Introduction
The rules and risks regarding the discontinuation of cortisone preparations are based on the body’s own processes. The hormone cortisone is normally produced in the adrenal cortex by the body itself. The production is subject to a so-called control cycle.
This means that when the cortisone level in the blood is low, the adrenal cortex produces the hormone. If the level is high, it produces less. As a rule, the natural cortisone level is highest in the morning between 6.00 and 8.00 and lowest in the evening.
Since the natural cortisone is weak in its effect, synthetically produced cortisone preparations are used for medical purposes. These then ensure an increased cortisone level in the blood. The body’s own production of cortisone is then reduced.
Since the adrenal cortex needs some time to restart production, cortisone should never be discontinued abruptly after several weeks of cortisone therapy. The dose must be slowly reduced over a period of months. In this context, one speaks of a so-called “sneaking out” of the cortisone preparation.
What are the consequences?
In extreme cases, taking medication with cortisone could completely inhibit the body’s own cortisone production in the adrenal cortex. If this happens over a longer period of time, the corresponding cells of the adrenal cortex regress. This is known as adrenal cortex atrophy.
As a result, the adrenal cortex is not able to resume cortisone production from one moment to the next after a long period of inactivity. The extent and speed of this suppression of the body’s own cortisone synthesis also depends on the time of day when the cortisone is administered externally. If this takes place at the times when the body’s own daily level is actually at its lowest, the inhibition of the adrenal cortex is strongest.
Accordingly, cortisone preparations taken in the evening suppress the adrenal cortex more strongly than those taken in the morning. In addition, the suppression of the body’s own cortisone production depends on the type of external intake. If cortisone is administered into the vein as a cortisone tablet or cortioson injection, the cortisone level varies during the course of the day.
However, if cortisone is administered to the body as a depot injection into the muscle, a sustained, even cortisone level is produced. In this way, the body’s own cortisone synthesis is particularly strongly inhibited. An abrupt cessation of cortisone administration from outside could cause an acute cortisone deficiency in the body.
Since cortisone has important tasks in the metabolic processes of the muscles, skin, fatty tissue and the protein and sugar metabolism pathways, a deficiency can result in corresponding deficiencies. A sudden cessation of cortisone could cause a flare-up of the disease or inflammation. In addition, the side effects may be more severe.
Complaints such as: can occur. Furthermore, a change in mood, often in a depressive direction, can develop. Cortisone also plays an important role as a so-called stress hormone.
Thus it has an essential protective function for the body. If this fails, it can have fatal consequences. In particular, if the adrenal cortex shows weakness but has not completely failed, the lack of cortisone may initially be unremarkable.
In this case, the adrenal cortex can produce the body’s own cortisone for “everyday use”. But in a stress reaction, such as in the case of an inflammation, an accident, a serious injury or an operation, the cortisone synthesis would then be insufficient. This could lead to an abrupt drop in blood pressure and further life-threatening reactions could follow. Conclusion: that the sudden cessation of cortisone could possibly lead to life-threatening adrenal cortex insufficiency. – Fatigue
- Gastrointestinal problems
- Joint Pain
- Muscle stiffness
- Muscular weakness
- Unrest
- Nervousness
- Insomnia
- Sweating and fever
