Pred Spread

[HamishPMR]

Can anyone point me towards any sensible articles on Pred Spread. Whilst I have reduced my BMI to 27 I do seem to have more fat on my tummy and love handles (sorry I don't know technical name). I am nearly 3 years with PMR and presently on 3.5mg daily for about a year. I keep trying to get below this dosage with no success. Thank you. Hamish, Edinburgh

[PMRpro Ambassador]

Not sure what you want - maybe have a read of past threads here? Plenty about weight gain on pred ...

Pred triggers the liver to release random spikes of glucose, they trigger the release of insulin to deal with them and often there is far more insulin than needed because there is no follow-up of the expected additional glucose from a meal. This excess insulin leads to the deposition of fat in particular places: around the midriff, on the face and neck and at the back of the neck. It is much the same as in Cushing's disease - and called Cushing's syndrome - the difference in terminology is because it is always due to too much corticosteroid but in the disease it is endogenous, produced in the body due to a medical problem which must be identified and rectified, in the syndrome we know where the steroid comes from, it is the exogenous daily dose and that requires to be reduced.

Unfortunately, like most fat deposits, there are a bit resistant to dietary measures.

Corticosteroid-induced lipodystrophy is the posh name:

en.wikipedia.org/wiki/Corti...

I didn't gain weight after starting pred originally - but what weight I had gained during the inactivity of untreated PMR redistributed to the more typical Cushing places but it wasn't very obvious. When I was switched to Medrol/methyl prednisolone it immediately went very Cushingoid, within weeks and included the muscle wasting side. I was later put onto prednisone and adopted a low carb way of eating - and lost the 35lbs of excess I had accumulated. That is a lot when you are 5 foot nothing in your socks! I did get rid of a lot of weight but am still rather cuddly - time to get a bit more disciplined ... And yes - the rolls of fat are where you suggest

[HamishPMR in reply to PMRpro]

Thank you

[dancersize2]

I like the term pred spread. That does describe it very well. My wardrobe has certainly noticed the extra padding. Hoping getting back to dancing will help slim me down again.

[AncientMariner]

I have the same problem in all the areas you have mentioned. It is complicated in the neck area in that I had throat cancer and the chemo/radio may well have caused some issues as to swelling there, the GCA and steroids helpfully followed on after. I won't know what is what until the Prednisolone is well down and some of this starts to disappear (I hope). It's a valid concern as we are people not a diagnosis and it's not as if lockdowns help us to get the exercise that would help either so weve all had a bit of a whammy really.