Oral and Injected Steroids: Do You Know the Associated Risks?

Posted July 25, 2025 by Monarch Medical

 

Has anyone ever told you that if you take frequent oral or injectable steroids, that you might develop diabetes, weakened bones, or a big dimple from loss of tissue at the injection site? Probably not. However, these are real potential side effects of steroids. Steroids come in many forms. Common oral steroids include prednisone, prednisolone methylprednisolone (Medrol Dose Pack). Injectable steroids include kenalog or depo medrol. For some, steroids can make them feel like superman. A patient once told me “I got so much stuff done around the house and I went to work and I wasn’t even tired at the end of the day. Not to mention I could breathe without wheezing.” In some ways, steroids are like Superman. They help reduce the acute inflammation and ease symptoms across multiple conditions, whether that is an asthma flare, hives, severe congestion from seasonal allergies or poison ivy. Steroids help with almost everything short term. So you may be thinking, what’s the problem with feeling like Superman once in a while? Well, the issue is that the more often you take steroids, the higher the risk of side effects, many of which can be long lasting.

 

The Side Effects

 

Short term steroids, whether taken orally or injected, can:

  • Make you feel like Superman OR they may make you feel angry, aggressive and irritable

  • Elevate blood pressure

  • Elevate blood sugar

  • Cause lower leg swelling

  • Cause increased eye pressure (glaucoma)

  • Cause sleep disturbance

  • Skin dimpling at injection site (for injection only)

Chronic steroid use or even 1 steroid burst or injection per year increases the risk of long term side effects including:

  • Skin thinning and easy bruising

  • Bone loss or osteoporosis

  • High Blood Pressure

  • Diabetes

  • In children, slow or poor growth

  • Glaucoma and cataracts

  • Weight gain

  • Immunosupression and increased risk of infection (more likely in conditions were people are “steroid dependent”)

  • Buffalo Hump, an endearing term for dorsocervical fat pad. This occurs when fat accumulates at the back of the neck and between the shoulder blades, giving the visual appearance of a “buffalo hump”. This is more commonly seen in conditions were people are “steroid dependent”.



The Recommended Amount in your Lifetime

 

Newest research has shown that having more than 1,000 mg in your LIFETIME increases your risk of developing long term side effects and the conditions listed above. This means, that if your provider prescribed 40 mg x 4 days for an asthma flare- you could only do that 6 times in your lifetime before exceeding 1000 mg. If your doctor prescribed you a burst and taper that started at 60 mg for 3 days and then tapered down from there by 10 mg every 3 days, that one burst would give you a total of 630 mg. This is more than half of the allotted amount in a lifetime. Given steroids are often prescribed in differing amounts and are not tracked among prescribers in different health systems, one could quickly reach that 1,000 mg lifetime threshold with 2 or more urgent care visits per year.

 

The Takeaway

 

In the end, the message is not that you can never ever take steroids. There is a time and place where steroids are needed and are the best option. For example, in a severe asthma flare, we sometimes have to use steroids to regain control. However, when looking at long term management for asthma, allergies, COPD, hives, nasal polyps etc. there are better and safer treatment options to control the symptoms. The goal for all of these conditions is that you never need steroids. If you are an asthmatic that goes to urgent care twice a year for flares and gets steroids- that is too much. If you are someone with seasonal allergies and gets a steroid injection every year- that is too much. With good management it is possible to have symptom control without any steroids in a given year. If you know that you depend on steroids for control of your asthma, copd, nasal polyps, hives or other disorder of allergic or type 2 inflammation, make an appointment to talk with out experienced nurse practitioners at Monarch Medical. We can help you find a treatment plan that controls your symptoms and allows you to say no the side effects of steroids.

 

Reference

Allergy & Asthma Network (2025). Understanding Oral Corticosteroid Side Effects.

https://allergyasthmanetwork.org/ocs-oral-corticosteroids/understanding-ocs-side- effects/