Researchers identified a “dose response risk” between steroids and infection, meaning that the higher the prescribed dose, the more likely it is that corticosteroids may increase the risk of infections because they have a wide variety of effects on the immune system. The dosage of the drug has a great impact on the risk of infection. The risk of infection is higher at high doses (for example, 60 mg of prednisone), “but it has been found that the risk of serious infection doubles approximately even in people who take 10 to 20 mg of prednisone, says Dr. The risk of infection with corticosteroid doses lower than 10 mg is unclear, he notes.
Steroids also reduce the activity of the immune system, which is the body's natural defense against diseases and infections. There are usually no serious side effects if you take steroid injections, a steroid inhaler, or a short course of steroid tablets. However, long-term treatment at high doses, especially with steroid tablets, can cause problems in some people. For most people, steroid inhalers and steroid injections shouldn't cause annoying side effects.
Steroid tablets are generally prescribed with more caution, as they can cause more problems. Corticosteroid tablets are the most potent type of steroid medication because they can affect the entire body. For example, steroid tablets may be recommended if you are pregnant and have severe asthma, because your baby's risk of uncontrolled asthma is greater than that of the medication. If a woman needs to take steroid tablets while breastfeeding, a type called prednisolone is generally recommended, since it is believed to have the lowest chance of causing adverse effects to the baby.
As a precautionary measure, it is generally recommended that a nursing mother wait three to four hours after taking a tablet before feeding her baby. High-dose inhaled steroids can sometimes cause some of the more serious side effects that are most commonly related to steroid tablets (see below), but this is rare. Short, occasional cycles of steroid tablets taken for no longer than three weeks are highly unlikely to cause annoying side effects. You may have regular checkups and tests for conditions such as diabetes, high blood pressure and glaucoma if you need to take long-term steroid tablets.
There's usually no reason why a person can't use a steroid inhaler or spray, but they should be used with caution in people with ongoing infections, such as tuberculosis (TB). Dvorin and Ebell wrote: “Physicians might assume that short-term steroids are harmless and free of the well-known long-term effects of steroids. A Danish study found a high risk of diabetes and osteoporosis among patients who had received one or more steroid injections per year for three or more years to treat allergic rhinitis, another steroid use that lacked evidence of benefit.