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Can hormonal imbalance be a cause of weight gain?

Dr Vivien Lim talks about a condition in which excessive steroid hormones can cause weight gain.


weight gain


Obesity is an increasingly prevalent health challenge globally. With obesity comes increased risks of diabetes, high blood pressure and cholesterol problems.


In the majority of obesity cases, weight gain is contributed by a caloric imbalance. This means that the calories from food that is taken in by the body exceeds the body’s caloric needs. When this goes on for a period of time, it results in weight gain.


In less common cases, hormonal imbalance may be the reason behind the increase in weight. One such condition in which this may happen is Cushing’s syndrome.



What is Cushing’s syndrome?

Cushing's syndrome is a condition where there is an excess of steroids in the body causing several characteristic changes in the body.



What are the symptoms of Cushing’s syndrome?

A person with Cushing’s syndrome may experience the following symptoms:


  • Weight gain especially in the tummy and face
  • Obesity
  • Increased appetite
  • Tiredness
  • Decreased concentration and impaired memory
  • Insomnia
  • Thin skin that is easily bruised
  • Purplish stretch marks on the tummy
  • Flushed skin in cheeks
  • Menstrual irregularities
  • Weakness in limbs
  • Worsening control of current diabetes
  • Worsening high blood pressure
  • Increased susceptibility to infections

It should be noted that the presence of these characteristics do not confirm the presence of Cushing’s syndrome. These characteristics are common and may have other causes.



What causes Cushing’s syndrome?

The vast majority of cases are due to the person taking in steroids in the form of complementary medications containing steroids as an ingredient. Many times, the medication is bought abroad or online and the patient is unaware of its components. Long-term usage of the medication then causes Cushing’s syndrome and its various characteristics to develop.


In a minority of cases, the steroids are produced in excess from the body. Mostly, this is due to a tumour in the pituitary gland, a small gland just beneath the brain and behind the nose that produces in excess a command hormone known as ACTH. This command hormone then goes to the adrenal glands, the glands that sit on top of the kidney, causing them to produce excess steroids. In rare cases, the source of the ACTH is a cancer. The adrenal glands may also harbour a tumour that produces excess steroids.



How to treat Cushing’s syndrome?

This depends on the cause of the disease. If the disease is due to ingestion of complementary medication adulterated with steroids, then the condition may be cured by stopping the medication.


This is best done with supervision by an endocrinologist (a doctor who specialises in glands and hormones). The endocrinologist would first have to do a thorough examination to establish a diagnosis of Cushing’s syndrome and determine the cause. This may be in the form of blood tests and scans of pituitary or adrenals. The endocrinologist will also have to assess the patients for other complications that result from excessive steroid intake, such as diabetes, high blood pressure and even osteoporosis.


If the condition was caused by steroid ingestion, the dosage and duration of the drug intake have to be taken into account. This might not be easy in the case of complementary medication containing steroids. The suspected medication might have to be sent for analysis of the component drugs. The doctor will then advise a suitable period for the patient to wean off the steroids.


The longer the duration and greater the quantity in which the drug was taken, the longer the weaning off period. In rare cases, the steroids cannot be weaned off as the body’s natural ability to produce its own steroids has been damaged.


If Cushing’s syndrome was caused internally, the best way forward would be to remove the source of the excess steroids, whether it is the pituitary gland, the adrenal glands or the cancer. 

 

Dr Vivien Lim





    Article by Dr Vivien Lim, Endocrinologist at Gleneagles Hospital.


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