There is a (limited) place for steroids in medicine

Re the excellent report on AIDS and HIV (WDDTY vol 13 no 11), vested pharmaceutical interests have been responsible for fundamental misunderstandings concerning the nature of AIDS and the use of AZT, an example of a grievous abuse of power by commercial interests.

My concern, however, is to point out that the adrenal glands produce adrenal hormones which are so vital to our health that, without them, we would die within a few days. These hormones, the steroids cortisol and hydrocortisone, are entirely vital to our health. The problems arise (i) if your adrenals are weakened (by stress or illness) and replacement of the missing cortisones is mandatory for health; or (ii) if the system is exposed to cortisol above normal physiological levels, as a result of medicines, aerosols or creams.

It’s the old story, really. You must not have too little, and you must not have too much. Too much will certainly damage a number of systems, including the adrenals themselves and the immune system. My point is that cortisone, hydrocortisone and prednisolone are not only perfectly safe for poorly functioning adrenals – the worst-case scenario would be Addison’s disease – they are essential, safe and proper to use as long as the deficiency lasts.

Furthermore, at physiological doses, the immune system is helped and improved – suppression only occurs at higher, so-called therapeutic doses. Steroids are not to be thought of as universally damaging; we run on them and they are essential. It is their misuse that causes problems.

I must take leave to doubt the suggestion that malnutrition can cause such a degree of overproduction of natural cortisol as to eventually lead to immune-system failure. There does not appear to be any research evidence to back up the suggestion. It is very much more likely that, once the disease is established, the adrenals will progressively weaken and the immune system will further collapse as a result.- Dr Barry Durrant-Peatfield, LRCP, MRCS, CAM, via e-mail