glucocorticoids

You may have heard of anabolic steroids, which can have harmful effects. But there's another type of steroid - sometimes called a corticosteroid - that treats a variety of problems. These steroids are similar to hormones that your adrenal glands make to fight stress associated with illnesses and injuries. They reduce inflammation and affect the immune system.

You may need to take corticosteroids to treat:

• Arthritis
• Asthma
• Autoimmune diseases such as lupus and multiple sclerosis
• Skin conditions such as eczema and rashes
• Some kinds of cancer

Steroids are strong medicines, and they can have side effects, including weakened bones and cataracts. Because of this, you usually take them for as short a time as possible.

Anabolic steroids are synthetic (man-made) versions of testosterone. Testosterone is the main sex hormone in men. It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Women do have some testosterone in their bodies, but in much smaller amounts.

Health care providers use anabolic steroids to treat some hormone problems in men, delayed puberty, and muscle loss from some diseases. But some people misuse anabolic steroids by taking them in a way that's different than their provider prescribed.

Some bodybuilders and athletes use anabolic steroids to build muscles and improve athletic performance. They may take steroids by swallowing tablets or capsules, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses used to treat medical conditions. Using them this way, without a prescription from a provider, is not legal or safe.

Misuse of anabolic steroids, especially over a long period of time, has been linked with many health problems, including:

• Acne
• Stunted growth in teens
• High blood pressure
• Changes in cholesterol
• Heart problems, including heart attack
• Liver disease, including cancer
• Kidney damage
• Mood changes such as irritability and aggressive behavior

In men, it can also cause:

• Baldness
• Breast growth
• Low sperm count/infertility
• Shrinking of the testicles
• Testicular cancer

In women, it can also cause:

• Changes in your menstrual cycle (period)
• Growth of body and facial hair
• Male-pattern baldness
• Voice deepening
• Decreased breast size

Even though they don't cause a high, anabolic steroids can lead to addiction. You can have withdrawal symptoms if you stop using them, including:

• Fatigue
• Restlessness
• Loss of appetite
• Sleep problems
• Decreased sex drive
• Steroid cravings
• Depression, which can sometimes be serious and even lead to suicide attempts

Behavioral therapy and medicines can be helpful in treating anabolic steroid addiction

NIH: National Institute on Drug Abuse

Eosinophilic esophagitis (EoE) is a chronic disease of the esophagus. Your esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. If you have EoE, white blood cells called eosinophils build up in your esophagus. This causes damage and inflammation, which can cause pain, trouble swallowing, and food getting stuck in your throat.

EoE is rare. But because it is a newly recognized disease, it is being diagnosed more often. Some people who think that they have reflux (GERD) may actually have EoE.

Researchers are not certain about the exact cause of EoE. They think that it is an immune system/allergic reaction to foods or to substances in your environment, such as dust mites, animal dander, pollen, and molds. Certain genes may also play a role in EoE.

EoE can affect anyone, but it is more common in people who:

• Are male
• Have other allergic diseases, such as hay fever, eczema, asthma and food allergies
• Have family members with EoE

The most common symptoms of EoE can depend on your age.

In infants and toddlers::

• Feeding problems
• Vomiting
• Poor weight gain and growth
• Reflux that does not get better with medicines

In older children::

• Vomiting
• Abdominal pain
• Trouble swallowing, especially with solid foods
• Reflux that does not get better with medicines
• Poor appetite

In adults::

• Trouble swallowing, especially with solid foods
• Food getting stuck in the esophagus
• Reflux that does not get better with medicines
• Heartburn
• Chest pain

To find out if you have EoE, your doctor will likely:

• Ask about your symptoms and medical history. Since other conditions can have the same symptoms of EoE, it is important for your doctor to take a thorough history.
• Do an upper gastrointestinal (GI) endoscopy. An endoscope is a long, flexible tube with a light and camera at the end of it. Your doctor will run the endoscope down your esophagus and look at it. Some signs that you might have EoE include white spots, rings, narrowing, and inflammation in the esophagus. However, not everyone with EoE has those signs, and sometimes they can be signs of a different esophagus disorder.
• Do a biopsy. During the endoscopy, the doctor will take small tissue samples from your esophagus. The samples will be checked for a high number of eosinophils. This is the only way to make a diagnosis of EoE.
• Do other tests as needed. You may have blood tests to check for other conditions. If you do have EoE, you may have blood or other types of tests to check for specific allergies.

