Recently I had a case, the woman was 40 something, eating healthy, exercising daily, nothing I could put my finger on…but still she was gaining weight. After a thorough investigation figured out that she was in fact taking a steroid medication to treat her autoimmune hepatitis which was breaking havoc on her metabolism!
Now to make it very clear, we are not talking about the “doping” kind of steroids. No! We are talking about corticosteroids. The kind that are prescribed to patients with inflammatory and autoimmune diseases. Corticosteroids are known for causing weigh gain and also lypodystrophy (fat deposition or redistribution in undesirable places). And good news is both weight gain and corticosteroid induced lypodystrophy (CIL) are reversible.
So what are these Corticosteroids to begin with?
Our body, to be more specific, our adrenal glands (two small glands siting atop of both kidneys each) produce a type of steroid hormones known as Cortico-Steroids. Cortico refers to adrenal cortex, outer part of the gland that is responsible for the production of these hormones.
Does that mean these steroid hormones are all natural?
Yes and No. Yes our body produces them, but the ones present in your asthma medication, RA medication or any such anti-inflammatory medication are the synthetic analog of the real thing. But equally potent none the less.
Why do we need these corticosteroids?
There are two types of corticosteroids, one that influences glucose metabolism (hence called Glucocorticoid), and the other that plays a role in the metabolism of minerals (name, mineralocorticoid). They both play vital role in physiological processes like
- Inflammatory pathways
- Stress response
- Gluconeogenesis (converting proteins and fats into glucose)
- Immune response
- Fluid balance/Hydration
Most autoimmune and inflammatory conditions like Rheumatoid Arthritis, Autoimmune Hepatitis, Multiple Sclerosis, Lupus, Ulcerative Colitis, Crohn’s Disease are treated with corticosteroids. So are some other common ones like Asthma, Itchy eyes. atopic eczema, COPD, pollen allergy, food allergies.
Corticosteroids don’t necessarily cure any of these conditions but they provide a relief from pain and symptoms by suppressing the immune response and also reducing the inflammation.
What are some common drugs (medications) that contain corticosteroids?
Prednisone, Prednisolone, Dexamethasone, Fluticasone Priopionate, Hydrocortisone Butyrate etc.
How does Steroids Cause Weight Gain?
Glucocorticosteroids influence and promote adipogenesis (formation of new fat cells). And not just that, steroids are also known to stimulate appetite and you all probably know what increased appetite means, don’t you!?
↑Corticosteroids ≡ ↑ Fat Cells Generation
↑Corticosteroids ≡ ↑ Appetite
↑Corticosteroids ≡ ↑ Abdominal Fat Deposition
What other side effects are there to medicinal use of steroids?
- Prolong use can cause Insulin Resistance which can lead to a myriad of health issues.
- Skin that is thin and easily bruised
- Weak and Brittle bones (osteoporosis)
- Mood swings
So, Should you stop taking steroid medication?
Never cut a dose in half or stop taking ANY medication without consulting with your doctor first! This is specially true for Steroidal medications as withdrawal symptoms might not be pretty. If you are concerned about the side effects of your medications, speak with your doctor about safer alternatives.
But What About the Weight? How to lose it?
Weight gain caused because of hormonal issues is always a tricky one. Generally Calories Out > Calories In equation works effectively, but not in this case. Which is why it is always advised to consult a registered dietitian and seek personalised diet and lifestyle recommendations. I will conclude this topic with my expert tip that might just work for some of you…
Cut that Lauki ka juice out of your breakfast and substitute it with a glass full of low fat milk. This will not just give you much needed calcium and strong bones but also will provide the calories to kick start your metabolism, to stimulate your क्षुधा-अग्नि.
If you are a DawaiBox user, take advantage of our "Chat With Dietitian" feature and get personalised diet recommendations absolutely free of cost.