My sister has chronic back pain. It’s now over a year since she had her last
operation on her back. The doctors have
taken x-rays, and from those x-rays, they cannot see where the problem is. To the specialist that did this operation,
the operation has been successful. She
was waiting to go for a MRI.
Recently she went for the MRI and they have
come up with diagnoses. Now they need to
treat her and find an effective method that she does not have to continually
live in pain.
The doctor did mention treating her condition
with cortisone. The main concern that my
sister has with regards to this treatment that it will cause her to gain
weight.
When my sister asked me, does cortisone cause
weight gain? I lied to her and said no!!
A better understanding what cortisone is to
give a brief description what it is.
Cortisone is a steroid that is closely related to a hormone that our
body produces naturally in the adrenal gland.
This hormone is called cortisol.
Cortisol plays a role in metabolic regulation as well as the body’s
fight or flight response. Cortisone may
have the same effects.
Doctors prescribe cortisone for a variety of
inflammatory conditions to reduce the swelling, pain and discomfort of the
patients. Patients with asthma and other
chronic conditions associated with inflammation may take this hormone for
extended courses. Cortisone is also used
for the treatment of very bad eczema. Treatment
of eyes; and certain cancers.
What matters is how much of the steroid gets into the body. An asthma
inhaler will deliver most of the steroid only to where it is needed; the tubes
of the lungs. Eczema creams stay largely on the skin. In both cases very little
steroid is absorbed into the rest of the body so side effects can be kept low.
Steroid tablets or injections are different because the drug is absorbed and
distributed throughout the body by those routes.
The main to minimize the side effects of cortisone it to keep the dose
as low as possible. There is a limit on
how this can be done and still get the necessary benefits.
Side effects
of taking cortisone orally are as follows:-
Stomach
upsets, headache, dizziness, menstrual changes (irregular, delayed, absent
periods), trouble with sleeping, increased appetite, or weight gain may occur.
This medication should
not be used if you have certain medical conditions. bleeding problems, history of blood clots,
brittle bones (osteoporosis),
diabetes, eye diseases (e.g., cataracts,
glaucoma,
herpes infection of the eye), heart problems (e.g., congestive
heart failure), high blood
pressure, other infections (e.g., tuberculosis,
herpes), kidney
disease, liver problems (e.g., cirrhosis),
mental/mood conditions (e.g., psychosis,
anxiety, depression),
low blood minerals (e.g., low potassium or
calcium), stomach/intestinal problems (e.g., ulcer, ulcerative
colitis, diverticulitis), thyroid
problems.
Side
effects of cortisone injections are as follow:-
The injected
cortisone can crystallize in the body.
These crystals can cause pain and inflammation that is worse than the
problem that is actually being treated.
There could be some skin discoloration around the injection site, but
this is not harmful.
Cortisone can increase sugar levels.
People with diabetes should closely monitor sugar levers for a day or
two following a cortisone injection.
The injection site can become infected, but this is rare.
Some people have an allergic reaction to cortisone. This is rare as the
cortisone is similar to the naturally hormone found in the body. Some can have an allergic reaction to the
local anesthetic which is added to the injection.
Doctors
do not recommend cortisone injections for patients who have an existing
infection, including skin infections and septic arthritis. In
addition, cortisone injections may be inappropriate for patients who are taking
blood thinners or who have broken bones.
Some
patients may be concerned about weight gain and water retention from
corticosteroid use. However, these side effects are common only for patients who
take corticosteroid medications orally for an extended period of time.
When
cortisone medication is injected into a joint, these side effects do not occur.
While
doing this research, I really believed that I had lied to my sister when she
asked me the question, does cortisone make a person fat, and my answer was no. The doctors wanted to inject the cortisone in
the effect site and that weight gain is typical of cortisone taking orally.
The good
news for those that take cortisone orally, a person does not have to get fat because
they taking cortisone orally. There are
certain things that one can do that will prevent weight gain. Cortisone taking orally will increase
appetite.
To stop gaining weight you will have to reduce your calorie intake and increase
your physical activity.
The easiest way to eat fewer calories without feeling hungry is to fill
up on high-fiber (whole-grain breads and cereals) and low-energy foods (such as
fruit and vegetables) and to include a source of protein at each meal (lean
meat, chicken, fish, and pulses). Don’t
be tempted to skip meals, especially breakfast, as you are likely to snack on
high-fat/calorie foods instead. Kick
start your metabolism with a healthy breakfast such as porridge or another
whole-grain breakfast cereal with lower-fat milk, or a poached egg on whole
meal toast – this should keep you going until lunchtime. For lunch, go for whole-grain sandwiches and
lower-fat fillings such as chicken and salad, hummus or grilled vegetables. Also good are baked potatoes with baked beans,
which will provide you both fiber and protein.
It is worth keeping a simple food diary for a couple of days – not
necessarily to “calorie count” but so that you can spot easy ways to cut back.
Drinks can also make a substantial contribution to calorie intake, and
simply having a filter coffee instead of a latte, opting for diet drinks or
water instead of standard soft drinks and cutting back on alcohol can all make
a difference.
Use the diary to look at your eating patterns and identify the times
when you eat most or are likely to snack on higher-calorie foods. If you
continue to gain weight, it might be worth joining a slimming group to give you
some support or asking your GP if you can be referred to a dietitian for more
advice.
People with concerns about cortisone
and their weight can discuss some strategies with their doctor or a
nutritionist. It may be helpful to
measure meals and take other steps to regulate the amount of food eaten over
the course of the day, and to eat several small meals instead of one or two
large ones. Some patients may need to
cut back on certain foods while taking the medication. Gentle exercise like yoga or swimming may help
patients stay fit on cortisone without running the risk of incurring an injury.