Real-world evidence links long-term use of oral and inhaled steroids to adrenal insufficiency

Medical Xpress / Joint Congress of European Society of Paediatric Endocrinology & Endocrinology ^ | May 10, 2025 | Dr. Patricia Vaduva et al

[ConservativeMind]

Individuals taking steroid tablets for more than 3 months are over 6 times more likely to be diagnosed with adrenal insufficiency than those treated with nonsteroidal anti-inflammatory drugs, according to research. In addition, they have a greater risk of being hospitalized for adrenal insufficiency, while long-term users of inhaled steroids have an increased risk of developing adrenal insufficiency but without any increase in the number of hospitalizations.

Steroids, also called corticosteroids, are anti-inflammatory medicines used to treat various conditions such as asthma, chronic obstructive pulmonary disease (COPD), allergies, arthritis and autoimmune diseases. When taking these widely-prescribed medicines, such as prednisolone, for more than three weeks, the dose has to be reduced gradually because abruptly stopping them can cause the adrenal gland to stop producing the stress hormone cortisol—a condition known as adrenal insufficiency.

In this study, Dr. Patricia Vaduva and colleagues examined 558,667 individuals who used steroid tablets or inhaled steroids for 3 months to 5 years, and compared them to individuals treated only with nonsteroidal anti-inflammatory drugs (NSAIDs). The researchers found that those who used steroid tablets for more than 3 months were over 6 times more likely to be diagnosed with adrenal insufficiency and over 3 times more likely to be hospitalized for adrenal insufficiency than those who only used NSAIDs. Similarly, those who took inhaled steroids had a 55% higher risk of being diagnosed with adrenal insufficiency, but did not have an increased risk of being hospitalized for the same condition.

Dr. Vaduva added, "Our findings show that even low doses of inhaled steroids can lead to adrenal insufficiency."

[ConservativeMind]

Both steroid types may cause problems, with longer term use.

Always be careful about how you stop steroid use.

[ConservativeMind]

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[Jonty30]

I’ve talked with ex-pro bodybuilders. It seems, assuming you can recover, that it takes about 3 years for your body to recover from TRT supplementation. That is assuming you didn’t damage yourself to becoming unreverable.

[Getready]

Long term steroid use has almost ALWAYS been known to suppress adrenal gland function.
Look up “HPA axis suppression”....for a brief review .this is a well known phenomena for at least 48 years.
Someone made a lot of money doing this redundant study. ....only good thing is that it pretty well educates the dumbesh*t recipe readers who are in the medical fields now.

[nagant]

Another selective population study? Why would we not instead conclude that the original inflammatory conditions were causing the adrenal insufficiency? ...or that a third unstudied factor was causing both?

DHEA is the body’s natural steroid, the mother hormone of all hormones. DHEA is produced by the adrenal glands, and stimulates adrenal health and productivity. We lose DHEA output as we age. DHEA is available as a supplement.