety of medications, called a "shotgun approach", is not a good option for any issue. This can result in further health issues and complications that slow the recovery process. When on steroids, paradoxical reactions can occur. Rather than feeling calm and energized, for example, you can end up feeling more fatigued, anxious, and unwell.

While steroids can be beneficial, constant medical supervision by your physician is key to protecting your health and wellbeing.  It’s best to have a safe, sustainable, and balanced approach when using steroids. It’s also important for you to discuss with your physician how brain structure affected by steroid use could be a concern.

Questions That Still Remain On Brain Structure Affected by Steroid Use

What questions remain regarding the brain structure affected by steroid use? Some questions that researchers need to address in the future include:

  • Are the effects of glucocorticoid medications on the brain reversible?
  • How are the effects dependent on the dose and duration of the steroids?
  • How are the effects dependent on the type of glucocorticoid medication?

Hopefully, research will show that there are safe ways to use these medications. But in the meantime, it may be best to use them sparingly, if at all.

Brain Structure Affected by Steroid Use: The Takeaway

Steroids can help as well as hurt. Research shows that brain structure affected by steroid use is a serious concern. However, with experienced physician guidance, steroid use can be efficiently monitored to minimize the risk of health complications. It may be best to work to address the root cause of medical issues and keep steroid use short-term and minimal, if at all possible. If you suffer from a condition that requires steroid use and have concerns, speak to your doctor.

If you are concerned about steroids and would like assistance in determining natural ways to tackle inflammation, the team at Dr. Lam Coaching can help. We offer a free** no-obligation phone consultation at +1 (626) 571-1234 where we will privately discuss your symptoms and various options. You can also send us a question through our Ask The Doctor system by clicking here.

© Copyright 2023 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Research on whether brain structure affected by steroid use indicates that long-term use does have an effect. Steroids can cause structural and volume changes in the white and gray matter of the brain. The is believed to have the potential to cause psychiatric side effects, like mood disorders.

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