Patients who have had prolonged steroid therapy may experience which of the following?

Prolonged steroid therapy leads to adrenal gland atrophy due to the suppression of the hypothalamic-pituitary-adrenal (HPA) axis. When exogenous steroids are introduced into the body, particularly in high doses or over an extended period, the adrenal glands decrease their production of corticosteroids because the body senses the excess hormone and attempts to regulate itself by reducing its own production. As a result, the adrenal glands may shrink and lose their ability to produce hormones effectively. This atrophy becomes particularly crucial during any transition where steroids are tapered or discontinued, as the body may struggle to respond appropriately to stress without adequate adrenal output.

In contrast, options such as increased adrenal hormone levels, improved antibody responses, and enhanced metabolic function are not typical outcomes of prolonged steroid therapy. In fact, long-term use of steroids often leads to increased susceptibility to infections (due to immune suppression) and various metabolic changes that can be detrimental to overall health. Thus, recognizing adrenal gland atrophy as the consequence of extended steroid use is vital for understanding the implications of such therapy on the endocrine system.