Steroid Weight Gain

[Red-head44]

hi everyone. Been back on 40mg steroids and coming back down. I’m at 15 at the mo. I’d lost 2 stone from weight gain from initial steroids from 2016 but have put back on 1.5 stone. I’ve contacted a dietician privately and have cut out all sugar and salt since second week in Jan 25. Eating extremely healthily following a Mediterranean diet mostly but each week weight creeps up another 1lb or so. I’m assuming it’s nothing I’m doing wrong and I’ll continue gaining weight until I’m back off steroids??

[PMRpro]

Ordinary healthy eating isn't good enough - you have to be really low on carbs to avoid weight gain when you are on steroids. It isn't just sugar - it is all carbs, including most fruit which must be limited (berries are best).

Come over to the PMRGCAuk forum - we are all on pred and many of us have minimised weight gain and even lost weight while on pred so have lots of advice to offer.

[Investigator1]

PMPpro is spot on. When I started on Steroidscit was approaching lockdown. I had already been on a low carb lifestyle for 2 years, and I still am. It’s not Keto (it was) but I just like to keep my daily carb intake under about 80. I did and still do exercise. Not excessive, mostly walking (done 25k this week so far) will be on the pushbike today for an hour. It helped me so much. Meet at it Red-head. And don’t forget to have a few treats in there too. We’re only human. Nick.

[Red-head44 in reply to Investigator1]

I’ll take a look at PMPpro today. Exercise isn’t an option really. We’ve got a large Labrador and I’m out one or two short walks or one longer walk a day with him but anything else is out of the question. Housework is a challenge but keeps me moving - extremely breathless after anything physical. I’ve tried increasing the exercise bit by bit but after 8yrs aknowledged that that didn’t work!!!

[PMRpro in reply to Red-head44]

Exercise has been shown not to help weight loss - the body seeks more calories!! And cutting carbs is easy as long as you are aiming at them and not trying to balance things as you appear to be doing with conventional nutritional advice. It is all to do with the effect of pred on the liver: it triggers the release of glucose from the body stores in liver and muscle. The BS shoots up which in turn triggers insulin - and then the BS falls too low because there isn't a meal to use up that insulin, That makes you crave carbs to bring it back up. That all creates a rollercoaster of ups and downs. Any excess carbs are stored as fat - and you gain weight. You can't control the pred effect on blood glucose but you can control the dietary contribution. Some people find they even have to avoid eating in a window a few hours after taking their pred. But it can be done.

[Red-head44 in reply to PMRpro]

I take my press immediately after eating (usually) porridge for breakfast and then don’t eat again until around 1pm

[Red-head44 in reply to PMRpro]

What platform is PMRpro on?

[PMRpro in reply to Red-head44]

HU but the PMRGCAuk forum:

healthunlocked.com/pmrgcauk

Not that I agree with the ZOE line a lot of the time, but one of the things that Tim Spector found was that for some people, porridge has a massive effect on blood sugar. Anything that raises BS will contribute to weight gain on pred. Most people find the problematic time period is 4 to 8 hours after taking pred - so your lunch comes in that time. A protein breakfast and not eating until late afternoon might well help with your weight problem.

[Red-head44 in reply to PMRpro]

👍

[AmyS1]

Check your dietitian is registered with the HCPC. Try reducing your portions and exercise. If your BMI is greater than 25 you should try to reduce your weight rather than gain on steroids. An experienced dietitian can help.

[Red-head44 in reply to AmyS1]

She is and has so many letters after her name. Portion size is probably a factor but it’s a balance of reducing portion size at the two main meals of the day and then picking between meals, I’d rather not eat between meals. I’m eating too much in the evening and not fasting for long enough overnight. And find counting carbs difficult as they appear on both the carb list and the protein list. Feel I’m fighting a losing battle and just wonder why I’m bothering 😢😢😢😢😢

[Investigator1 in reply to Red-head44]

Hey Cmon Red-Head44 there’s always a way, you’ve said you’re getting out well that’s half the battle. I still struggle not eating between meals, my typical day is Greek full fat yoghurt with berries in the morning (you’ll find the full fat contain less sugar) then lunch it’s soup or salad, if I have bread it my low card version of about 2 carbs per slice. Then evening meal we hit vegetables whatever kind, with fish or meat (about 200g each) . In the form of dinners, chillies, curries etc. We don’t eat Potatoes, Pasta or Rice, we substitute. We hit with that lot about 70 carbs a day. Remember to go with “Net Carbs” if I am baking I use Lupin Flour, it’s about 1/10th Carbs of normal flour. We don’t drink alcohol during the week and when we do it’s dry white wine or the odd spirit. Look you know where we are if you need help. Nick

[Red-head44 in reply to Investigator1]

Yep I’m doing the yoghurt full fat with berries but we’re very rural and need to shop! Agreed soup or salad for lunch. And I’ve not been eating potatoes since Jan. so agreed for evening meal too. I’ve been keeping food diaries logging my BS testing results and BP daily. I try not to bake and have been making my own bread whole meal but not eating much of that. No pasta but have been having brown rice occasionally. One alcohol drink per week. Stopped spread and am using extra virgin OO and coconut oil and butter sparingly.

[Investigator1 in reply to Red-head44]

Blimey! I have to say you’re stricter than me!

[PMRpro in reply to Investigator1]

Two of us over at PMRGCAuk could only lose weight on under 25g carbs - that is a lot of salad but not much else!! Maintaining has been easier though - though the other lady found she has had to continue limiting carbs even after getting of pred altogether or theweight starts going back on.

[Investigator1 in reply to PMRpro]

You’re right there PMRpro for me the exercise isn’t about losing weight, it’s getting out there, feeling good about yourself and being generally active. It sparks something in me and keeps me with an up and at em attitude therefore I do more moving about.

[PMRpro in reply to Investigator1]

See - I can only assume I don't exercise hard enough because I've never had this boost people go on about, I felt good after a day skiing but nothing else.

[oldtimer2 in reply to Red-head44]

I've always had to write down everything that I eat when I'm on steroids as my judgement of how much to eat goes out of the window. I have to have smaller portions, and I've taken on board the "don't eat between 7pm and 7am." It's a battle because I used to 'comfort eat' but it doesn't actually comfort when you look at the daily weight and in the mirror.

It sounds to me as if you've already got things 'almost' under control - don't beat yourself up too much at 'failures', there's always next week - when you might be feeling a bit better too!