In some situations, a medical professional will issue steroids for a patient. These can be in the form of tablets (oral medication), and injection or via an inhaler. We know that steroids can be a highly beneficial treatment for a number of conditions and can often be life-saving.
We do also know that, if we are giving a patient steroids, the body may reduce its own production of steroids. If a patient stops these high dose steroids suddenly, e.g. if they suffer an injury or illness, there is a small chance of the body not having enough corticosteroid to cope with the injury or illness. This can be the case with if you are taking oral steroids every day, or if you have had a number of courses of oral steroids over a 12 month period. New guidance now recommends repeated injections of steroids and high dose inhaled steroids may also enter the bloodstream and reduce the body’s own production of steroids in this way.
The list of what classes as a high dose inhaler can be found at https://www.brit-thoracic.org.uk/media/455532/uhl-dose-advice.pdf
We are therefore recommending all our patients who are on a high dose of oral or inhaled steroids to carry around a card with them which alerts others that they are on these medications. This means that if you are unwell or injured, healthcare professionals are aware that you are taking these medications and will make sure you do not stop them suddenly.
We do not have a perfect system of identifying who will benefit from carrying one of these cards. Steroid doses can change, and patient may be taken off or put on medications at different times.
We use computer searches to identify patients who we think would classify as being on high dose steroids. These searches are not foolproof so please feel free to contact us if you think you have been offered a steroid card incorrectly, or indeed if you think you should have one but haven’t yet been given one.
We understand that this advice may cause alarm, and that is certainly not our intention. It is really important to stress that the vast majority of patients who take steroids will have no problems with them. Steroids have been used for many years and they are a vital treatment for many patients with conditions such as polymyalgia, inflammatory bowel disease, asthma and COPD, alongside treatment musculoskeletal problems.