Kenyan women looking to lose weight are now buying a prescription-only drug used mostly to treat lupus, severe asthma, cancer and inflammatory bowel disease, among other diseases.
On social media, these women share the “success” of taking prednisone, ignoring that it has severe side effects, especially if not prescribed by a doctor.
Dr Rosslyn Ngugi, a consultant endocrinologist at Kenyatta University Teaching Referral and Research Hospital (Kutrrh) and AAR hospitals, says doctors have been seeing a growing number of patients arriving with complications from prednisone obtained without a prescription.
“Steroid-induced diabetes, osteoporosis fractures, gastrointestinal bleeding and severe infections are among the conditions associated with unsupervised use,” says Dr Ngugi.
She explains that prednisone is a synthetic corticosteroid that is only available on prescription. It is a man-made version of cortisol, a hormone produced naturally by the adrenal glands.
The medicine is available in tablet, liquid, or injectable forms and is used to treat conditions such as asthma, chronic obstructive pulmonary disease (COPD), autoimmune diseases such as lupus and rheumatoid arthritis, severe allergic reactions, inflammatory bowel disease, and certain cancers.
In patients who have received an organ transplant, it is used to prevent rejection.
However, some women are overlooking its core usage to treat illnesses, and they are promoting prednisone on social media, with claims that it helps with weight loss and increases energy levels.
“Women in particular are seeking it out as a quick fix for weight loss and inflammation, obtaining it without medical oversight,” she says.
Why does it require a prescription?
Dr Ngugi explains that prednisone carries a risk of serious side effects. It can mask or worsen infections, and prolonged use causes adrenal suppression—the shutdown of the body’s own cortisol production.
Prednisone. The drug is a hormone, not a performance-enhancing drug
Photo credit: Shutterstock
“A doctor needs to weigh up the benefits against the risks and monitor the patient's laboratory results,” she says on why the drug has to be prescribed and regulated by a doctor.
“In many countries, prednisone is used as a quick fix for rashes, body aches, weight loss or to boost energy,” she says, noting that agencies including the World Health Organisation (WHO) and the US Centres for Disease Control and Prevention have expressed concern about unsupervised use.
Dr Ngugi also notes that the medicine should only be bought on prescription, and not over the counter because of its effectiveness.
“It works fast. Pain, inflammation and swelling can subside within hours,” she says.
Some users also conflate prednisone with anabolic steroids, seeking it for its perceived muscle-building effects.
“That is a significant misconception. Prednisone is a hormone, not a performance-enhancing drug.”
Besides weight loss, some Kenyans are using as a painkiller.
The misunderstandings that patients bring to her clinic follow a consistent pattern. Many believe prednisone is a stronger version of ibuprofen. Dr Ngugi says this is not the case; instead, prednisone is a hormone with system-wide effects. Others also assume that a short course is harmless.
“Even five to seven days can affect blood sugar and mood,” she says.
Some are buying it over the counter to self-treat include mild allergies, skin rashes and general aches and pains, having seen it being recommended on social media. Many Kenyans nowadays seek medical advice or buy prescription drugs based on social media trends, which is increasingly becoming dangerous.
Some women are overlooking prednisone's core usage to treat illnesses and are promoting the drug on social media, with claims that it helps with weight loss and increases energy levels.
Dr Ngugi, for instance, says there are safer alternatives to prednisone.
“Antihistamines and nasal steroids are appropriate for allergies. Topical hydrocortisone and emollients can treat most skin rashes. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, along with physiotherapy, heat and ice, can manage musculoskeletal discomfort.”
“However, none of these is risk-free, and they do not carry the same hormonal and immune risks,” she says.
Side effects can affect various body systems
Experts say using prednisone for weight loss will achieve the exact opposite result. Dr Ngugi says that, in the short term, prednisone can cause insomnia, increased appetite, mood changes, fluid retention, heartburn and elevated blood sugar.
The drug also stimulates appetite centres in the brain while altering how the body stores fat and retains sodium and water. With longer-term use, characteristic physical changes appear, including moon face (a swollen, rounded face) and fat redistribution to the upper back and trunk (referred to as a buffalo hump).
She says that the effects on blood sugar are also significant, as prednisone increases liver glucose production and causes insulin resistance.
“It can reveal diabetes in someone who is predisposed to it, or trigger steroid-induced diabetes even in people who were previously healthy,” says Dr Ngugi. “Blood pressure is also affected through sodium and water retention, with long-term cardiovascular risk elevated as a result.”
Similarly, long-term use reduces bone formation, leading to osteoporosis and fractures. It also causes muscle breakdown and weakness, a condition called steroid myopathy.
The immune system is suppressed by design when the drug is used therapeutically, but becomes a liability under unsupervised use, making bacterial, viral and fungal infections more likely. Live vaccines, she says, must also be avoided during treatment.
Adrenal suppression and the danger of stopping abruptly
One of the most serious consequences of prolonged use is the effect on the body’s own hormone system.
Dr Ngigi explains that when prednisone is taken for more than two to three weeks, the brain signals the adrenal glands to stop producing cortisol. The body registers that there is already enough cortisol being supplied externally, and, over time, the adrenal glands can shrink.
“Cortisol is essential for managing stress, maintaining blood pressure and regulating blood sugar,” she says. “If the adrenals are suppressed and someone stops taking prednisone suddenly, the body has no fallback.”
The result can be an adrenal crisis, which is a medical emergency involving severe fatigue, nausea, vomiting, dangerously low blood pressure and confusion. Reducing the dose gradually is standard practice because it gives the adrenal glands time to resume their function.
Prednisone can also affect mental health, causing insomnia, anxiety, irritability, euphoria and depression. At high doses, psychosis is a rare but recognised risk. Most of these effects resolve after tapering.
Dr Ngugi stresses that anyone taking prednisone, whether prescribed or not, should seek immediate medical attention if they experience severe abdominal pain or vomiting, sudden swelling, shortness of breath, changes in vision, a fever or other signs of infection, black or tarry stools, severe mood changes or symptoms consistent with an adrenal crisis when stopping the drug.
“This is a powerful medication with a legitimate place in medicine,” she says. “But it is not something the body handles without consequences. It needs oversight.”
