Before surgery · Steroids
Do I Need Extra Steroids for Surgery?
Long-term steroids can stop your body making enough of its own stress hormone for surgery. Answer a few questions to see whether extra 'stress-dose' cover is likely — then confirm with your team.
⚠️ Don't stop your steroids
Never stop long-term steroids before surgery — that's the dangerous move. You keep taking them; the team adds extra cover if needed. Always tell your anesthetist you take steroids.
Frequently asked questions
Why might I need extra steroids for surgery?
Taking steroid tablets for more than a few weeks can dampen your body's own cortisol production. Surgery is a major stress that normally triggers a surge of cortisol — if your body can't make enough, blood pressure can drop dangerously (an adrenal crisis). Extra 'stress-dose' steroids around the operation cover that gap. It's a safety step, decided by your team.
Should I stop my steroids before surgery?
No — never stop long-term steroids suddenly before surgery. Stopping abruptly is dangerous because your body can't switch its own production back on quickly. You normally keep taking them, and the team adds extra cover around the operation if needed. Always tell your anesthetist you take steroids.
What counts as 'long-term' steroids?
Generally, taking an oral steroid such as prednisolone for more than about 3 weeks, or repeated courses, can suppress your own cortisol — especially at doses of 5 mg a day or more. High-dose inhaled steroids, frequent steroid injections, or strong topical steroids over large areas can occasionally have a similar effect. Tell your team about any steroid use.
Does this apply to inhalers or creams?
Usually standard inhaled or topical steroids don't need stress-dosing, but high doses, large areas, or long-term use occasionally can suppress cortisol. It's always worth mentioning any regular steroid — inhaled, topical, injected or oral — to your pre-op team so they can judge.