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What Causes Sudden Weight Gain?

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Posted on Tue, 14 Oct 2014
Question: Hi dr, last month when i checked my thyroid it was normal and the endocrinologist told that my weight gain is not because of thyroid disorder but due to medicine betnesol which i was taking for wheezing problem now from last 4 months im not taking it, last month when i checked my weight it was 124, and from last 12 days im on brisk walk for 30 minutes daily and also trying hard to cut out the calories intake but when i checked my weight now it shows as 129 i have gained 5 kgs in span of 1 month, im not able to understand what is causing weight gain issue, im fed up of my weight ...i am trying my best to lose it, but dont knw why it is increasing day by day. Please help me with your kind suggestions.
doctor
Answered by Dr. Binu Parameswaran Pillai (56 minutes later)
Brief Answer:
Weight gain and few questions

Detailed Answer:
Good day,
Noted your concern.
Your Thyroid profile report looks good. Not to worry about it.
As your endocrinologist pointed out, your weight gain could be due to steroid tablets which you took for wheezing. How much of Betnesol did you take and did you stop it suddenly? Did you feel any giddiness or difficulty on stopping the tablet?

Are you on any other medications? Any alcohol intake?

Have you developed any pinkish stretch marks on the sides of your abdomen or thighs etc recently ? Any difficulty getting up from sitting position?

I would like to know these things so that I can guide you further

Regards'
Binu


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (5 minutes later)
Hi Dr

How much of Betnesol did you take and did you stop it suddenly?

i was taking betnesol forte 5 mg i guess but im not sure.

Did you feel any giddiness or difficulty on stopping the tablet?

Not at all as soon as i stopped it i was asked to take asthalin inhaler. i did not tamper the medicine.

Are you on any other medications? Any alcohol intake?

No other medication sometime for bodyache i take everan painkiller and as mentioned before i take inhaler asthalin when feel uneasy.

Have you developed any pinkish stretch marks on the sides of your abdomen or thighs etc recently ? Any difficulty getting up from sitting position?

Yes there are pinkish strecth marks on my abdomen but do not feel difficulty in getting from sitting position.

Appreciate your reply sir.







doctor
Answered by Dr. Binu Parameswaran Pillai (6 minutes later)
Brief Answer:
Photo of stretch marks

Detailed Answer:
Thank you for the reply.
Which Endocrinologist did you meet in Bangalore?
Could you take a photo of the stretch marks and attach to this question?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (12 minutes later)
Sir i consulted Dr Mala Dharmalingam in Ramaiah Hospital XXXXXXX and i have attached few images please check.

Thanks.
doctor
Answered by Dr. Binu Parameswaran Pillai (8 minutes later)
Brief Answer:
Got the photos

Detailed Answer:
Thank you. Got the photos.
This is the typical stretch marks of Cushing's Syndrome. In your case it is most likely due to Betnesol intake,
Dr.Mala is the Head of the department of Endocrinology at Ramiah and she is a very XXXXXXX endocrinologist.
If interested, I can suggest another endocrinologist in XXXXXXX ST.Johns hospital and I can duscuss your case with them. You may need further tests.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (6 minutes later)
Yes Dr, i consulted Dr Mala thrice and 1st i had thyroid test from thyrocare with which Dr Mala was not impressed she again asked me to do it from the ramaiah lab and that is what the report i have uploaded and dr what would be the problem behind my so excess weight gain betnesol has lured my life sir, you have mentioned about few tests which are those tests, please explain Dr, i want to get rid of these things and lead a healthy normal life, i eat as how a normal person eats and also i have avoided the junk foods following diet but its of no user, Please help me dr.
doctor
Answered by Dr. Binu Parameswaran Pillai (15 minutes later)
Brief Answer:
Endocrinology work up

Detailed Answer:
Okay. BEtnesol can surely cause Cushing's Syndrome. But it will gradually disappear when you stop the drug.Do not worry, we just have to make sure that your pituitary- cortisol axis is normal. If the tests are normal, then no need to worry. Stay relaxed.

Few tests i would recommend.

1) Serum electrolytes
2) 8 AM Fasting morning SErum Cortisol
3) Fasting blood glucose.

I would advice you to meet the Endocrinology department at St.Johns XXXXXXX It is a good endocrinology department and they work as a team work. I would recommend Dr XXXXXXX of endocrinology department. She is known to me.

Instead of getting the tests done in a priate lab outside, it is better to do in an institute. Hormone tests are better done in a good lab. That is why Dr.Mala advised you to repat the tests.

