If you have myasthenia gravis (MG), you may have been prescribed corticosteroids. Corticosteroids work by keeping an overactive immune system from attacking the body. In MG, corticosteroids prevent the immune system from causing harm to the neuromuscular junction, which is the area where the nerve meets the muscle.
Because MG is incurable, many patients are on corticosteroids for years. If you are one of those patients, here is what you need to know about the long-term use of corticosteroids.
Risks and side effects
Under normal circumstances, corticosteroids are typically prescribed for a short period of time for their anti-inflammatory properties. After the inflammation has been sufficiently dealt with, doctors typically stop administering them as soon as possible.
There is a good reason for this. The long-term use of corticosteroids can cause a condition known as Cushing’s syndrome, and the most common cause of Cushing’s syndrome is long-term corticosteroid use. This condition comes as a result of prolonged exposure to elevated levels of cortisol, which can be abnormally produced by the body, or in the case of glucocorticoid prescription, from the drugs administered.
Symptoms of Cushing’s syndrome include weight gain, and fat typically accumulates on the face and the upper back.
In addition, patients may experience more brittle bones and weaker muscles. Patients also become more susceptible to high blood sugar, diabetes mellitus and high blood pressure. Some patients may experience fatigue as well.
Learn more about MG signs and symptoms
Monitoring your symptoms
Because of the possibility of Cushing’s syndrome as a result of the prolonged use of corticosteroids, doctors typically prescribe patients with MG other immunosuppressants in addition to corticosteroids. The goal here is to ensure that the corticosteroids prescribed can be progressively tapered down to as low a dose as possible.
If you are on long-term glucocorticoids and experience any of the symptoms above, speak to your doctor, who may be able to adjust your corticosteroid dose to keep these symptoms to a minimum. However, your doctor needs to be careful to not reduce your corticosteroid dose so much so that your MG symptoms return.
Hence, it is important to keep a diary of the symptoms you experience, whether it be from MG or the side effects associated with glucocorticoids. Only then can your doctor get a fuller picture of your symptoms and prescribe a treatment regimen that works for you.
