Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Weight Gain Caused By Prednisone

Does Prednisone Cause Weight Gain?

Obesity is a global problem and is associated with a number of metabolic issues and health concerns. One of the many contributions and causes of weight gain is the inappropriate use of certain drugs or supplements that affect the normal metabolic or biochemical activities of the body, leading to fluctuations in body weight. One such drug is prednisone - a chemical derivative of the endogenous hormone cortisol. Cortisol, the stress hormone, is released by the adrenal gland in response to diseases and infections. However, in certain situations, such as inflammatory or autoimmune diseases, the demand significantly increases and is therefore fulfilled by synthetic forms of cortisol like prednisone.

What Causes Weight Gain While Consuming Prednisone?

Prednisone intake for extended periods of time is associated with weight gain. The causes of this weight gain include:

  • Increase in fluid accumulation and total plasma volume as a result of changes in the serum concentration of sodium ions. Excessive sodium absorption from the kidneys, under the influence of prednisone, leads to concurrent fluid absorption, which in turn leads to weight gain and bloating.
  • Increase in usual appetite and desire for a higher calorie intake.
  • Prednisone decreases the peripheral utilization of glucose by creating a state of relative insulin insensitivity[4]. As a result, your cells undergo a state of starvation since glucose cannot enter the cells, despite high blood glucose concentration. This also releases other hormones that initiate protein catabolism (breakdown of proteins) to produce more glucose from processes like gluconeogenesis - a process involving glucose production from non-carbohydrate sources like proteins and fats. This explains fat redistribution and the high propensity to develop abdominal striae, poor wound healing, loss of muscle mass and thinning of the skin in long-term prednisone users. Glucose, like sodium also causes osmotic movement of water and leads to bloating and weight gain.

Clinical data suggests that a dosage of 0.75mg/kg/day for a period of more than 6 months can lead to considerable weight gain and the appearance of other cushingoid features[3].

How to Lose Weight Gained by Prednisone Intake

Fortunately, weight gained caused by prednisone can be controlled by tapering the dosage to less than 10mg/day. If you are required to take prednisone for extended periods of time, speak to your doctor about alternative options. Other helpful remedies include:

  • Consuming a low sodium diet while you are on prednisone therapy, which helps to reduce bloating and subsequent weight gain.
  • Consuming a high potassium diet by increasing the intake of fresh fruits and vegetables - a strategy that can also lead to appetite suppression due to high fiber content. High potassium foods include prunes, apricots, apples, bananas, spinach, tomato and dates.
  • Increasing your intake of complex carbohydrates and consuming small, frequent meals.
  • Avoiding processed and refined sugars and introducing more high quality proteins into your diet to make up for muscle and protein losses.

One frustrating aspect of long-term prednisone therapy is futile weight loss efforts. A lot of people experience a great deal of difficulty in controlling weight gain by dietary management alone, and experts suggest that increasing physical activity can help in returning the metabolism to nearer normal levels.

Although it may be difficult to perform strenuous physical activity due to fatigue, low energy, pain or other symptoms of illness or prednisone therapy, you can definitely benefit from resistance training, strength training, aerobic exercise and yoga.

Weight gain is a known side effect of prednisone therapy, but you can adopt various strategies to control the weight gain. It is also recommended to see a dietitian for professional dietary guidelines to further manage any weight issues.

References:

  1. Kyle, V., & Hazleman, B. L. (1989). Treatment of polymyalgia rheumatica and giant cell arteritis. II. Relation between steroid dose and steroid associated side effects. Annals of the rheumatic diseases, 48(8), 662-666.
  2. Sansome, A., Royston, P., & Dubowitz, V. (1993). Steroids in Duchenne muscular dystrophy; pilot study of a new low-dosage schedule. Neuromuscular Disorders, 3(5), 567-569.
  3. Griggs, R. C., Moxley III, R. T., Mendell, J. R., Fenichel, G. M., Brooke, M. H., Pestronk, A., & Miller, J. P. (1991). Prednisone in Duchenne dystrophy: a randomized, controlled trial defining the time course and dose response. Archives of neurology, 48(4), 383.
  4. Midtvedt, K., Hjelmesæth, J., Hartmann, A., Lund, K., Paulsen, D., Egeland, T., & Jenssen, T. (2004). Insulin resistance after renal transplantation: the effect of steroid dose reduction and withdrawal. Journal of the American Society of Nephrology, 15(12), 3233-3239.

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