There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet.

Medicines used to treat EoE are:

• Steroids, which can help control inflammation. These are usually topical steroids, which you swallow either from an inhaler or as a liquid. Sometimes doctors prescribe oral steroids (pills) to treat people who have serious swallowing problems or weight loss.
• Acid suppressors such as proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.
• Monoclonal antibodies, which can reduce inflammation and may help with swallowing. They can be used in adults and children over age 12.

Dietary changes for EoE include:

• Elimination diet. If you are on an elimination diet, you stop eating and drinking certain foods and beverages for several weeks. If you are feeling better, you add the foods back to your diet one at a time. You have repeat endoscopies to see whether or not you are tolerating those foods. There are different types of elimination diets:
• With one type, you first have an allergy test. Then you stop eating and drinking the foods you are allergic to.
• For another type, you eliminate foods and drinks that commonly cause allergies, such as dairy products, egg, wheat, soy, peanuts, tree nuts and fish/shellfish.
• Elemental diet. With this diet, you stop eating and drinking all proteins. Instead, you drink an amino acid formula. Some people who do not like the taste of the formula use a feeding tube instead. If your symptoms and inflammation go away completely, you may be able to try adding foods back one at a time, to see whether you can tolerate them.

Which treatment your doctor suggests depends on different factors, including your age. Some people may use more than one kind of treatment. Researchers are still trying to understand EoE and how best to treat it.

If your treatment is not working well enough and you have narrowing of the esophagus, you may need dilation. This is a procedure to stretch the esophagus. This makes it easier for you to swallow.

Your adrenal glands are two small organs that sit on top of each kidney. The adrenal glands make different types of hormones you need to stay alive and healthy. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work.

The adrenal glands make the hormones cortisol, aldosterone, adrenaline, and noradrenaline. They also make hormones that your body uses to make sex hormones (estrogen and testosterone). All of these hormones do many important jobs, including:

• Turning food into energy and managing blood sugar levels
• Balancing salt and water
• Keeping blood pressure normal
• Responding to illness and stress (your "fight or flight" response)
• Timing when and how fast a child develops sexually
• Supporting pregnancy

When you have an adrenal gland disorder, your body makes too much or too little of one or more hormones. The symptoms depend on the type of problem you have and how much it affects the hormone levels in your body.

There are many types of adrenal gland disorders, including:

• Addison's Disease - a condition in which the adrenal glands don't make enough cortisol
• Cushing's Syndrome - a condition caused by too much cortisol in the body, often from taking steroid medicines for a long time
• Aldosterone-producing adenoma - a benign tumor (not cancer) that makes too much aldosterone and may cause serious high blood pressure
• Hereditary paraganglioma-pheochromocytoma - an inherited condition causing different types of tumors that make adrenaline and other hormones. Some tumors may become cancerous.
• Adrenal gland cancer - cancerous tumors, including adrenocortical carcinoma and neuroblastoma
• Congenital Adrenal Hyperplasia (CAH) - a group of inherited disorders in which the adrenal glands don't make enough cortisol. The most common type is 21-hydroxylase deficiency (also called CAH1). In the United States, newborn babies get a blood test to see if they have CAH. People born with CAH may not have symptoms until childhood or later in life.

The cause of adrenal gland disorders depends on the type of disorder you have. Causes can include:

• Medicines such as steroids
• A problem in another gland, such as the pituitary gland. The pituitary gland releases hormones that affect how the adrenal glands work.
• Changes in genes (mutations). These changes can cause the adrenal glands to make too much or too little of one or more hormones.
• Infections

In many cases the cause of the problem isn't clear.

Health care providers use different tests to check for adrenal disorders depending on your symptoms and health history. For example, you may have tests of your blood, urine (pee), or saliva (spit). These tests check your hormone levels. Your provider may order x-rays, CT scans, or MRI scans to look for tumors.

Different types of adrenal gland disorders have different treatments. They include medicines and surgery. Radiation therapy is sometimes a treatment for tumors. There are treatments to cure certain adrenal gland disorders. For other disorders, treatments can manage your symptoms.

