Many years ago I gained a great deal of weight because of taking prescribed HRT. I became desperately ill and exhausted and had very high blood pressure. I was so fat I could barely walk. My doctors laughed at me when I complained of my symptoms - great pain, severe and almost constant headaches, massive weight gain, swollen veins, thin skin, etc. and I was told to eat less. Yet I was not overeating!
In late 1997 I became aware that there was a lot of salt in bread and cheese and breakfast cereals, and because of this I altered my eating to reduce and eventually to exclude all avoidable sodium. This brought down my blood pressure to normal. More spectacularly, and very unexpectedly to me, the sodium reduction brought down my weight by 51 pounds! - This was nothing to do with cutting calories or eating less. - The weight I lost was water, which I deduced was held in my body by the salt - held in my veins, specifically, because they had become massively distended and painful since I had taken the HRT. I worked out that it was oestrogen that had caused the sodium and water retention and this was confirmed when I looked up the side-effects of oestrogen. I then realised that oestrogen was a steroid, though it is not normally referred to as such, and that the sodium and water retention came about because certain steroids and certain other drugs weaken the walls of the blood vessels. I realised that I was a 'steroid victim'.
Since 1988 I have been providing a free telephone helpline for people in pain in my area and since 1998 have been advising all callers to eat less salt, particularly when they were obese or when I recognised that they had been damaged by steroids, HRT or amitriptyline. Their weight loss, too, has been dramatic and swift. Obese people who follow my suggestions and make a genuine effort to reduce their sodium intake routinely lose about a stone (14 pounds) weight in the first month. Obese people are obviously overweight in large part because of sodium and water retention, and the weight they rapidly and easily lose when they reduce their salt intake is made up of salt and water.
The massive rise in the incidence of obesity is caused by an amalgamation of several factors, including, as is now clear, over-salted foodstuffs and inappropriate prescribing of certain medications.
Tony Blair's government only demonstrated concern about salt intake and, very importantly, the provision of information about sodium content on food labels, in its later years - at a guess, I'd say since about 2003. Both Labour and Tory administrations allowed the food companies free rein to ladle more and more salt into their products, thus damaging irrevocably the health of innocent salt-sensitive purchasers. Let's look at what successive governments with their successive Department of Health personnel have done about recommendations made in regard to salt, high consumption of which is the cause of a huge proportion of the ill-health and disability of the nation:
The Department of Health's Committee on Medical Aspects of Food and Nutrition Policy (COMA) was disbanded in March 2000.
The following information was taken on July 11th 2006 from http://www.actiononsalt.org.uk/recommendations.htm but since then appears to have been removed from the internet. I find it surprising that such interesting information has been removed. It's a good job I copied and pasted it when I did. The website itself http://www.actiononsalt.org.uk/ is still on the internet.
Recommendations made about salt
1 Nutritional Aspects of Cardiovascular Disease 1994 This COMA report considered the evidence for a causal relationship between the consumption of sodium and both the level of blood pressure and the rise in blood pressure with age. A statement in the report said it recommended: "A reduction in the average intake of common salt (sodium chloride) by the adult population from the current level of about 9g/day to about 6g/day. There needs to be a gradual reduction in the amount of sodium from salt added to processed food and food manufacturers, caterers, and individuals should explore and grasp the opportunity for reducing the sodium content of foods and meals." The Chief Medical Officer at that time, accepted all the recommendations in this COMA report except for the recommendation to reduce salt. The reason for this is not clear but is believed to be pressure from industry. Department of Health (1994), "Nutritional Aspects of Cardiovascular Disease", HMSO, London.
2 Dietary Reference Values 1991 This COMA report considered that: "Current sodium intakes are needlessly high and we caution against any trend towards increased intakes". It set its recommended intake for salt, as with all the other recommended intakes for nutrients, on the basis of the balance of risks and benefits, which might practically be expected to occur. The RNI for a particular population group is defined as the amount of the nutrient that is enough or more than enough for about 97% of the people in this group. The Reference Nutrient Intake (RNI) for sodium for adults was set at 1600 mg/day. This is equivalent to approximately 4g of salt, if all the sodium was present in the diet as sodium chloride. This is considerably less than the present intake of 9-12g. Department of Health (1991), "Dietary Reference values for food, energy and nutrients for the United Kingdom", HMSO, London
I wonder why The Chief Medical Officer in the early '90s apparently did nothing to implement the recommendation of a maximum of 4g of salt a day, and apparently gave greater consideration to the desires of the food industry than to the health of the nation, and I wonder how many deaths and how much terrible suffering he was, therefore, personally responsible for? And I wonder why his successors in the post were so tardy in taking effective steps to give warnings about salt consumption? - Political considerations? - What though, could be more important in this matter than the health of the members of public - the electorate - the tax-payers, in fact?
I consider the failure to put pressure on food manufacturers and caterers to reduce the sodium content of foods and meals until recent times to be a dereliction of duty of successive political administrations and health departments. - I remember buying McCance and Widdowson's 'Composition of Foods' in the late '90s, at considerable cost, in order to discover how much sodium there was in food. There was no way consumers could get this information from the pack. - The people of this country have been very ill-served in this matter, yet Tony Blair in one of his speeches sought to blame the innocent victims of the culpable negligence of Department of Health personnel and others!
It was reported on 19 July 2006 in Britain's "Daily Telegraph" that the British Pharmacological Society has drawn attention to the widespread poor prescribing practices among doctors.
