The catabolic steroid acts by breaking down the tissues, unlike anabolic steroids which builds the tissues. This action helps muscle dystrophy patients compensate muscle loss. Therefore, the paradox explains why researchers believe it is due to the immunosuppressant and anti-inflammatory effects of the catabolic steroid. Prednisone works similarly to hydrocortisone, by breaking down tissue to release glucose and activate energy in reaction to any threat or stress. Additionally, it helps fight inflammation through suppressing the immune system. According to some researchers, prednisone may help in stimulating muscle protein production.
Corticosteroids can produce reversible hypothalamic- pituitary adrenal (HPA) axis suppression with the potential for corticosteroid insufficiency after withdrawal of treatment. Adrenocortical insufficiency may result from too rapid withdrawal of corticosteroids and may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for up to 12 months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. If the patient is receiving steroids already, dosage may have to be increased.