Side effects of glucocorticoids

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Although HC in appropriate physiologic replacement doses may be
critical to good health, it may cause side effects in some individuals.

Side effects may include:
• Decreased potassium
• Fluid retention
• may be caused by low potassium; test and supplement if needed
• may be caused by cortisol being high in relation to the available
T3; higher doses of thyroid medication may correct it
• Weight gain
• this will be corrected when thyroid is optimized
• Elevated progesterone
• Decreased testosterone and/or estrogen
• Decreased aldosterone
See discussion of sex hormones here

Symptoms of too high a dose of HC may include:
• Easy bruising
• Elevated blood pressure, particularly the systolic measure
• Fluid retention, particularly in the legs
• Weight gain, particularly in belly area
• Anger

Side effects of long-term use of pharmacologic (high) doses
Moon-shaped face
Increased fat in the back of the neck and upper back area (hump)
Weak and/or deteriorating muscles
• Reddish purple lines on the arms, face, legs, trunk, or groin
• Thin skin, easy bruising and slower wound healing
• Thinning bones (osteoporosis) and fractures
• Clouding of the lens in one or both eyes (cataracts)
• High blood sugar, which can trigger or worsen diabetes
• Increased risk of infections

Unexpected tiredness
A physiologic replacement dose of HC would be expected to help
resolve issues of fatigue. However, a new feeling of tiredness when the
body has adjusted to the correct dose of hydrocortisone can occur, as
adrenaline that had been substituting for low cortisol is no longer being
produced.