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Because steroids are hormones, patients who use them for long periods of time must be carefully monitored. The most common side effects are: weight gain; thinning of the skin; upset stomach; muscle weakness in the thighs, shoulders, and neck; “masking” or hiding a fever; mood swings; insomnia; pneumonia; and increased blood sugar levels (especially in patients with diabetes). Steroids can also interact with some seizure medications, either raising or lowering the seizure medicine levels in the blood, which can affect their effectiveness. Your doctor can explain other side effects that may occur with steroid use.