What is a consequence of long-term steroid use?

Long-term steroid use can lead to the suppression of adrenal gland function, which results in adrenal atrophy. When exogenous corticosteroids are introduced into the body, particularly in significant doses or over prolonged periods, the hypothalamus and pituitary gland sense that there are adequate levels of cortisol, which leads to a decrease in the stimulating hormones that typically trigger adrenal activity. Consequently, this lack of stimulation results in reduced production of natural adrenal hormones, causing the adrenal glands to shrink or atrophy over time.

In this context, atrophy refers to the diminishing size and functional capacity of the adrenal glands due to the chronic suppression of their activity. If the steroid use is ceased, there may be a period of adrenal insufficiency until the adrenal glands can recover and resume normal hormone production, which can sometimes take weeks to months, depending on the duration and dosage of the steroids used. Understanding the implications of long-term steroid use is crucial for managing patient care and anticipating complications during treatment or withdrawal processes.