Can reducing the dose of Dexamethasone cause liver problem?
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
Almost 5 years back, my father had an operation for a brain tumor in the left tempero-parietal region. He had Dexamethasone injections 12 mg and radiation on a linear accelerator 51 and 45. After two years, he had a CT and everything was fine. He even walked. But, when we started lowering the dose of the hormone he stopped walking. He took those 12 mg for five months. Now, he has steroid diabetes and retinopathy. We lowered the dose of Dexamethasone slowly and currently, it is 0.88. Now his bile production is bad and his stool is yellow. When the dose was 0.96 everything was fine with the bile. He takes Essentiale three times a day, Pankreatin 8000 thrice daily, Omez 20 mg once a day, Ascorutin thrice daily and Citrocalcium.
When we lowered the dose of the evil hormone to 0.88, the bile problem started. When we started to give double the dose of Essentiale, everything started to be fine again. But, with the usual dose again the problem has come. Because of this hormone his sugar level does not drop. He is getting Insulin injection and the sugar level is 5.2. My questions are does the gall problem occur because of Dexamethasone? Is there any medicine to restore adrenal cortex function? How can one stop taking this hormone? How can we make him walk again? Will he ever be fully functional again? Thanks in advance.
Hi,
Welcome to icliniq.com.
I would like to know a few things very clear here.
From your history, I gather that he had surgery on the brain and was on steroids post-op. And also he received radiotherapy. For what condition the brain surgery was done? He might be having what is called as steroid-induced diabetes and for which Insulin is the treatment. Steroids can harm the liver over time, but they would have been prescribed because the benefit at that time was more than the harm that would have been caused. We need to know the clinical improvement with reduced dose for further reduction. There are no medicines that can restore the adrenal cortex function. His steroid production is suppressed due to exogenous steroids. It needs tapering and then if possible can be stopped. I can comment on his recovery only after knowing his exact detail of the medical procedure done and the diagnosis.
Patient's Query
Hi doctor,
My father has been taking the steroid for 5 years. Every time when the dose gets reduced he will suffer for a couple of day and then will get better. They used to reduce the hormone once a month and until the 0.88 mg he recovered every time. Now, there is a problem in gall. I do not know about any other changes after the reduction. His diagnosis was oligoastrocytoma. I do not know much. We are much worried to reduce the dose now. What does tapering steroid mean? How do we stop the Dexamethasone? If it is stopped, will his liver, eyes, hearing and diabetes become fine again?
Hi,
Welcome back to icliniq.com
Maybe your father has become steroid dependent now. To taper the dose means to slowly reduce the dose over a period of time as his condition permits. I can understand your concern for your father, but without the exact diagnosis and the treatment regimen for his condition, it is very difficult to let you know. His sugars might improve after stopping the steroids. But eye damage by retinopathy will not improve much.
Patient's Query
Hi doctor,
The first diagnosis was oligoastrocytoma. Should we just keep giving the liver medicine? Or should we keep reducing the killing hormone till zero?
Hi,
Welcome back to icliniq.com.
It is very difficult to say whether we can stop or not. It all depends on how he responds and how soon or late we can taper and stop. It is a very big decision to be made. I would suggest that the treating doctor who is following your dad's health can give the best decision. Till then let him continue the medicine under the doctor supervision.
Patient's Query
Hi doctor,
His doctor said that we can stop the hormone after couple of months of treatment. Anyways your opinion was very helpful. Thank you very much for all your help. We will try to find a good doctor in our region and hope we can kick that hormone out.
Hi,
Welcome back to icliniq.com.
All the best. Hopefully, all shall be fine very soon.
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