Hence may i suggest you not to do the tests which i mentioned at an outside lab. Get it done only after meeting endocrinologists at St.Johns Hospital. If you are interested, i can give the contact details.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (4 minutes later)
Dr s.t johns hospital is a bit far from my place, so do u know anyone in ramaih hospital, and the tests which are mentioned above is for what ? i have done serum cortisol, FBS a month ago i am sharing the report please check it, and what about my weight gain dr what should i do now, how will the treatment go further.
doctor
Answered by Dr. Binu Parameswaran Pillai (8 minutes later)
Brief Answer:
Need to observe

Detailed Answer:
Oh okay.

I knew a person in Ramiah hospital, but he is now in Gulberga.

Yourr cortisol test ( morniing) was bit on lower side ( < 5) which is probably because of long term Betnesol intake. I guess, you will be okay after stopping Betnesol. It just recently you stoppd it. You may have to wait for up to 2-3 months for the weight loss. But if you havent lost weight then, we may have to do an Overnight Dexamethasone suppression test. It is again a simple test. But we will wait for 3 moonths and based on your weight, we can plan then.

Till then, stop Betnesol or similar steroids. Do exercise and avoid all sugary food. Avoid fast food.

I know that you are getting very impatient and restless and want to get the weight reduced fast. But please understand that, there is no quick fix.

Since there is defenite intake of Betnesol, we have to wait atleast 3 months after stopping it to assess you further.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (5 minutes later)
Yes dr i understand but you know its almost 4 months of stopping betnesol but no changes, im only taking asthalin inhaler for wheezing problem there is any problem with that ? and what is Overnight Dexamethasone suppression test, i understand that there is no quick thing which can bring down my weight but its increasing which is worrying me im 21 yrs , height 176 cm and my weight is 129 kg i am afraid that it would lead to any other disease, and what about the tests which you have mentioned above Dr shall i do it in ramaiah and discuss with Dr Mala or u feel its better to visit any other endo specialist.
doctor
Answered by Dr. Binu Parameswaran Pillai (20 minutes later)
Brief Answer:
Dexamethasone suppression test

Detailed Answer:
Hi,
You may continue with Dr.Mala. Since you havent lost weight after stopping Betnesol, then you need investigations now.

Overnight Dexamethasone suppression test is to find out if your body is producing excess cortisol.

The test is like this,
a) Take 2 tablets of 0.5 mg of DExamethasone ( DEXONA) tablet at 11 pm today.
b) Tomorrow sharp at 8 AM check Serum cortisol ( fasting)

If the result is > 1.8 mcg/dl, then the test is positive


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (7 minutes later)
Thanks you very much for all your time Dr, last question if the result is positive then what is the further treatment and also if negative ? what would be the cost of this test Dr, just for information.
doctor
Answered by Dr. Binu Parameswaran Pillai (4 minutes later)
Brief Answer:
Test as described.

Detailed Answer:
The cost of 2 tablets of 0.5 mg Dexamethasone tablet is around 2-3 rupees. The cortisol test next day cost around 400- 800 rupees. Thats all.

If it is positive, you need further tests. For that, you surely need Endocrinology advice.

If it is negative, we may also have to do a 24 hour urine free cortisol test later.


Do the test exactly the way i described.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (2 minutes later)
ok dr i have to do serum cortisol or Overnight Dexamethasone suppression test , what should i tell the lab person.
doctor
Answered by Dr. Binu Parameswaran Pillai (5 minutes later)
Brief Answer:
Tests

Detailed Answer:
First identify a good lab. ( i prefer SRL/RANBAXY or similar good labs) or a good institute like Ramiah hospital, Manipal Hospital or St.Johns Hospital.

Ask them availability of serum cortisol test. If they have it, take 2 tablets of Dexamethasone 0.5 mg at 11 pm and sleep. Next day exactly at 8 AM, blood has to be drawn for Serum Cortisol ( fasting). You just have to tell them Serum Cortisol at 8 AM. ( if the cortisol value is > 1.8 mcg/dl, then test is positive).

I hope i have answered your question/. Please feel free to ask further if you have more questions. If there are no more questions, you may please close it.
Wish you good health

Binu
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Sudden Weight Gain?

Brief Answer: Weight gain and few questions Detailed Answer: Good day, Noted your concern. Your Thyroid profile report looks good. Not to worry about it. As your endocrinologist pointed out, your weight gain could be due to steroid tablets which you took for wheezing. How much of Betnesol did you take and did you stop it suddenly? Did you feel any giddiness or difficulty on stopping the tablet? Are you on any other medications? Any alcohol intake? Have you developed any pinkish stretch marks on the sides of your abdomen or thighs etc recently ? Any difficulty getting up from sitting position? I would like to know these things so that I can guide you further Regards' Binu