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Documented Long-Term Side Effects of Corticosteroids Bone loss and fractures due to calcium and vitamin D depletion and impaired osteoblast activity (2) Blood sugar dysregulation and steroid-induced diabetes through increased insulin resistance and gluconeogenesis (3) Muscle wasting and impaired connective tissue repair from protein catabolism and suppressed synthesis (4) Weakened immunity, delayed healing, and prolonged infections related to micronutrient depletion and immune suppression (5) Weight gain, mood changes, and insomnia driven by hormonal and circadian disruption (6,7) Abnormal blood lipids, hypertension, and increased cardiovascular risk , including heart attack, with long-term use (8) Thinning skin and easy bruising from collagen breakdown and connective tissue loss (9) Psychiatric effects , including anxiety, irritability, depression, andin severe casessteroid-induced psychosis, particularly at higher doses or with prolonged exposure (10) Even short-term corticosteroid use can cause side effects in susceptible patients