When “miracle drug” turns into “poison”: What are the health traps behind glucocorticoids?

Tuchong Creative

In the World Health Organization's list of essential medicines, there is a "miracle drug". It saves lives but also "harms" people. It "cures all diseases" but is also the "source of all diseases". It is a glucocorticoid analogue.

The adrenal cortex in our body secretes a substance called glucocorticoids, such as cortisol, which can help us control inflammation, regulate the immune system, reduce allergic reactions, etc. Glucocorticoid analogs are artificially synthesized drugs that imitate glucocorticoids. What? Not familiar with it? You can't do without them when you are allergic to pollen, skin allergies, eczema or asthma. In addition, they can suppress the immune system and treat various chronic diseases. Not only do they have a "wide range of business", but the effect is also very obvious. Take dexamethasone as an example. It can not only be used to treat arthritis, but also for first aid to help relieve severe allergic reactions such as swelling of the throat. In cancer treatment, doctors sometimes choose dexamethasone to help patients relieve inflammation caused by tumors or treatment.

It can be said that glucocorticoid analogs are "magic drugs" that can "cure all diseases." But while saving lives, they are also "harming people." Because although glucocorticoid drugs have obvious therapeutic effects, excessive use will bring many side effects.

The most obvious ones are obesity and Cushing's syndrome.

Long-term use of hormone drugs may cause metabolic disorders in the body, leading to fat redistribution and increasing the risk of obesity. When we go to the hospital for a physical examination, we are often told that excessive "cortisol" can lead to obesity. In fact, it is the glucocorticoids that are to blame. If the hormone increases further due to certain diseases, it will cause Cushing's syndrome when it reaches a certain level. The patient's face, back of the neck, and internal organs will become enlarged, and the face will also have symptoms of excessive blood, easy bruising, and purple stripes. At the same time, the patient will also have high blood sugar and high blood pressure.

Glucocorticoid therapy may also suppress the hypothalamic-pituitary-adrenal axis, leading to adrenal insufficiency and atrophy.

The hypothalamus-pituitary-adrenal axis is a key endocrine system in the human body, responsible for regulating the body's response to stress and maintaining many physiological functions. The hypothalamus is the "headquarters" and the pituitary is the "messenger", which ultimately transmits the hypothalamus's instructions to the adrenal glands. The adrenal glands are "soldiers" that have two roles: secreting hormones and providing feedback regulation. Excessive exogenous glucocorticoids will reduce the hypothalamus's "instructions" for producing cortisol. Over time, this will lead to adrenal cortex hypoplasia and atrophy.

Regardless of the dosage, long-term use of hormone drugs can also lead to osteoporosis, osteonecrosis and myopathy. Therefore, people who use hormone drugs for a long time need to be careful to prevent fractures. In addition, long-term use of hormones increases the incidence of myocardial infarction and cerebrovascular events, increases the risk of infection, and produces psychological disorders, including abnormal pleasure, mania, and even depression.

Therefore, glucocorticoid analogs drugs "cure a myriad of diseases" while also "creating a myriad of diseases".

A large part of the reason for the above situation is that folk "prescriptions" and "miracle doctors" seek temporary relief from symptoms and abuse glucocorticoids, which can cause serious or even fatal side effects. To avoid these tragedies, medical institutions need to design and implement clear diagnostic and management pathways when using hormones. There is no magic drug that can cure all diseases.

This article is a work supported by the Science Popularization China Creation Cultivation Program. Author: Simply Say

Reviewer: Zhang Furong, Associate Researcher, Wenzhou Tracheitis and Asthma Research Institute

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.