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Current therapeutic landscape: Lifestyle interventions (diet, weight loss, exercise) remain first-line therapy

Reported side effects of corticosteroids include: Hydroelectrolytic disorders: sodium retention, potassium loss, hypokalemic alkalosis, fluid retention, congestive heart failure in susceptible patients, hypertension Musculoskeletal: muscle weakness, myopathy, loss of muscle mass, aggravation of myasthenic symptoms in myasthenia gravis, osteoporosis, vertebral compression fractures, aseptic necrosis of the head of the femur and humerus, pathologic fracture of long bones, tendon rupture Dermatological: impaired wound healing, atrophy and thinning of the skin, fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, suppression of reactions to skin tests, allergic dermatitis, urticaria, and angioedema

Baldini G, Phelan KD

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We know its tempting to give it a good shake to mix it, but this is a destructive act