Calcium , Vitamin D

Helpful Interactions

One of the most serious side effects of long-term corticosteroid use is accelerated osteoporosis. Although we don't fully understand how this works, corticosteroid interference with calcium and vitamin D is known to play a major role.

Calcium and vitamin D supplements are definitely beneficial for fighting ordinary osteoporosis ; in addition, there is good evidence that they also protect against osteoporosis brought on by corticosteroids. 1 A review of 5 trials enrolling a total of 274 participants found that calcium and vitamin D supplementation significantly prevented bone loss at the lumbar spine and forearm in corticosteroid-treated individuals. 2 For example, in a 2-year double-blind placebo-controlled study of 130 individuals, supplementation with 1,000 mg of calcium and 500 IU of vitamin D daily actually reversed steroid-induced bone loss, causing a net bone gain. 3

Aloe and Licorice (Topical)

Possible Supportive Interactions with Topical Corticosteroids

Aloe and licorice are two herbs sometimes used topically for skin problems. Preliminary evidence suggests that each one might help topical corticosteroids, such as hydrocortisone, work better. 4,5

Dehydroepiandrosterone (DHEA)

Possible Helpful Interaction

There are theoretical reasons (but little direct evidence) to believe that individuals taking corticosteroids, such as prednisone, might be protected from some side effects by taking DHEA at the same time. 9,10

Chromium

Supplementation Possibly Helpful

Long-term, high-dose corticosteroid treatment can cause diabetes. This may be at least partly caused by chromium deficiency. A very preliminary study found treatment with corticosteroids caused increased loss of chromium in the urine. 11 Another preliminary study found that individuals with corticosteroid-induced diabetes could improve blood sugar control by taking chromium supplements. 12

Creatine

Possible Helpful Interaction

Long-term use of corticosteroids, whether orally, or possibly, by inhalation, can slow a child’s growth. One animal study suggests that use of the supplement creatine may help prevent this side effect. 15

Ipriflavone

Possible Harmful Interaction

The supplement ipriflavone is used to treat osteoporosis. A 3-year, double-blind trial of almost 500 women, as well as a small study, found worrisome evidence that ipriflavone can reduce white blood cell count in some people. 13,14 For this reason, anyone taking medications that suppress the immune system should avoid using ipriflavone except under physician supervision.

Licorice (Internal)

Possible Harmful Interaction

When taken by mouth, the herb licorice appears to enhance some actions of oral corticosteroids, but interfere with others. 6-8 Because of the unpredictable nature of this interaction, individuals using oral corticosteroids should avoid licorice.