Why are steroids gradually reduced in therapy?

The gradual reduction of steroids in therapy is primarily aimed at preventing adrenal crisis. When a patient has been on long-term corticosteroid therapy, the body’s natural production of cortisol can be suppressed because the synthetic steroids provide an external source of the hormone. If steroids are abruptly discontinued, the adrenal glands may not have started producing sufficient cortisol again, leading to a state of adrenal insufficiency. This can result in an adrenal crisis, which is a life-threatening condition characterized by severe fatigue, low blood pressure, and even shock.

By tapering the dosage of steroids gradually, healthcare providers allow the adrenal glands time to recover and resume their natural production of cortisol. This approach minimizes the risk of adrenal crisis and ensures that the body can safely adjust to the absence of the steroid therapy.

While increasing muscle mass, preventing withdrawal symptoms, and enhancing drug absorption may be relevant in various contexts of medication management, they do not directly relate to the primary reason why steroids are reduced gradually in therapy. The focus on adrenal crisis underscores the significant physiological processes involved when managing steroid therapy.