Opening your blood test results and seeing numbers outside the usual range can feel unsettling, especially when you are already navigating life on steroids. Take a breath. Many of the changes steroids cause in your blood are expected and well understood; they are all part of how the medicine works. Knowing which are the ordinary ripples of treatment, and which are worth a quick word with your care team, can make those results feel much less worrying. Let's walk through the main ones together.
White blood cells
Your white blood cell count shows what your immune system is up to. On steroids, this number often rises, and much of the time that is simply the medicine reshuffling cells that were already there, rather than a sign of infection. Your medical team can usually tell the difference from the fuller breakdown on your report, and from how you are feeling.
Inflammation markers (CRP)
CRP (C-reactive protein) is a marker your body raises when there is inflammation, and steroids tend to lower it, which can be a reassuring sign your treatment is working. It helps to know that a low CRP can look calmer than the full picture, because steroids soften this signal. If your CRP is raised while you are on steroids, that is worth a conversation.
Blood sugar
Steroids can lift your blood sugar, often most in the afternoon and evening after a morning dose. If you live with diabetes, your usual readings may creep up, and, for some people, steroids bring on raised blood sugar for the first time. UK diabetes specialists, the Joint British Diabetes Societies, tend to see readings above 11.1 as the point where your team may want to look more closely. A single high reading is rarely a cause for concern on its own, so please do not change any medication by yourself. What helps most is noticing a pattern over a few days and sharing it. Do reach out sooner if you feel very thirsty, are urinating more than usual at night, or your vision becomes blurry. Keeping your blood sugar under control has gentle, practical steps.
“Steroids also change our metabolism, the way we handle blood sugar, and the way fat is stored.” Dr Meredith Marinaro
Calcium and your bones
Here is one that surprises many people. Your calcium result can sit comfortably in the normal range even while steroids are quietly affecting your bones. Your body works hard to keep blood calcium steady, sometimes by drawing on your bones to do it, so a normal number does not mean your bones are safe. The clearer picture comes from a bone density (DEXA) scan and a chat about vitamin D and calcium. Supporting your bone health walks you through what protects your bones, and Rebuilding your bones after steroids: what actually works goes deeper.
Cholesterol and fats
Over time, steroids can raise your cholesterol and other fats in the blood. One slightly raised result is not an emergency, and these are numbers your team follows as part of a longer story. Looking after the everyday things like staying active, eating well and keeping an eye on your blood pressure all help. Maintaining your lipid levels has friendly, doable ideas.
A gentle but important note
Steroids can suppress the signals your body would normally raise when an infection takes hold, and they can lower your defenses at the same time. This means your blood tests, and even the way you feel, may be masking developing problems. If you have a fever, chills, feel shivery or unwell, become breathless, or notice new pain, please contact your care team the same day, even if a recent blood test looked reassuring. Keeping infections at bay shares simple ways to protect yourself.
“With a tool like Sam, patients will be able to take a little more control of their treatment. More improved and informed conversations with care teams happen when patients are empowered.” Paula J. Eichenbrenner (TMA Executive Director)
When to reach out
Please contact your care team if you notice signs of infection or very high blood sugar, such as drowsiness, being sick, or fast breathing. If you are ever seriously unwell, in an accident, or cannot keep your steroid tablets down, use your steroid emergency card, as you may need extra support quickly.