Steroids can be life-saving for people who need them. These medicines help control inflammation and other serious health problems. But when you’re sick, your body might react differently, especially if you take steroids regularly. Knowing the “sick day rules” can help you stay safe and recover faster.
This guide explains what to do when you are sick and use steroids. It also highlights why following these rules is crucial for your health.
Why Do Steroids Require Sick Day Rules?
Your body naturally makes a hormone called cortisol. It helps manage stress, fight infections, and maintain energy. When you take steroids like prednisone or hydrocortisone, your body reduces its natural cortisol production.
During illness or stress, your body usually produces more cortisol to help you cope. But if you are on steroids, your body can’t do this as effectively. This is why you need to adjust your steroid dose during sick days.
Ignoring sick day rules can lead to a dangerous condition called adrenal crisis. This happens when your body doesn’t have enough steroids to handle stress. Symptoms include severe fatigue, low blood pressure, nausea, and confusion.
Sick Day Rules for Steroid Users
Rule 1. Adjust Your Dose for Fever or Illness
If you feel unwell with a fever or more than a mild illness, increase your steroid dose:
- If you take less than 10 mg of prednisolone daily, double your dose.
- If you take 10–19 mg daily, increase to 20 mg.
- If you take 20 mg or more, no increase is needed.
For hydrocortisone users, take 20 mg immediately, then 10 mg every six hours until you feel better.
Rule 2. Seek Medical Help for Severe Symptoms
Contact a doctor immediately if you experience:
- Severe vomiting or diarrhea for more than 24 hours.
- A major injury.
- The need for surgery or medical procedures like colonoscopy prep.
You may need steroid injections to recover safely.
Rule 3. Carry Emergency Supplies
Always keep a medical alert bracelet and an emergency steroid injection kit. These can help during unexpected sickness or accidents. Teach someone close to you how to use them.
Steroids and Specific Illnesses
Common Cold or Flu
- Increase your steroid dose as per your doctor’s instructions.
- Rest and stay hydrated.
Fever
- Take 2–3 times your normal steroid dose.
- Monitor your symptoms. If the fever doesn’t go down or you feel worse, call your doctor.
Vomiting or Diarrhea
- You may not absorb oral steroids if you vomit. Use an emergency hydrocortisone injection.
- Stay hydrated. Electrolyte drinks can help restore your salt and fluid levels.
Surgery or Medical Procedures
- Inform your doctor beforehand.
- You may need extra steroids during and after the procedure.
Adrenal Crisis: A Serious Emergency
An adrenal crisis is rare but dangerous. It happens when your body doesn’t have enough steroids to handle stress. Symptoms include:
- Severe weakness or dizziness.
- Nausea and vomiting.
- Confusion or fainting.
If you suspect an adrenal crisis:
- Administer an emergency hydrocortisone injection immediately.
- Call an ambulance or go to the nearest hospital.
- Inform medical staff about your steroid use.
Tips to Stay Prepared
- Keep a Steroid Card: Write down your medication details, dose, and emergency instructions. Carry this card with you at all times.
- Inform Family and Friends: Teach those close to you about your sick day rules.
- Plan for Travel: Carry extra steroids and a hydrocortisone injection kit. Research nearby hospitals before travelling.
Children and Steroid Sick Day Rules
If your child takes steroids, the sick day rules are similar. However, their doses might differ. Always consult a paediatrician for the right adjustments.
- Teach carers, teachers, or babysitters about emergency procedures.
- Ensure the child wears a medical alert bracelet.
Questions to Ask Your Doctor
- How much should I increase my steroid dose during sick days?
- When should I use a hydrocortisone injection?
- What should I do if I feel unwell but don’t have a fever or vomiting?
- Can I take over-the-counter medicines with my steroids?
When to Seek Emergency Help
Call for help if you experience:
- Severe fatigue or confusion.
- Low blood pressure or fainting.
- Persistent vomiting or diarrhoea.
- Signs of an adrenal crisis.
Summary
Steroid sick day rules are essential for anyone on long-term steroids. They help your body cope with the stress of illness and prevent life-threatening complications like adrenal crises.
Always increase your dose during sickness, carry emergency hydrocortisone, and stay hydrated. Inform your doctor when unwell, and educate your loved ones about your care plan.
Being prepared can save your life. Follow these steps to manage sick days safely and confidently.
FAQs
Is it ok to take steroids when sick?
Yes, it is usually safe to take steroids when you are sick. In fact, you may need to adjust your dose depending on how unwell you feel.
If you have a mild illness like a cold, you can continue your regular dose. But for fever, severe illness, or stress, your body may need more steroids. This is because your natural cortisol levels can’t rise as they normally would. Always talk to your doctor if you’re unsure.
What is the steroids taper rule?
The steroid taper rule helps you lower your steroid dose slowly to allow your body to start making natural cortisol again. The tapering plan depends on your dose and how long you’ve taken prednisone. Short-term users may reduce their dose daily, while long-term users need a slower schedule. Always follow your doctor’s instructions and never stop steroids suddenly.
Do steroids stop sickness?
Steroids don’t stop sickness, but they help control symptoms caused by inflammation. They can reduce pain, swelling, and immune reactions, making you feel better. However, steroids don’t fight infections or cure the illness itself. Always use them as prescribed by your doctor for the best results.