Someone using their inhaler.

What to Know About Asthma and Steroids

Asthma is a chronic lung disease that causes inflammation and constriction of the airways, along with increased mucus production, which makes breathing difficult. Because different factors play a role in the disease, various medications and treatments are often needed to control symptoms. For example, bronchodilators decrease constriction and open the airways, but additional drugs are sometimes required to treat other symptoms, such as inflammation, which is where steroids can help.

What are Steroids?

Steroids are a class of medication that decrease inflammation in the body. They are similar to cortisol, which is a hormone made by the adrenal glands.

It is important to understand that steroids used to treat asthma are not the same as the type of steroids some bodybuilders and athletes use to gain muscle size.

Are Steroids Good for Asthma?

In many instances, the use of steroids can prevent asthma symptoms from developing and can decrease complications from poorly controlled asthma.
Corticosteroids work by reducing the swelling and inflammation in the lungs. They can also help decrease mucus production. When there is reduced inflammation in the lungs, the airways are less likely to react to asthma triggers.

There are different forms of steroids available to treat asthma. Common asthma medications containing steroids include methasone, budesonide and fluticasone.

It is helpful to remember that although steroids are useful for people with asthma, they may not work for every person with the disease. Everyone has their own unique course with asthma. Also, not every person with asthma may require steroids. One indicator that steroids might be helpful is if you need to use a fast-acting inhaler every day.

Can Steroids Worsen Asthma?

Steroids are a strong drug. Like any type of medication, some people can have an adverse reaction to steroids. For example, in research published in the Journal of General Internal Medicine, studies indicated that about 0.3% of people with asthma have a bad reaction to systemic steroids, such as prednisone. What happens in this small percentage of people is the steroids induce bronchospasm, which makes their asthma worse. When inhaled, steroids can sometimes have the same effect.

Researchers also found that even when they do not make the condition worse, steroids are ineffective in about 5% to 10% of people that have severe asthma. It is not entirely clear why certain people do not respond to steroids, but one theory is people with severe asthma have increased levels of the inflammatory protein interferon-gamma, and steroids may not help.

Things to Keep in Mind About Asthma and Steroids

If steroids are prescribed for the treatment of asthma, there are several things to keep in mind. Here is what to remember.

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Steroids are Available in Different Forms

Steroids are not all the same. There are different types of steroids and different routes of administration. Steroids for asthma are available in the following forms:

  • Inhalers
  • Pills
  • Injections
  • Intravenous solutions
  • Nasal sprays

In treatment for asthma, inhalers are usually prescribed once or twice a day to prevent symptoms. They are taken even if symptoms are not present. Nasal sprays are typically used to treat allergies or allergic asthma. Steroids in the form of pills, injections, or intravenous solutions are usually given during an acute flare-up of asthma symptoms.

Inhalers That Contain Steroids are not Rescue Medications

Steroid inhalers may have a role in treating asthma, but they are not taken to treat sudden symptoms, such as shortness of breath or wheezing. Steroid inhalers are not considered a fast-acting inhaler.

Steroids for Asthma Have Side Effects

The type of side effects often depends on the route of administration and dose. For example, inhaled steroids do not usually have the systemic effects of steroids administered orally or intravenously, but steroid inhalers can have localized side effects, including:

  • Dry mouth
  • Oral yeast infection
  • Hoarseness

Oral or intravenous steroids for asthma may have more side effects since they affect the entire body. Possible side effects include:

  • Insomnia
  • Increased appetite
  • Weight gain
  • Irritability
  • Restlessness
  • Increase in blood sugar levels

Long-term use of oral steroids may have additional side effects, such as bone loss. Some research also indicates that moderate to high doses of oral steroids may slow growth in children during the first year of treatment.

You May Need a Steroid Burst During Acute Exacerbations

Even if you do not regularly use a steroid inhaler, you might be prescribed a steroid burst during an asthma attack. A burst is a short course of oral steroids given for five to 10 days. Although the dosage can vary, 40mg to 60mg is a typical dose. Some doctors prefer to prescribe a tapered dose and gradually reduce the amount given.

Only Take Steroids as Directed by Your Doctor

Whether you use a steroid inhaler, or you are prescribed an oral dose due to an asthma attack, take it as directed. Taking the proper dosage as directed can help control asthma symptoms. If side effects are bothersome, talk to your doctor as soon as possible, It might be possible to lower the dosage or switch to another type of drug.