NIH: National Institute of Child Health and Human Development

Aspergillosis is a disease caused by a fungus (or mold) called Aspergillus. The fungus is very common in both indoors and outdoors. Most people breathe in the spores of the fungus every day without being affected. But some people get the disease. It usually occurs in people with lung diseases or weakened immune systems.

There are different kinds of aspergillosis. One kind is allergic bronchopulmonary aspergillosis (also called ABPA). Symptoms of ABPA include wheezing and coughing. ABPA can affect healthy people but it is most common in people with asthma or cystic fibrosis.

Another kind is invasive aspergillosis, which damages tissues in the body. It usually affects the lungs. Sometimes it can also cause infection in other organs and spread throughout the body. It affects people who have immune system problems, such as people who have had a transplant, are taking high doses of steroids, or getting chemotherapy for some cancers.

Your doctor might do a variety of tests to make the diagnosis, including a chest x-ray, CT scan of the lungs, and an examination of tissues for signs of the fungus. Treatment is with antifungal drugs. If you have ABPA, you may also take steroids.

Centers for Disease Control and Prevention

Drug use, or misuse, includes:

• Using illegal substances, such as
  • Anabolic steroids
  • Club drugs
  • Cocaine
  • Heroin
  • Inhalants
  • Marijuana
  • Methamphetamines
• Misusing prescription medicines, including opioids. This means taking the medicines in a different way than the health care provider prescribed. This includes
• Taking a medicine that was prescribed for someone else
• Taking a larger dose than you are supposed to
• Using the medicine in a different way than you are supposed to. For example, instead of swallowing your tablets, you might crush and then snort or inject them.
• Using the medicine for another purpose, such as getting high
• Misusing over-the-counter medicines, including using them for another purpose and using them in a different way than you are supposed to.

Young people's brains are growing and developing until they are their mid-20's. This is especially true of the prefrontal cortex, which is used to make decisions. Taking drugs when young can interfere with developmental processes occurring in the brain. It can also affect their decision-making. They may be more likely to do risky things, such as unsafe sex and dangerous driving.

The earlier young people start using drugs, the greater their chances of continuing to use them and become addicted later in life.Taking drugs when you are young can contribute to the development of adult health problems, such as heart disease, high blood pressure, and sleep disorders.

The drugs that are most commonly used by young people are alcohol, tobacco, and marijuana. Recently, more young people have started vaping tobacco and marijuana. There is still a lot we don't know about the dangers of vaping. Some people have unexpectedly gotten very ill or have even died after vaping. Because of this, young people should stay away from vaping.

There are many different reasons why a young person may take drugs, including:

• To fit in. Young people may do drugs because they want to be accepted by friends or peers who are doing drugs.
• To feel good. Abused drugs can produce feelings of pleasure.
• To feel better. Some young people suffer from depression, anxiety, stress-related disorders, and physical pain. They may do drugs to try to get some relief.
• To do better in academics or sports. Some young people may take stimulants for studying or anabolic steroids to improve their athletic performance.
• To experiment. Young people often want to try new experiences, especially ones that they think are thrilling or daring.

Different factors may raise a young person's risk for drug use, including:

• Stressful early life experiences, such child abuse, child sexual abuse, and other forms of trauma
• Genetics
• Prenatal exposure to alcohol or other drugs
• Lack of parental supervision or monitoring
• Having peers and/or friends who use drugs

• Changing friends a lot
• Spending a lot of time alone
• Losing interest in favorite things
• Not taking care of themselves - for example, not taking showers, changing clothes, or brushing their teeth
• Being really tired and sad
• Eating more or eating less than usual
• Being very energetic, talking fast, or saying things that don't make sense
• Being in a bad mood
• Quickly changing between feeling bad and feeling good
• Missing important appointments
• Having problems at school - missing class, getting bad grades
• Having problems in personal or family relationships
• Lying and stealing
• Memory lapses, poor concentration, lack of coordination, slurred speech, etc.

Drug use and addiction are preventable. Prevention programs involving families, schools, communities, and the media may prevent or reduce drug use and addiction. These programs include education and outreach to help people understand the risks of drug use.

