DEAR DR. DONOHUE: When a person is put on prednisone, what does it accomplish? I mean, if a person has asthma, he's put on prednisone. Why? Or say he has ulcerative colitis. What does prednisone do there? Is something attacking the immune system in these diseases, and doctors don't know what, so they use prednisone? -- W.P.
ANSWER: The word "steroid" brings confusion because it encompasses so many different substances. An athlete who wants to bulk up muscles takes "steroids" -- unwisely. That variety of steroid is male hormone steroids, also known as anabolic steroids.
Prednisone is a different steroid. It's a member of the cortisone family of hormones. Our body makes cortisone. Without cortisone, we would die. It is also synthesized in laboratories to be used as a drug.
The corticosteroids, as these drugs (hormones) are called, have many actions. They regulate how the body processes sugars and starches (carbohydrates). They can break down protein and shunt it into a cycle where it is converted into glucose (sugar) for energy. They determine the distribution of fat.
Most importantly, steroids calm inflammation and rein in a misfiring immune system. In asthma, airways are so inflamed that they suddenly constrict when the slightest irritant lands on them. Prednisone quiets the inflammation and permits airways to expand. In ulcerative colitis, the colon is inflamed due to an assault by an errant immune system. Prednisone eases the inflammation and controls the misbehaving immune system.
Steroids as drugs are powerful medicines, and they have powerful side effects when they are taken by mouth for long periods and in high doses. They cause bone thinning. They can cause muscle breakdown. They delay healing. They cause fat to leave arms and legs and settle in the face and upper torso.
DEAR DR. DONOHUE: I am pregnant with my first child and have a family history of preeclampsia. Should I follow a special diet or take vitamins to avoid developing this condition? -- S.M.
ANSWER: Preeclampsia is a condition that can occur during pregnancy in which blood pressure rises and protein appears in the urine. It puts both mother and fetus at risk of complications. It can cause the placenta to separate from its moorings in the uterus. It can cause kidney failure for the mother. It can cause the mother's blood platelets to take a dive and put her at risk of hemorrhaging. It can lead to the mother having convulsions. When the three symptoms of protein in urine, high blood pressure and convulsions occur, the condition is called eclampsia -- an even greater medical emergency.
Family history does play a role in the appearance of preeclampsia. The role of heredity becomes even more significant if the woman's mother had preeclampsia.
There is no diet or vitamin that can prevent preeclampsia. All you have to do is inform your doctor that there is a history of it in your family, and the doctor can take it from there. He or she will want to check you more frequently than the average pregnant woman is checked.
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