Why is corticosteroid a "double-edged sword"?

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1. What are corticosteroids?

Corticosteroids (corticosteroids) are steroid hormones produced by the body or made by man. These include drugs such as prednisone and cortisone.
Systemic corticosteroids refer to corticosteroids that are administered orally or by injection and are distributed evenly throughout the body. It does not include corticosteroids used in the eyes, ears, nose, on the skin, or inhaled. Although small amounts of this corticosteroid can be absorbed into the body.

The natural corticosteroids are hydrocortisone (Cortef) and cortisone which is produced by the outer part of the adrenal gland (cortical, hence the name corticosteroid). Corticosteroids are classified into:
Glucocorticoids (anti-inflammatory) that inhibit inflammation (arthritis, colitis, bronchitis, asthma and certain skin rashes, allergies and inflammation related to the eyes) , nasal) and immunity while supporting the breakdown of fats, carbohydrates and proteins. In addition, Glucocorticoids are used to treat systemic lupus, severe psoriasis, leukemia, lymphoma, idiopathic thrombocytopenic purpura, and autoimmune hemolytic anemia. These corticosteroids are also used to suppress the immune system and prevent rejection in people who have undergone an organ transplant. Corticosteroids work to regulate the balance of salt and water in the body (salt retention effect). Synthetic corticosteroids have similar activity to natural corticosteroids and can be used to replace corticosteroids in people whose adrenal glands are not functioning to produce enough corticosteroids. However, they are often used as a substitute for treatment of immune, inflammatory diseases or salt and water balance.

2. Side effects of corticosteroids

Corticosteroids have a lot of side effects from mild to severe even serious. These side effects will become apparent when corticosteroids are used in high doses or for a long time. Some of the more commonly mentioned side effects are:
Retention of sodium (salt) and substances in the body causing weight gain or swelling of the legs (edema) High blood pressure Loss of potassium Headache Muscle weakness Puffiness Facial hair growth Slow wound healing Glaucoma Cataracts Stomach and duodenal ulcers Loss of diabetes control Irregular menstrual periods Buffalo hump Prolonged use of corticosteroids can cause obesity, growth retardation in children and even It can even lead to convulsions and mental confusion. These mental disorders include depression, euphoria, insomnia, mood swings and personality changes, or altered mental behaviors.

In addition, corticosteroids also increase the rate of infection and reduce the effectiveness of vaccines or antibiotics. Because, it affects and suppresses the immune system.
Shrinkage (atrophy) of the adrenal glands can also be caused by long-term corticosteroid use. At this time, it makes the body unable to produce cortisol, the body's natural corticosteroid. In addition, it also causes adrenal necrosis of the hip joint, causing pain and more serious surgical intervention. Therefore, any sign of hip or knee pain in people taking corticosteroids requires prompt medical supervision.
Using corticosteroids for a long time should not be stopped suddenly. This will lead to risks for the adrenal glands. Because, at this time, the body cannot secrete enough cortisol to make up for the deficiency. Signs of potential adrenal involvement are usually nausea, vomiting, and shock.
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References: medicinenet.com, en.wikipedia.org