You can help prevent your children from using drugs through:

• Good communication with your children
• Encouragement, so your children can build confidence and a strong sense of self. It also helps parents promote cooperation and reduce conflict.
• Teaching your children problem-solving skills
• Setting limits, to teach your children self-control and responsibility, provide safe boundaries, and show them that you care
• Supervision, which helps parents recognize developing problems, promote safety, and stay involved
• Knowing your children's friends

NIH: National Institute on Drug Abuse

Asthma is a chronic (long-term) lung disease. It affects your airways, the tubes that carry air in and out of your lungs. When you have asthma, your airways can become inflamed and narrowed. This can cause wheezing, coughing, and tightness in your chest. When these symptoms get worse than usual, it is called an asthma attack or flare-up.

The exact cause of asthma is unknown. Genetics and your environment likely play a role in who gets asthma.

An asthma attack can happen when you are exposed to an asthma trigger. An asthma trigger is something that can set off or worsen your asthma symptoms. Different triggers can cause different types of asthma:

• Allergic asthma is caused by allergens. Allergens are substances that cause an allergic reaction. They can include
  • Dust mites
  • Mold
  • Pets
  • Pollen from grass, trees, and weeds
  • Waste from pests such as cockroaches and mice
• Nonallergic asthma is caused by triggers that are not allergens, such as
  • Breathing in cold air
  • Certain medicines
  • Household chemicals
  • Infections such as colds and the flu
  • Outdoor air pollution
  • Tobacco smoke
• Occupational asthma is caused by breathing in chemicals or industrial dusts at work
• Exercise-induced asthma happens during physical exercise, especially when the air is dry

Asthma triggers may be different for each person and can change over time.

Asthma affects people of all ages, but it often starts during childhood. Certain factors can raise your risk of having asthma:

• Being exposed to secondhand smoke when your mother is pregnant with you or when you are a small child
• Being exposed to certain substances at work, such as chemical irritants or industrial dusts
• Genetics and family history. You are more likely to have asthma if one of your parents has it, especially if it's your mother.
• Race or ethnicity. Black and African Americans and Puerto Ricans are at higher risk of asthma than people of other races or ethnicities.
• Having other diseases or conditions such as obesity and allergies
• Often having viral respiratory infections as a young child
• Sex. In children, asthma is more common in boys. In teens and adults, it is more common in women.

The symptoms of asthma include:

• Chest tightness
• Coughing, especially at night or early morning
• Shortness of breath
• Wheezing, which causes a whistling sound when you breathe out

These symptoms can range from mild to severe. You may have them every day or only once in a while.

When you are having an asthma attack, your symptoms get much worse. The attacks may come on gradually or suddenly. Sometimes they can be life-threatening. They are more common in people who have severe asthma. If you are having asthma attacks, you may need a change in your treatment.

Your health care provider may use many tools to diagnose asthma:

• Physical exam
• Medical history
• Lung function tests, including spirometry, to test how well your lungs work
• Tests to measure how your airways react to specific exposures. During this test, you inhale different concentrations of allergens or medicines that may tighten the muscles in your airways. Spirometry is done before and after the test.
• Peak expiratory flow (PEF) tests to measure how fast you can blow air out using maximum effort
• Fractional exhaled nitric oxide (FeNO) tests to measure levels of nitric oxide in your breath when you breathe out. High levels of nitric oxide may mean that your lungs are inflamed.
• Allergy skin or blood tests, if you have a history of allergies. These tests check which allergens cause a reaction from your immune system.

If you have asthma, you will work with your health care provider to create a treatment plan. The plan will include ways to manage your asthma symptoms and prevent asthma attacks. It will include:

• Strategies to avoid triggers. For example, if tobacco smoke is a trigger for you, you should not smoke or allow other people to smoke in your home or car.
• Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to carry with you all the time. It may also include other types of medicines which work quickly to help open your airways.
• Control medicines. You take them every day to help prevent symptoms. They work by reducing airway inflammation and preventing narrowing of the airways.

If you have a severe attack and the short-term relief medicines do not work, you will need emergency care.

Your provider may adjust your treatment until asthma symptoms are controlled.

Sometimes asthma is severe and cannot be controlled with other treatments. If you are an adult with uncontrolled asthma, in some cases your provider might suggest bronchial thermoplasty. This is a procedure that uses heat to shrink the smooth muscle in the lungs. Shrinking the muscle reduces your airway's ability to tighten and allows you to breathe more easily. The procedure has some risks, so it's important to discuss them with your provider.

