Here’s a question from a reader:
I recently had a respiratory infection. I went to urgent care, and the doctor prescribed a steroid. It seemed to make it hard to fall asleep, but I couldn’t tell how much, if at all, they helped my lungs. Do these medications really alleviate respiratory symptoms?
Dr. McEver Prescribes
Health care providers frequently prescribe oral or injected steroids like prednisone for acute respiratory tract infections. Despite common usage, though, there’s little evidence they affect conditions such as bronchitis, sinusitis and influenza in otherwise healthy people.
Steroids suppress inflammation. They’re critical for some people with chronic lung conditions such as asthma. And those who live with diseases marked by severe joint inflammation — such as rheumatoid arthritis and lupus, conditions that our researchers and physicians study and treat at the Oklahoma Medical Research Foundation — often manage their chronic pain with these drugs.
While a steroid may bring a burst of energy or reduction in some symptoms for someone with an acute illness, the effects are temporary. In a 2017 study of adults with lower respiratory tract infections, researchers treated participants with either an oral steroid or placebo. They found no clinically significant difference in the duration or severity of illness between the two groups.
Still, a 2020 Harvard study found that over nine years, health care providers prescribed steroids to more than 1 million Americans with respiratory tract infections.
As you discovered, taking steroids too close to bedtime can cause problems sleeping. Although serious side effects are rare, a recent study from the University of Michigan also found the short-term use of steroids linked to increased risks of sepsis, blood clots and bone fractures in the month following taking the drug.
The prospect of a quick fix for viruses is alluring but still elusive. With rest, common respiratory infections usually resolve on their own. There’s no need for steroids. It just takes time.
Do you have a health query for Dr. McEver? Email firstname.lastname@example.org and your question may be answered in a future column!