IgG4-related disease steroid side effects: How to cope

Last updated June 2, 2025, by Patricia Weiser, PharmD
✅ Fact-checked by Patrícia Silva, PhD

 

Steroids are a common IgG4-related disease (IgG4-RD) treatment, and they can be highly effective in easing symptoms and reducing inflammation. However, like many medications, they come with some trade-offs.

Steroid side effects, especially from long-term use, can affect your appearance, mood, and overall health. Knowing what to expect and how to manage these changes can make it easier to continue treatment so you can experience the benefits of taking steroids for IgG4-RD.

How steroids help treat IgG4-RD

IgG4-RD is a chronic condition that causes inflammation and scarring in one or more organs, often without overt symptoms, and sometimes over the course of years. Many people do not know they have it until symptoms worsen or a flare leads to more obvious health problems.

Steroids, also called corticosteroids, are usually the first treatment for IgG4-RD. They are powerful, fast-acting medicines that help calm the immune system, lower inflammation, and relieve symptoms quickly.

For many people with IgG4-RD, steroids relieve symptoms within a few weeks. In some studies, more than 80% of people saw their symptoms go away (remission) or experienced a meaningful improvement while taking steroids as their only treatment.

Steroid treatment usually continues for several months, depending on how your body responds to the medication.

Some people may continue taking them long term as a maintenance treatment, while others may gradually stop under the guidance of their doctor. If symptoms return, they may be used again as a short-term treatment to help calm a flare.

Common side effects of steroids

Steroids can play a powerful role in managing IgG4-RD, especially during flares. However, their side effects can impact many aspects of your life, from your emotional well-being to your physical appearance.

Side effects and long-term risks of taking steroids may include:

  • acne
  • bone thinning (osteoporosis)
  • delayed wound healing
  • difficulty sleeping
  • fragile or thinning skin
  • headache
  • high blood pressure
  • high blood sugar, which can lead to (or worsen) diabetes
  • mood swings or irritability
  • muscle weakness
  • sweating more than usual
  • weight gain and increased appetite.

Other side effects may include an increased risk of infection, changes in vision, and heart problems. The risks can vary depending on your dosage, how long you take IgG4-RD steroids, and whether the disease has already affected specific organs.

The good news is that managing steroid side effects is possible through healthy habits and regular check-ins with your doctor.

Coping with appearance-related changes

Steroids can change how fat is distributed in your body. You may notice changes such as weight gain, a more rounded face (sometimes called “moon face”), puffiness, or skin issues like acne or thinning skin.

These changes can affect both the physical and emotional health in people living with IgG4-RD. An active, healthy lifestyle can make these changes less noticeable and help you feel better about yourself.

Stay active

Staying active can help offset weight gain. Aim for gentle movement such as walking, light strength training, or yoga most days of the week, and choose fun activities or exercise with a friend to make it easier to stay consistent.

Another benefit of exercise is it can help relieve pain or other symptoms related to IgG4-RD while supporting your physical fitness.

Eat a balanced diet

Consider planning your meals around vegetables, whole grains, lean proteins, and healthy fats. Limiting salty and ultra-processed foods may help reduce swelling caused by fluid buildup, which is often exacerbated by steroid treatment. Drinking plenty of water can also help keep swelling in check.

Practice good skincare habits

Taking good care of your skin can help manage skin-related side effects. Stick to a simple skincare routine that includes daily sunscreen use, and consult a dermatologist if you require more targeted skin treatments.

Reach out to your care team

If changes in appearance affect your mood or self-confidence, discuss this with your healthcare team.

Your care team may recommend mental health support or an IgG4-RD support group, which can be a helpful outlet for you. Just talking about what you’re going through with other people who have gone through the same thing can be encouraging.

Managing fatigue and mood swings

Steroids can disrupt sleep and mood, adding to the fatigue already common with IgG4-RD. You may feel tired during the day or have trouble sleeping at night. In some cases, taking steroids can make you feel irritable or even lead to mood disorders such as anxiety or depression.

Taking steroids in the morning, or earlier in the day, may help reduce sleep disruption at night. Keeping a consistent sleep schedule, limiting caffeine and alcohol before bed, and getting moderate exercise earlier in the day may also boost energy and mood.

It can also be helpful to inform family and friends about how steroids may affect your mood, as they may notice changes in your mood and behavior before you do.

If side effects are interfering with your daily life, ask your doctor about strategies, therapy, or medications that could help.

Tips and strategies for coping with steroid side effects

Managing IgG4-RD often means balancing steroid benefits with the risk of side effects. Certain lifestyle changes and medical strategies can help you manage the most common IgG4-RD treatment side effects.

Blood sugar

Steroids may raise your blood sugar. This is especially important to be aware of if you already have diabetes or prediabetes.

Watching your diet and being more active can help. Your doctor may also recommend blood sugar checks or prescribe diabetes medications to manage your blood sugar levels. 

Blood pressure

Steroids may cause more salt and water to remain in your body, which can lead to an increase in blood pressure. Reducing your salt intake and staying active may help offset these side effects.

It’s also important to drink enough water and eat plenty of fruits, vegetables, and whole grains. Your doctor may recommend medication if your blood pressure is high.

Bone health

Steroids can weaken your bones over time. If you have IgG4-RD and have been taking steroids for several months, your doctor may recommend calcium and vitamin D supplements, especially if you have a history of fractures.

You can plan your meals to include foods that will increase your calcium and vitamin D levels. Good sources of calcium include yogurt, milk, cheese, and leafy greens. Foods rich in vitamin D include salmon, tuna, sardines, and fortified cereals.

Other strategies to protect your bone health include staying physically active to support bone strength and asking your doctor about bone-protecting medications, especially if you have risk factors for osteoporosis.

Stomach problems

Take steroids with food, ideally a full meal, to reduce the chance of an upset stomach. Let your doctor know if pain or discomfort continues. They may suggest medicines to protect your stomach lining.

Infections

Steroids may lower your immune defenses. Practice frequent hand-washing and avoid contact with sick individuals whenever possible.

Protect yourself before starting steroids by getting up to date with recommended vaccines (such as a flu shot, pneumonia vaccine, or shingles vaccine), but only if your doctor recommends doing so.

Eye health

Steroids may raise the risk of cataracts, which happen when the lens in your eye becomes cloudy. Steroids may increase the pressure inside your eye and your risk of a vision problem called glaucoma.

Get regular eye exams and tell your doctor if you notice any vision changes, such as blurred vision.

When to talk to your doctor about alternatives

If side effects are interfering with your daily life, talk to your doctor. Some signs it may be time to revisit your treatment options include:

  • bone fractures or weak bones
  • high blood sugar or trouble managing diabetes
  • ongoing infections
  • severe mood changes or fatigue
  • stomach ulcers
  • uncontrolled high blood pressure or heart concerns
  • vision problems.

Your doctor may recommend adjusting your steroid dosage, changing when you take the medications, or trying a different IgG4-RD treatment.

Managing side effects early can help protect your long-term health as you live with this chronic condition. Your healthcare team can help you weigh the benefits and risks of taking steroids and help you decide what’s best for you.

IgG4-RD 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.

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