Steroids Dangers

By David Perlmutter, MD, FACN

Summer is here allowing us to spend more time outdoors enjoying the sun's warmth as we pursue our favorite recreational activities. All of nature seems to flourish in the summer months, including a vast variety of flowering plants and trees which may fill the air with clouds of pollen. High levels of airborne pollen can significantly disrupt the lives of allergy sufferers. Perhaps the most common complaint of allergy sufferers is nasal congestion and irritation. The typical approach of conventional medical practitioners to treat these symptoms is to prescribe a nasal spray containing a steroid medication. Commonly prescribe steroid nasal sprays include Nasalide®, Decadron®, Beconase®, and Vancenase®.

Because these drugs are so liberally dispensed and utilized, it's important to recognize that while using a nasal spray may seem harmless enough, there may be significant dangers with their prolonged use.

First, remember that they are steroids. That means that their usage may be associated with a variety of problems, including inhibition of wound healing, recurrent episodes of nose bleeding, headache, sore throat, vomiting, overgrowth of yeast in the nose, worsening of diabetes, immune system suppression, worsening of osteoporosis, and several eye disorders. Coughing, wheezing, and shortness of breath are also symptoms endured by the allergy sufferer, which unfortunately are also typically treated by steroid medications, usually delivered by the use of an inhaler. Several commonly used products of this type include Azmacort®, AeroBid®, Decadron®, Vanceril®, and Beclovent®.

Unfortunately, most patients are not aware of the significant dangers of using these medications. Yet, the evidence continues to mount that there may be important consequences about which patient should certainly be made aware.

In the March 5, 1997 issue of the Joumal of the American Medical Association, Dr. Edeltraut Garbe and co-workers described the results of their study to evaluate the risk of glaucoma in patients using inhaled steroid medications. In light of the widespread and long-term usage of these medications, their results are nothing short of alarming. They found that ongoing usage of high doses of inhaled steroids for three months or more increased the risk of glaucoma by an astounding 44%.

In addition to this increased risk for glaucoma, the likelihood of cataract formation is also profoundly enhanced in patients using inhaled steroid medications. In a large, wellconducted study appearing in the July 3, 1997 issue of the New England Journal of Medicine, Australian researchers reported a 300% increase in incidence of cataracts in users of inhaled steroids.

These studies were published in the two most widely read and highly respected medical journals in America. Yet, despite the fact that a large segment health care practitioners have seen and are likely aware of this information, the use of inhaled and nasal steroids will likely continue to represent one of the primary choices for treating nasal and pulmonary allergy conditions. Nutritionally minded health care practitioners have long known that a group of substances called bioflavonoids can play a very important role in alleviating allergy-related symptoms. Bioflavonoids are chemicals found in fruits and vegetables responsible for much of their color and taste. Research aimed at understanding the biological activity of bioflavonoids dates back to the original work of Dr. Szent-Gyorgi published in 1936. The general public is now becoming much more aware of bioflavonoids since one group, the anthocyanidins, is thought to be responsible for some of the health benefits of red wine.

But it is the anti-allergic activity of the bioflavonoids that has really aimed the spotlight on this nutritional component as of late. Since the early 1980's, a large number of publications have demonstrated the actual biochemical pathways by which the flavonoids are able to inhibit a variety of allergic and hypersensitivity reactions.

Quercetin, one of the most widely studied bioflavonoid, profoundly inhibits the release of the chemical histamine from cells. Histamine plays an important role in the allergic response (hence the widespread use of antihistamines) and it works. In our experience, quercetin, along with vitamin C, has provided many of our allergy patients remarkable improvements in a variety of symptoms. Quercetin is typically found, combined with other bioflavonoids and vitamin C, in various natural allergy relief preparations found in health food stores. A typical adult dosage of quercetin is 400 mg twice a day with vitamin C 5001000 mg twice a day as well and, while steroids markedly increase the risk for cataracts, quercetin may have just have the opposite effect. Researchers who publish their work in Biochemical Pharmacology in 1976 demonstrated that quercetin actually proved effective in preventing and treating cataracts induced by diabetes.

Another useful natural remedy in the treatment of nasal and respiratory allergy symptoms is stinging nettles. Traditionally, nettles was administered as a tea made from the leaves of this perennial plant. Now it is available in tablet form at most health food stores. One tablet twice a day is a typical adult dosage, although some people still prefer to use the tea. Interestingly, the root of the stinging nettle plant is now being used in Germany for the treatment of prostate cancer and in Russia, scientists are exploring the use of the leaves in the treatment of cholecystitis (inflammation of the gallbladder).

Finally, we can't overlook the pivotal role that the essentially fatty acids play, not only in regulating general immune function, but also in reducing the overactivity of the immune response, which characterizes allergic reactions. Allergy sufferers should pay particular attention to supplementing their diets with essential fatty acids from both the Omega 3 and Omega 6 groups. This is easily accomplished by taking one tablespoon of fresh coldpressed flax seed oil each day or, two capsules of EPA (fish oil), along with two capsules of either Borage oil or evening primrose oil. One of the ancient tenants of medicine is, "above all, do no harm."That means that first and foremost health care practitioners should seek out treatments that are not only effective but also unlikely to cause serious consequences. Unfortunately, because the pharmaceutical industry is so successful in influencing how medicine is practiced in this country, doctors have essentially been conditioned to reach for powerful and frequently dangerous medications for the treatment of common problems when often a less promoted natural approach may accomplish the same goal but without the risks.