A corticosteroid is a hormone released by the body in times of stress. Medicines made from synthetic versions of this hormone, such as cortisone and cortisol, are widely used to treat allergies, skin conditions, arthritis, and breathing disorders. Cortisone also suppresses the immune system, a phenomenon that may help explain the connection between stress and illness. This can be an unwanted side effect, but it can also be helpful in treating autoimmune conditions in which the body’s natural defenses overreact.

In the 1930s at the Mayo Clinic in Rochester, Minnesota, the biochemist Edward Kendall (1886–1972) and the rheumatologist Philip Hench (1896–1965) noticed that some of the clinic’s arthritis patients experienced temporary pain relief after stressful events like illness, childbirth, or surgery. This observation lead them to theorize that the experience had triggered the creation of a substance in the body that acted as a natural antirheumatic. They identified a hormone, called compound E, which they believed was responsible for this reaction, but were not able to begin testing until 1948. The results were amazing: the first patient to receive an injection of compound E reported less pain within 3 days. Today, compound E is known as cortisone, and injections are a common treatment for arthritis, joint and tendon inflammation, and sports overuse injuries.

Similar compounds, including cortisol, can be taken orally or inhaled to treat autoimmune disorders such as allergies, asthma, Crohn’s disease, lupus, rheumatoid arthritis, and ulcerative colitis and to help prevent the rejection of transplanted organs. One of the most common oral corticosteroids is the drug prednisone. Topical cortisone creams are also available in prescription and nonprescription strengths for the treatment of eczema, psoriasis, and other skin irritations.

Corticosteroids can suppress fever and the entire immune system, making people more susceptible to serious illness and infection. Anyone receiving corticosteroid treatment should avoid people who have chicken pox or measles and should not receive vaccines made from live viruses. People who take other medications or who have liver or kidney disease, diabetes, a thyroid disorder, osteoporosis, glaucoma, cataracts, stomach ulcers, mental illness, or high blood pressure may need special tests to determine whether they can safely take cortisone. Cortisone usually should be avoided during pregnancy and breastfeeding, and it can affect growth in children.

ADDITIONAL FACTS

  1. In the body, most naturally occurring corticosteroids are produced in the morning hours.
  2. Edward Kendall and Philip Hench were awarded the Nobel Prize in Physiology or Medicine in 1950 for their discovery of cortisone.
  3. Natural cortisone is produced in the adrenal cortex. It is also known as hydrocortisone.