ABPA or Steroid Side Effects? Understanding Symptoms During Long-Term Treatment
Last reviewed: April 2026
Many people living with Allergic Bronchopulmonary Aspergillosis (ABPA) who take long-term steroids find it difficult to tell whether their symptoms are caused by the condition or the treatment.
Symptoms in ABPA can come from both the condition and long-term steroid treatment. Fatigue, weakness, mood changes, and general unwellness are common to both, making it difficult to identify a single cause without clinical review.
This is especially true for people taking corticosteroids such as methylprednisolone or prednisolone.
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Key Points
- ABPA and steroid treatment can cause overlapping symptoms.
- Fatigue, low mood, and general unwellness can come from either the condition or medication.
- Long-term corticosteroid use can cause additional side effects.
- It is common to feel unsure what is causing symptoms.
- Ongoing or worsening symptoms should be discussed with your healthcare team.
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Why is it hard to tell the difference?
ABPA is an immune-driven lung condition that causes inflammation. Treatment often includes corticosteroids such as methylprednisolone or prednisolone, which reduce inflammation but can also affect many systems in the body.
This means that:
- The disease itself can cause symptoms
- The treatment can also cause symptoms
As a result, people often experience a combination of both.
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Symptoms caused by ABPA
ABPA commonly affects the lungs but can also cause more general symptoms.
- Fatigue and low energy
- Breathlessness
- Cough and mucus production
- Chest tightness
- General feeling of being unwell
Fatigue can be particularly prominent, especially during flare-ups.
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Side effects of long-term steroids
Corticosteroids such as methylprednisolone are highly effective treatments, but long-term use can lead to a range of side effects.
- Fatigue and weakness (including muscle loss)
- Mood changes (anxiety, low mood, irritability)
- Easy bruising (skin becomes thinner)
- Stomach irritation or pain
- Dizziness or feeling unwell
- Sweating
- Bone or joint discomfort
Learn more about treatment approaches in aspergillosis treatment options.
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Where symptoms overlap
Some symptoms can be caused by both ABPA and steroid treatment, making them difficult to interpret.
| Symptom | Possible cause |
|---|---|
| Fatigue | ABPA inflammation or steroid effects |
| Low mood / anxiety | Medication effects or impact of chronic illness |
| Weakness | Muscle loss from steroids or reduced activity |
| General unwell feeling | Both |
This overlap is one of the most challenging aspects of long-term management.
🔎 Not sure what’s causing your symptoms?
Many people with ABPA feel exactly the same—this overlap is one of the most common challenges during long-term treatment.
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Understanding specific symptoms
Some symptoms are more commonly linked to treatment effects:
- Easy bruising – often related to steroid use
- Heel or ankle pain – may relate to tendon or joint effects
- Stomach pain – can be linked to steroid irritation
Other symptoms, such as fatigue, dizziness, and nausea, may have multiple possible causes.
Because of this, it is often not possible to attribute symptoms to a single cause without clinical review.
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When to seek medical advice
You should contact your healthcare team if you experience:
- Persistent or worsening fatigue
- New dizziness or nausea
- Ongoing stomach pain
- Increasing weakness
- Mood changes affecting daily life
These symptoms do not necessarily indicate a serious problem, but they may mean that treatment or support needs to be reviewed.
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Summary
In ABPA, symptoms such as fatigue, weakness, and low mood can arise from both the condition and its treatment. Long-term steroid use can add additional effects, making it difficult to distinguish between causes.
If symptoms are persistent or worsening, it is important to discuss them with your healthcare team so that appropriate adjustments or support can be considered.
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Further Reading
- Allergic Bronchopulmonary Aspergillosis (ABPA)
- Treatment of Aspergillosis
- Weight Loss and Weakness in Aspergillosis
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Author & Review
Prepared for aspergillosis.org to support patient understanding. Content reflects current clinical knowledge and patient-reported experience.
Disclaimer
This information is for general education only and does not replace advice from your healthcare team.
