Thread by @donkaloli

Steroids and Cushing's syndrome!

A thread

For so long in Uganda and Africa at large, corticosteroids are being used over the counter (OTC) to treat common cold, simple allergies etc. However, corticosteroids have a considerable number of side effects including: hypertension,

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Diabetes, lipid disorders, sleep apnea, osteoporosis, myopathy, and disorders of coagulation (will further be discussed below). But patients use steroids without being aware of this.

Lets discuss steroids first👇
Commonly called steroids but 'll be important to clarify and

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differentiate them from sports steroids by calling them corticosteroids. Our bodies can produce all kinds of steroids for example cortisol, aldosterone, estrogens, testosterone etc.
Our interest is on the corticosteroids mainly cortisol.
This is produced by the adrenal

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glands just on top of your kidneys.

Some functions of cortisol;
🕸 Manages how your body uses carbohydrates, fats, and proteins

🕸 Keeps inflammation down

🕸 Regulates your blood pressure

🕸 Increases your blood sugar (glucose)

🕸Controls your sleep/wake cycle

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🕸 Boosts energy so you can handle stress and restores balance afterward

Therefore, corticosteroids constitute an ideal treatment for various inflammatory and autoimmune disorders due to their anti-inflammatory and immunodeficiency actions.
Examples are;
1. PREDNISOLONE

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2. DEXAMETHASONE (DEXA)
3. BETAMETHASONE
4. PREDNISONE
5. HYDROCORTISONE
6. FLUTICASONE
Etc
Am sure you must have used one of the above drugs before in your life🤔
They come in the following formulations: oral, topical (creams), aerosol (inhalers), and injectable.

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They are commonly used to treat the following conditions; arthritis mostly Rheumatoid Arthritis, Asthma, Chronic Obstructive Pulmonary Disease (COPD), Systemic Lupus Erythematosus, Inflammatory Bowel Disease (IBD, Crohn's Disease and ulcerative Colitis) Etc

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Adverse effects occur in up to 90% of patients who take corticosteroids for >60 days. The adverse effects constitute what we call Cushing's syndrome and 👇 we discuss it:

Kindly note that Cushing's syndrome or disease is a wide topic but we shall limit our scope to that /

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induced by corticosteroids.

Cushing's syndrome (CS) is a condition that arises due to exposure of high cortisol levels in blood for a long time. Corticosteroids (the drugs) mimic the action of cortisol and are the most common cause of CS.

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Signs and symptoms of CS👇
📸Credit: ResearchGate

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1. Weight gain with a moon face
2. High blood pressure (Hypertension)
3. Increased blood sugars (Diabetes mellitus)
4. Abdominal Striae
5. Gonadal dysfunction including decreases libido, infertility, menstrual irregularities, amenorrhea , erectile dysfunction
Etc

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📸Credit: Mayo and ResearchGate
Striae Hirsutism

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In Summary
📸Credit: ResearchGate

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Way forward;
CS is a fatal condition because of the different diseases it comes with like hypertension and diabetes. To avoid this, we should only use corticosteroids under prescription or monitoring by your health care provider.

Kirenga Emmanuel
MBChB IV
@kiuvarsity

@MinofHealthUG @ainbyoo @newvisionwire @nyamadon @DianaAtwine @RedPepperUG @nilepostnews @DrOtileUg @rutayisire_ @SheaGirl8

For Clarity, Cushing's Syndrome is different from Cushing's disease.

@UnrollHelper