Suppression of Adrenal Function by Steroid Medications

In people who take large doses of steroid medications, such as prednisone or dexamethasone, the function of the adrenal glands can become suppressed. This suppression occurs because large doses of steroids signal the hypothalamus and pituitary gland to stop producing the hormones that normally stimulate adrenal function. or dexamethasone, the function of the adrenal glands can become suppressed. This suppression occurs because large doses of steroids signal the hypothalamus and pituitary gland to stop producing the hormones that normally stimulate adrenal function.

If the person abruptly stops taking steroids, the body cannot restore adrenal function quickly enough, and temporary adrenal insufficiency (a type of secondary adrenal insufficiency) results, and the person may have symptoms, such as weakness or dizziness. Also, when stress occurs, the body is not able to stimulate production of the additional steroids that are needed.

Therefore, doctors never stop the use of steroids abruptly if people have been taking them for more than 2 or 3 weeks. Instead, doctors gradually reduce (taper) the dose over weeks and sometimes months.

Also, the dose may need to be increased in people who become ill or otherwise severely stressed while taking steroids. Steroid medication use may need to be resumed in people who become ill or otherwise severely stressed within weeks of having the steroid tapered and stopped.