Key lessons I’ve learned as a doctor about my childhood corticosteroid use

Sometimes a childhood memory will return and leave me stunned. Last week, I found myself thinking about a medication I had taken every day for the first 11 years of my life: prednisolone. A doctor had prescribed it when I was about 1 year old, and I continued taking it routinely until I was 11.

Today, I’m both a physician and a sickle cell disease warrior, and one question still amazes me: How did my immune system survive a decade of daily prednisolone use?

Prednisolone belongs to a class of drugs called corticosteroids. It is used to treat inflammatory conditions, autoimmune diseases, and other conditions. However, it suppresses the immune system, which can increase the risk of infections. Other side effects may include hypertension, weight gain, predisposition to diabetes, increased appetite, osteoporosis, and osteopenia.

My experience reflects a different era of sickle cell care.

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This happened in the 1980s, when knowledge about sickle cell disease was limited worldwide. Here in Nigeria, especially in rural communities, access to specialized care was extremely scarce. My family lived in a village with only a few general practitioners and no hematologists. We had no internet, smartphones, medical websites, or artificial intelligence tools to provide health information. Many doctors treated sickle cell patients based only on symptoms, without treatment guidelines.

At the time, many families visited hospitals only when absolutely necessary. Ignorance, poverty, distance, and cultural and religious beliefs often discouraged routine medical follow-up care. As a result, people frequently reused old prescriptions whenever symptoms returned instead of seeking new medical advice.

In my case, the situation was even more concerning. A physician prescribed prednisolone and several blood-building prescriptions as routine medications for me. Because the drugs were intended for daily use, I continued taking them year after year. Whenever I experienced a painful sickle cell crisis, my parents simply added pain relievers. We rarely returned to the hospital, and no doctor reviewed my treatment plan for an entire decade. Looking back, that approach was deeply problematic.

My survival was an anomaly

Sickle cell disease already weakens the body’s ability to fight infections. The disease often damages the spleen, an organ that plays a vital role in immunity. Some patients eventually lose splenic function completely through a process known as autosplenectomy, while others require surgical removal of the spleen. Without a properly functioning spleen, patients become more vulnerable to serious infections.

For that reason, corticosteroids like prednisolone are not routine treatments for the long-term management of sickle cell disease. In situations where a patient has another medical condition like asthma or autoimmune or skin diseases that require steroids, physicians must use them carefully and monitor the patient closely.

For me, everything changed when a severe crisis forced me back to the hospital at the age of 11. While there, I met a specialist who immediately reviewed my medications and completely redesigned my treatment plan. For the first time, I received care that aligned with modern principles of sickle cell disease management.

When I reflect on those years today, I consider my survival both remarkable and difficult to explain medically. Yet surviving came with consequences.

I suffered infections that a stronger immune system might have prevented. Around the age of 12, I contracted tuberculosis, an infection that people with low immunity can be predisposed to.

I also experienced severe osteopenia and osteoporosis, conditions that weaken the bones and increase the risk of fractures. Sickle cell disease can contribute to both osteoporosis and osteopenia, as can long-term corticosteroid use. Unfortunately, I faced both risk factors simultaneously. I share this story because it highlights the importance of regular medical follow-up.

Healthcare constantly evolves. Treatments considered acceptable years ago may later prove ineffective or even harmful. Regular clinic visits allow healthcare professionals to review medications, monitor for complications, and make necessary adjustments.

Had I attended routine follow-up appointments, another physician might have corrected that prescription much earlier, and some of my later complications might have been prevented.

My experience also highlights the need for stronger medication control systems across many low-resource regions, including parts of Africa and Asia. Although regulations have improved since the 1980s, significant gaps remain.

Too many people still obtain medications without proper medical supervision. In some communities, patients can access powerful drugs, including opioids, with little oversight. This practice increases the risk of misuse, dependence, and avoidable health complications.

My story is not just about a prescription. It is a reminder that good healthcare requires ongoing monitoring, access to specialist care, and responsible medication regulation. Those safeguards save lives, and for people living with sickle cell disease, they can make all the difference.

Note: Sickle Cell Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sickle Cell Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to sickle cell disease.