A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, or malignant, with cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are metastatic, and they start somewhere else in the body and move to the brain.

Brain tumors can cause many symptoms. Some of the most common are:

• Headaches, often in the morning
• Nausea and vomiting
• Changes in your ability to talk, hear, or see
• Problems with balance or walking
• Problems with thinking or memory
• Feeling weak or sleepy
• Changes in your mood or behavior
• Seizures

Doctors diagnose brain tumors by doing a neurologic exam and tests including an MRI, CT scan, and biopsy. Treatment options include watchful waiting, surgery, radiation therapy, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack cancer cells with less harm to normal cells. Many people get a combination of treatments.

NIH: National Cancer Institute

Cancer is a group of related diseases. In all types of cancer, some of the body's cells begin to divide without stopping and spread into surrounding tissues.

Normally, new cells form as you need them, replacing old cells that die. Sometimes, this process goes wrong. New cells form when you don't need them, and old cells don't die when they should. The extra cells can form a tumor. Tumors can be benign or malignant. Benign tumors aren't cancer. Malignant tumors are cancer, and the cancer cells can spread to nearby tissues. They can also break away and spread to other parts of the body.

Children can get cancer in the same parts of the body as adults, but there are differences. Childhood cancers may happen suddenly, without early symptoms. Some types can often be cured. The most common children's cancer is leukemia. Some of the other more common types of cancer in children include brain tumors, lymphoma, and soft tissue sarcoma.

Symptoms and treatment depend on the type of cancer and how advanced it is. Treatments may include:

• Surgery
• Radiation therapy
• Chemotherapy
• Stem cell transplants
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells

NIH: National Cancer Institute

A cataract is a clouding of the clear lens inside your eye. This cloudiness blocks light from reaching the back of the eye, making it harder to see clearly. A cataract can affect one or both eyes, but it doesn't spread from one eye to the other.

Cataracts usually develop slowly. As they get worse, your vision can become blurry or dim. Brighter lighting or new eyeglasses may help at first, but if cataracts begin to interfere with your daily activities, you may need cataract surgery.

Without treatment, cataracts can cause severe or even permanent loss of vision.

Most cataracts develop as part of the normal aging process. This happens when the protein in the lens of your eye clumps together. Over time, these protein clumps grow larger and thicker, making it harder to see. The lens may turn yellow or brown, which can affect how you see colors.

Cataracts can also develop after an eye injury or surgery for another eye condition, like glaucoma.

Cataracts are very common in older adults. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. Your risk for developing cataracts increases as you get older. You may also be at an increased risk if you:

• Have certain health problems, like diabetes
• Have a family history of cataracts
• Have had an eye injury or eye surgery
• Take steroid medicines, used to treat conditions like arthritis or allergies
• Smoke
• Drink excessive amounts of alcohol
• Have spent a lot of time in the sun

You may not notice cataracts at first because they usually develop slowly. That's why regular eye exams are important. Common symptoms may include:

• Blurry or cloudy vision
• Colors that seem faded
• Glare from headlights, lamps, or sunlight that seems too bright
• Halos around lights
• Not being able to see well at night
• Double vision (this may go away as the cataract gets bigger)
• Frequent changes in your glasses or contact lens prescription
• Trouble reading or doing other everyday activities

Talk with your provider about these symptoms since they could also be signs of other eye problems.

A comprehensive eye exam is the best way to check for cataracts. Your provider will do several tests to check your vision and eye health. This includes a dilated eye exam, where your pupils are widened with special eye drops. This allows more light to enter your eye so your provider can clearly see tissues at the back.

Surgery is the only way to remove a cataract. At first, you may be able to improve your vision with new glasses and brighter lighting. But if cataracts are getting in the way of everyday activities like reading, driving, or watching TV, surgery is an option. During surgery, the cloudy lens is removed and replaced with an artificial lens, called an intraocular lens (IOL).

If you're worried that you're at risk for cataracts, talk to your provider to see if there's anything you can do to lower your risk. A few ways to protect your eyes include:

• Wear sunglasses and a wide-brimmed hat to block ultraviolet (UV) sunlight and help delay cataracts.
• Protect your eyes from injury when using power tools or playing certain sports.
• Eat a healthy diet with plenty of fruits, vegetables, leafy greens, nuts, and whole grains.

NIH: National Eye Institute