What are corticosteroids?
Corticosteroids are a class of the steroid hormone group that aim to regulate physiological functions such as stress; immune and inflammatory responses; metabolism of carbohydrates; regulation of blood electrolytes; and the catabolism of steroids - among other important functions. These hormones are produced by the outer part of the adrenal gland known as the adrenal cortex.
What conditions are treated with corticosteroids?
The most common conditions that may be treated with corticosteroid medications include:
- Inflammatory bowel disease (Crohn’s disease, ulcerative colitis, etc.)
- Autoimmune diseases (Autoimmune hepatitis, Rheumatoid arthritis, polymyalgia rheumatica)
- Joint and muscle conditions
- Asthma and allergies
- Addison’s disease
Although steroids may be a very effective treatment for various inflammatory and autoimmune conditions, synthetic steroid hormones are known to cause gastrointestinal and immune system side effects. The degree to which these side effects occur may vary from one individual to another, depending on various factors such as the dose and/or the period of time that the medication is taken.
Corticosteroids and the immune system
When it comes to autoimmune diseases, steroids work to suppress the immune cell activity. Long term, this may affect the protective role of the immune system which may increase susceptibility to bacterial and/or viral infections. Corticosteroids may reduce the efficacy of some vaccines and antibiotics.
Corticosteroids and gastrointestinal
Steroids may interfere with the production of protective mucous layers in the stomach. Although steroids are often prescribed to treat symptoms of gastrointestinal disorders, these have been shown to increase the risk of developing duodenal ulcers, stomach ulcers and gastrointestinal bleeding. The risks for these side effects are especially increased if steroids are taken along with non-steroidal anti-inflammatory drugs (NSAIDs); examples of these include ibuprofen and aspirin.
Natural therapies to reduce the side effects of corticosteroid drugs
Natural therapies aim to reduce or eliminate the side effects of corticosteroid drugs by taking a holistic approach through the use of lifestyle, dietary, nutritional and herbal suggestions.
Supporting the immune system
Simple natural ways to support the immune system include:
- Good quality and quantity of sleep
- Enjoying regular exercise and relaxation
- Avoiding tobacco smoke and limiting alcohol intake
- Eating a wholesome diet of fresh vegetables, fruit, wholegrain, nuts, seeds, meat, fish, poultry, eggs, legumes and healthy fats
- Avoiding processed or packaged foods.
Probiotics
Being that approximately 70% of the immune system resides in the digestive tract, it is important to make gut health a priority. To maintain thriving digestive health, the body needs tens of thousands of good bacteria to live in there.
To help support the growth of beneficial bacteria, foods such as yoghurt, sauerkraut, soft cheeses, kefir, sourdough bread, sour pickles and tempeh in the diet may help.
Since it is almost impossible to source the required number of probiotics through diet alone, it may be beneficial to take probiotic supplements.
Chat to your healthcare professional about the best probiotic for you.
Vitamin D
It is becoming more apparent that vitamin D may play an important role in anti-inflammatory and immune-modulating activities within the body.
Sources of vitamin D include:
- fatty fish (sardines, salmon, mackerel and tuna)
- beef liver
- cheese
- egg yolks
- foods fortified with vitamin D such as dairy products, orange juice and plant milk. Supplements in vitamin D may be necessary if levels are low. A blood test can check vitamin D levels.
Zinc and other micronutrients
Micronutrients such as essential fatty acids, vitamins A, B6, C, E, folate, iron and especially zinc may be depleted by corticosteroid use. In case of dietary restrictions, taking a supplement may help to ensure that the body’s immune system gets all the vital nutrients it requires.
Diet
Food is a very important element when treating or managing gastrointestinal and immune system health, especially when taking corticosteroids. These medications may cause weight gain, possibly due to an increase in appetite.
A healthy diet is also vital as steroids may deplete essential nutrients in the body.
A balanced, healthy diet to support the immune system and overall gut health may include the following:
Dairy in moderation; milk, cheeses, yoghurts and other dairy products that are as close to natural state as possible.
Vegetables include vegetables of all kind, but pay special attention to dark leafy greens and colourful vegetables.
Fruits fruits rich in vitamin C are key to supporting the immune system. Bananas also contain potassium that helps to replenish lost levels.
Whole grains pastas, breads, legumes, nuts, seeds and other whole grains are sources of essential vitamins and minerals such as vitamin B.
Protein lean meats and fatty fish, turkey and other sources of protein help to support growth and development as well as the immune system.
Exercise and physical therapy
Light to moderate exercise that elevates your heart rate is important to help build a strong immune system and fitness. Yoga, meditation and massage therapy can help with stress and relaxation - essential elements for immune support and gut health.
Herbal Medicine
Some herbal medicines may support the body’s immune system and gastrointestinal health.
Herbal medicine for digestive health
Corticosteroids may interfere with natural secretions in the gut. Herbs known as ‘bitters’ help to stimulate digestive secretions so that. This helps ensuremay help to prevent ulcers by ensuring that the gut has sufficient mucus to protect against its own acids.
Carminative and other gastrointestinal herbs may soothe the gut. Recommended herbs include:
Bitter herbs - promote gastric secretion and aid digestion.
- Gentian (Gentiana lutea)
- Barberry root (Berberis vulgaris)
- Dandelion (Taraxacum officinale)
- Artichoke (Cynara scolymus)
- Milk Thistle (Silybum marianum)
- Chamomile (Matricaria chamomilla)
Carminative herbs - may help to support digestion and reduce symptoms of gas and bloating.
- Fennel (Foeniculum vulgare)
- Cardamom (Elettaria cardamomum)
- Dill (Anethum graveolens)
- Cumin (Cuminum cyminum)
- Caraway (Carum carvi)
- Lemon balm (Melissa officinalis)
Mucilaginous herbs - create a healing cover that may soothe the gut wall.
- Marshmallow root (Althaea officinalis)
- Slippery elm bark (Ulmus rubra)
- Mullein leaf (Verbascum spp.)
- Psyllium (Plantago spp.)
- Oats (Avena sativa L.)
Fibre - absorbs moisture, increases stool size and aid peristalsis.
- Pectin (fruit, flaxseed, chia seed and oat bran)
- Psyllium (Plantago spp.)
Herbs for the Immune system
Some herbal medicines may help to support the immune system, which includes the lymphatic system These may help adrenal gland function.
Some herbs include:
- Eleuthero (Eleutherococcus senticocus)
- American ginseng (Panax quinquefolius)
- Astragalus (A. membranaceus)
The use of corticosteroids should not be stopped suddenly and withdrawal should always be under the care of a healthcare professional. Supporting the immune system and gastrointestinal health using vitamins, minerals and herbal medicines should be under the supervision of a healthcare professional to avoid interactions or side-effects.
The information provided is not intended to be used for diagnosis or treatment. If you are experiencing any health concerns, please consult your healthcare professional for advice.
Related reads:
References
- Hodgens, A. (2023, May 1). Corticosteroids. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK554612/
- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Hormones-cortisol-and-corticosteroids#conditions-treated-with-corticosteroids
- Drini, M. (2017). Peptic ulcer disease and non-steroidal anti-inflammatory drugs. Australian Prescriber, 40(3), 91–93. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478398/
- https://www.healthdirect.gov.au/blog/how-to-power-up-and-boost-your-immunity-asap
- https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/
- https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
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