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About Injectable Steroids

Dear Dr. Kagen:

Thanks so much for your site! Between this, Zyrtec's, and the AAAAI site, I have learned much about my problems and how to properly manage them.

My question is this: I recently received a steroid injection to control a severe (for me) asthma attack. My doctor said it would work 4-6 weeks, until the season passes its peak. Since then, I have contracted a cold and a mysterious, 48-hour high fever.

Do the corticosteroids, in the typical injectable or oral dosages, decrease one's immunity to other disease? Or, could it be that just the stress on my body during the peak of allergy season would render me less immune?

Just FYI, for whatever it's worth to you, my symptoms are more like a chronic bronchitis--some tightness with coughing up of mucous every day, especially in the morning. My new and better doctor put me on Zyrtec for the chronic allergies inherited from my dad, Polyhistine-D for congestion, PIMA syrup to break up the mucous (I can't believe what a difference it made!), Azmacort and albuterol (both inhalers were prescribed by previous docs).

Your website and the AAAAI site have helped me to understand how to more effectively use my inhalers by educating me about my particular immune response and how the inhalers act on the tissue. I realize I have been overusing the albuterol and under using the Azmacort out of fear of the word "steroid." Thank you for your service to the community!

Sue C.

Dear Sue:

Thanks for asking about your asthma symptoms and the use of steroid therapy.

We do not usually use systemic injectable steroids in out Allergy and asthma Clinic practice as it is too much of a good thing in most cases. When patients with asthma experience flare ups of their symptoms, it is due in large part to the inflammation within the region of the lungs. Systemic steroids deliver cortisone to the whole body and also to the part that really needs it - the lungs. Inhaled steroids are better directed to the area of inflammation and are associated with fewer side effects when used properly.

Steroids can impair the immune system when used in high doses. In general, it takes about 40mg of prednisone daily for 12 continuous days to retard the body's ability to fight infections. At theses doses, it is necessary to taper off of the steroid therapy gradually.

Your point is well stated that when a asthma sufferer needs to use albuterol more often, it is usually due to an inadequate inhaled steroid usage.

I hope this info helps you and your family.

Good luck.

Steve Kagen, M.D.
Allernet.com