Can oral steroids, such as prednisone, be used to manage symptoms of mold exposure?

From the Guidelines

Oral steroids, such as prednisone, can be used to manage symptoms of mold exposure, particularly in cases of severe nasal polyposis, but their use should be limited to short courses under medical supervision. When considering the management of symptoms related to mold exposure, it's crucial to prioritize treatments that address the root cause, such as removing the mold source, alongside symptomatic relief. For severe symptoms, especially those involving significant respiratory issues or nasal polyposis, oral steroids may be considered as part of the treatment plan, as evidenced by their effectiveness in reducing symptoms and polyp size, and improving nasal flow 1.

The use of oral steroids like prednisone is supported by studies showing their efficacy in managing severe inflammatory conditions, including those associated with mold exposure. However, it's essential to weigh the benefits against the potential risks, including side effects such as increased blood sugar, mood changes, and increased infection risk. The general approach to managing mold exposure symptoms starts with less invasive methods, including removal from the moldy environment, use of antihistamines, nasal sprays, or decongestants for mild to moderate symptoms.

In cases where symptoms are severe or persistent, and particularly when nasal polyposis is involved, a short course of oral prednisone (typically 20-40mg daily for 5-7 days, with a possible taper) may be prescribed to reduce inflammation, as suggested by the effectiveness of corticosteroids in treating nasal polyposis 1. It's critical to note that long-term steroid use is not recommended due to the associated risks, and the most effective long-term solution remains the identification and removal of the mold source.

Key considerations in the management of mold exposure symptoms include:

• Removal from the moldy environment as the first step
• Use of antihistamines, nasal sprays, or decongestants for mild to moderate symptoms
• Possible use of oral steroids like prednisone for severe symptoms under medical supervision
• Limiting oral steroid use to short courses due to potential side effects
• Identifying and removing the mold source as the long-term solution.

From the FDA Drug Label

Corticosteroids, including prednisone tablets, may exacerbate systemic fungal infections; therefore, avoid prednisone tablets use in the presence of such infections unless prednisone tablets is needed to control drug reactions For patients on chronic prednisone tablets therapy who develop systemic fungal infections, prednisone tablets withdrawal or dosage reduction is recommended.

Oral steroids, such as prednisone, should be used with caution in managing symptoms of mold exposure, as they may exacerbate systemic fungal infections. It is recommended to avoid oral steroid use in the presence of fungal infections unless necessary to control drug reactions 2.

From the Research

Oral Steroids for Mold Exposure Symptoms

• Oral steroids, such as prednisone, are commonly used to manage symptoms of various conditions, including asthma exacerbations 3.
• However, there is limited evidence on the use of oral steroids specifically for managing symptoms of mold exposure.
• Studies have shown that oral corticosteroids can have significant side effects, including infections, diabetes, and osteoporosis, especially with long-term use 4.
• Inhaled corticosteroids are often recommended as first-line controller medications for persistent asthma, and their efficacy and safety have been extensively studied 5, 6.
• The use of oral steroids for mold exposure symptoms would likely be considered on a case-by-case basis, taking into account the individual's overall health, the severity of their symptoms, and the potential risks and benefits of treatment.
• It is essential to weigh the potential benefits of oral steroid therapy against the risks of side effects and to consider alternative treatment options, such as inhaled corticosteroids or other medications, under the guidance of a healthcare professional.

Key Considerations

• The efficacy and safety of oral steroids for managing symptoms of mold exposure are not well established.
• Oral corticosteroids can have significant side effects, especially with long-term use.
• Inhaled corticosteroids may be a safer and more effective alternative for managing respiratory symptoms.
• Healthcare professionals should carefully evaluate the potential benefits and risks of oral steroid therapy for each individual patient.