Pinch of Salt
I am contributing to the million articles written by
patients about weight gain from taking inhaled (like
albuterol) and oral (like prednisone) corticosteroids
for asthma. Stating the obvious, the side effects of
these medications vary from person to person and also
depend on the dosage and the length of time they are
taken. If you've taken them long enough and have
talked to a doctor, you know what these side effects
are and also know what to do to deal with them. I
realize that being a patient does not in anyway
qualify me as an expert on this subject, so doctors,
please don't hate me for sharing my experience. :)
Here, I only speak of what I do to lose weight after
my treatment. Correct me if I am wrong.
Every year, I gain at least 20 lbs when I take my medications and I try not to lose sleep over looking full-faced! It takes a lot of convincing to tell myself that the weight gain is a fair sacrifice for mending my breathing. But, the good news is that the side effects of steroids is temporary and with diet and exercise the weight gain can be easily reversed in a few weeks time. I find that the best way to go about undoing the weight gain is to first understand what causes it. From reading online and talking to doctors, these seem to be some reasons why steroids cause weight gain:
One, that steroids cause sodium retention and potassium depletion in the body. The two together cause increased fluid retention (edema) and swelling. I have a swollen face, and fair amount of fluid retention in my legs. I have been told that restricting the amount of salt you take and having a diet that is rich in potassium can help reduce fluid retention.
Two, that steroids cause an increase in appetite. This, in my opinion is the real enemy. Now it is easy to say one should be careful about their food intake, but when you are ravenous and feel like you can eat an elephant alive, this idea of self-control seems impossible to follow and "hard to swallow". What makes it worse is, even after you are off medication, you still continue to remain a slave to this eating habit that you developed during your treatment and keep blaming the steroid for your vices! I can see that I am becoming one of those people who is eternally fixated on food (especially the rich/junk kind) and keep blaming the steroids for it.
Three, that steroids cause us to excuse ourselves from physical activity. A part of this excuse is valid of course. You can't possibly work out if your asthma is exercise-induced, or you are wheezing or coughing incessantly and are breathless all the time. Also, steroids cause high blood pressure, body pain, muscle and bone weakness, and decrease in stamina (especially long-term use). In my case, the real reason for lack of physical activity is lethargy. Being on steroids sounds like a convenient excuse not to exercise, but it really is not. Ironically, lack of exercise leads to obesity and obesity increases chances of asthma and asthma intern leads to obesity (through steroid intake).
Medics seem undecided on whether exercise helps with prevention of asthma or not. Some suggest that some kinds of exercises (like pranayama and buteyko) stretch the lungs and bronchial tubes, which may help reduce resistance to breathing and even encourage normal diaphragmatic breathing. Exercise also improves one's tolerance to physical exertion. That being said, sustained aerobic exercises might trigger an attack, so talk to your doctor on what might suit you best. It is generally advised that asthmatics should exercise towards the lower end of their target heart-rate. Here are some exercises listed in the order of "least to most-likely to induce asthma": swimming, walking, cycling, treadmill running, outdoor running!
To summarize: eating many small meals throughout the day, decreasing calorie intake, salt and sugar intake (sugar because steroids also increase blood-sugar level), increasing calcium and potassium in-take and exercising should do the trick.
I know that sounds like a lot... especially considering that this cycle repeats itself every year. But then again, looking good in a month’s time and for a good 10 months at a stretch is reward enough.
This post does not address other short and long term side effects of corticosteroids, which I might write about when they begin to bother me as much as weight gain currently is. But, I am off my steroids for this year (I hope!) and am getting ready for my workout. Wish me luck :)
Every year, I gain at least 20 lbs when I take my medications and I try not to lose sleep over looking full-faced! It takes a lot of convincing to tell myself that the weight gain is a fair sacrifice for mending my breathing. But, the good news is that the side effects of steroids is temporary and with diet and exercise the weight gain can be easily reversed in a few weeks time. I find that the best way to go about undoing the weight gain is to first understand what causes it. From reading online and talking to doctors, these seem to be some reasons why steroids cause weight gain:
One, that steroids cause sodium retention and potassium depletion in the body. The two together cause increased fluid retention (edema) and swelling. I have a swollen face, and fair amount of fluid retention in my legs. I have been told that restricting the amount of salt you take and having a diet that is rich in potassium can help reduce fluid retention.
Two, that steroids cause an increase in appetite. This, in my opinion is the real enemy. Now it is easy to say one should be careful about their food intake, but when you are ravenous and feel like you can eat an elephant alive, this idea of self-control seems impossible to follow and "hard to swallow". What makes it worse is, even after you are off medication, you still continue to remain a slave to this eating habit that you developed during your treatment and keep blaming the steroid for your vices! I can see that I am becoming one of those people who is eternally fixated on food (especially the rich/junk kind) and keep blaming the steroids for it.
Three, that steroids cause us to excuse ourselves from physical activity. A part of this excuse is valid of course. You can't possibly work out if your asthma is exercise-induced, or you are wheezing or coughing incessantly and are breathless all the time. Also, steroids cause high blood pressure, body pain, muscle and bone weakness, and decrease in stamina (especially long-term use). In my case, the real reason for lack of physical activity is lethargy. Being on steroids sounds like a convenient excuse not to exercise, but it really is not. Ironically, lack of exercise leads to obesity and obesity increases chances of asthma and asthma intern leads to obesity (through steroid intake).
Medics seem undecided on whether exercise helps with prevention of asthma or not. Some suggest that some kinds of exercises (like pranayama and buteyko) stretch the lungs and bronchial tubes, which may help reduce resistance to breathing and even encourage normal diaphragmatic breathing. Exercise also improves one's tolerance to physical exertion. That being said, sustained aerobic exercises might trigger an attack, so talk to your doctor on what might suit you best. It is generally advised that asthmatics should exercise towards the lower end of their target heart-rate. Here are some exercises listed in the order of "least to most-likely to induce asthma": swimming, walking, cycling, treadmill running, outdoor running!
To summarize: eating many small meals throughout the day, decreasing calorie intake, salt and sugar intake (sugar because steroids also increase blood-sugar level), increasing calcium and potassium in-take and exercising should do the trick.
I know that sounds like a lot... especially considering that this cycle repeats itself every year. But then again, looking good in a month’s time and for a good 10 months at a stretch is reward enough.
This post does not address other short and long term side effects of corticosteroids, which I might write about when they begin to bother me as much as weight gain currently is. But, I am off my steroids for this year (I hope!) and am getting ready for my workout. Wish me luck :)
