Rapid weight gain and failure to lose it on 3mg of pred.

[friz42]

Hi- I hope someone may help- about 18 months ago I started putting on weight at 3 pound a day- it went onto half stone then 1 and 2 and now 3 stone later. It is not food related. I know calories well and try to eat balanced diet. I have been on long term steroids going up and down but generally about 8mg a day. I had no problems with prednisolone for some time but then out of the blue this weight went on and i cannot get it off.

I am walking cycling eating little but to no avail. After this weight gain some months later I became adrenal insufficient, so tried hydrocortisone- same problem there- I look cushingoid but of course I am only on 3mg of pred a day. Any ideas as to what may have happened? I am profusely sweating (not menopause nor weather related) because my autoimmune problem is not controlled by 3mg of pred and 15mg of methotrexate. Sweating and very very thirsty. Urinate once a day and have sjorens and hypothyroid.

I thought I would ask on here as I know many of you are familiar with prednisolone and its problems.

Many thanks

[PMRpro Ambassador]

I found I gained weight with methotrexate - I was permanently hungry, something I never have suffered with just steroids but in a month on mtx I gained a good 2 lbs, not in your realm but I stopped the mtx and I could not get that weight off. I too had become Cushingoid on one form of steroid, methyl prednisolone, but by switching to another form of steroid (prednisone) and cutting carbs drastically I lost 35lbs or more in 18 months. In fact the early loss of fat around my middle with the diet, the first place it went from, was while I was still on methyl pred - so due to low carbs not different drug.

Some people don't lose weight while on any pred. jinasc found that and she had gained a LOT. Some people lose it as they reduce the pred dose and some people have to work on it - everyone is different. Often a good and apparently healthy diet still has too much carbohydrate to lose weight because of the pred effect which alters the way your body processes carbs, A couple of us here manage to maintain weight relatively easily but have to be down to a very low level of carbs to actually lose weight.

Is your hypothyroidism well managed? Pred suppresses TSH levels - which may mask poor thyroid function as the body wants to increase the TSH but the pred hides it.

[friz42 in reply to PMRpro]

Hi- Yes that is checked very often. In the early days before I was diagnosed with any other condition other than hypothyroid I did a lot of research in this area as my symptons were not controlled by levothyroxine at all. I had tried it all T3, Armour, had Tsh all over- low higher middle made no difference. Then went on to find auto antibodies suggesting vasculitis. Bit of a nightmare which still continues. I do not respond that well to meds and symptons only better on higher doses of prednisolone. My TSH levels have been pretty level and on same dose for some years now. I don't think its that.

I am going to see when I started methotrexate and see if any connection near weight gain In July 2018. It may be around that time.

I was diagnosed with hypothyroidism in 2009 and weight gain was not an issue for me until 2018 out of the blue.

I do not feel hungry at all on prednisolone/methotrexate whereas before I always had burning hunger pangs and ate little and often watching my weight.

[SheffieldJane]

Has your doctor looked into steroid induced diabetes? The thirst is very characteristic. I also wondered about water retention and like PMRPro the hypothyroidism . What a nightmare! I sincerely hope they sort this out for you. Personally, my suspicious eye would be looking at Methotrexate.

[friz42 in reply to SheffieldJane]

My daughter has Type 1 diabetes. I remember her thirst and night time visits to the toilet many times. I am sweating so badly I mean drenching clothes which again is unusual to be so bad I drink because so thirsty but don't need to urinate because I am forever trying to keep up with the water lost with sweating. I am concerned this cannot be good long term for the kidneys. I may have some water retention but unfortunately I have a consultant who rarely listens looks or examines but a great reputation.

I am having a nightmare with it all.

[SheffieldJane in reply to friz42]

Your GP will refer you for blood test for suspected steroid induced diabetes. It’s worth it if only to eliminate it.

A great reputation for what? Being a §…~_€…{!

Let us know how you get on. X