I was glad to see this, especially following on as it does, the Sunday Telegraph's report 'Sleaze in the Medical Profession' of July 9th 2006. As a steroid victim myself, damaged and made morbidly obese by being inappropriately prescribed HRT (without testing hormone levels first) and by inadequate monitoring and testing thereafter, I feel peculiarly well-placed to add my critical comments.
We are not just badly served by our extremely highly paid doctors, we are ill-served by our politicians and by the Department of Health and by the Parliamentary Select Committees and many other individuals and agencies and professional bodies who should be monitoring these matters. - I wrote well over 30 letters to MPs and Select Committees, medics, scientists, media people and others in 2001 about the dire consequences of inappropriate prescribing - often in high dose - of certain steroids and of HRT and of amitriptyline, an antidepressant drug. Following those I received only one helpful reply - from Professor Sir Richard Doll OBE MD DSc FRS, Emeritus professor of medicine at Oxford University, agreeing with what I had written about the obesity problems caused by poor prescribing and indicating that these could be lessened by diuretics and/or eating less salt/sodium, a fact I had already deduced. He wrote that all doctors should know this. - Mine didn't - and furthermore, mine CATEGORICALLY refused me diuretics when I asked to try them!
It is over 50 years since steroids were first prescribed and it is beyond belief that most doctors are still unaware in practice of their potential for causing sodium and water retention and morbid obesity and the many other serious health problems attendant on these...
Calorie counting and advice about increasing exercise and reducing fat and calorie intake to reduce obesity are ineffective, counter-productive and often damaging. - See the article in the British Medical Journal of November 2003 http://bmj.bmjjournals.com/cgi/content/full/327/7423/1085 for actual research on what happens when this advice is followed! - Over 800 obese adults were put on energy deficit diets, given diet sheets and plenty of instruction and help from trained staff, and apparently, visited fortnightly for a year, at the end of which they had GAINED weight! This mirrors the real experience of obese people, viz. - dieting makes you fat.
It is commonly accepted now, except by the 'experts', that less than 5% of dieters actually lose weight, and most gain weight as a result of dieting. - Even the ones who manage to lose weight do not usually improve their health. - See http://www.guardian.co.uk/medicine/story/0,11381,1515455,00.html for a report in The Guardian of Monday, June 27th 2005. It is about a huge research study of nearly 3000 people over a period of 18 years. The study found that overweight people who diet to reach a healthier weight are more likely to die young than those who remain fat. It also found that dieting causes physiological damage that in the long term can outweigh the benefits of the weight loss.
Contributing to the increase in obesity we have the widespread prescribing of steroids and HRT and other drugs which cause weight gain, and the failure of doctors to adhere to the protocols connected with the prescribing and monitoring of steroids. But pre-eminent, in my opinion, is the catastrophically damaging calorie-reduction advice that continues to be given despite such a wealth of evidence that it is bad advice.
Another possible factor is the increase in the amount of oestrogen in the water table.
Salt produces obesity only in vulnerable people, i.e.
Most medics do not understand what sodium retention is, and most are unaware that tablets they prescribe are causing this extremely damaging condition. They tend to blame obesity, mistakenly, on overeating. Similarly, most nutritionists and dieticians do not realise that obese people need to lose excess water to lose weight, and that excess water held in the body will not be affected by cutting calories. There can scarcely be anyone who has not heard hundreds of times over the message that overweight people should cut calories and cut down on fat and sugar. They have been conditioned to believe this. They do not need to be told it another thousand times.
The advice from the nutritionists is WRONG. It does not work! This nation HAS reduced its intake of calories and fat for some years now. With what result? Ever increasing obesity levels! Obese people need to concentrate on reducing salt, not calories.
Since the summer of 2001 I have been writing to MPs, to medical people, to journalists, to nutritionists and others, urging that suitable warnings be printed on packs of the tablets so that the destruction of more lives can be prevented. I have written hundreds of letters. The warning label should say something like:
DO NOT EAT SALT, OR FOODS CONTAINING SALT, WHILE TAKING THIS MEDICATION, BECAUSE IT COULD CAUSE FLUID RETENTION RESULTING IN MASSIVE WEIGHT GAIN.
To the best of my knowledge, no action has been taken. Nor is the public being told the truth about weight gain and weight loss. The best way to lose weight is to concentrate on eating less sodium and more potassium. (A book, written a few years ago by a hospital professor, about the health dangers of salt, makes no mention of steroid victims and specifically states, incorrectly, that HRT does not cause a salt problem!)
My present MP is Nick Clegg, LibDem, and I have written many times to him about these matters. I was pleased to receive a letter from him (dated 7 July 2006) informing me that he had written to the Secretary of State and raised the matter of the need for clear warnings on prescribed medicines and also that people on prescribed steroids should be warned to reduce sodium intake to lose weight and not calorie intake, which can be harmful to them. I hoped, therefore, that appropriate action would be taken about this in order to prevent/lessen needless suffering, just for the want of a little information. (Note, by the way, that for people taking the steroids or other medications that cause sodium and water retention, calorie reduction to lose weight not only CAN be harmful, it invariably IS harmful.)
We need publicity to tell people who are already morbidly obese steroid victims that
1) all they need to do to lose some of their excess weight is to eat less salt and, preferably also eat more fresh fruit and vegetables and
2) they must not restrict calories to try to reduce weight.
I seem to have omitted the drug companies is my sharing out of responsibility for the deplorable state of affairs dealt with on this website. - Let me remedy that by giving you this link: http://www.netdoctor.co.uk/interactive/news/theme_news_detail.php?id=17245163 where it is reported that Sir Iain Chalmers argues that the untrustworthiness of clinical health trials has reached endemic proportions in the UK and that "Research undertaken by pharmaceutical companies cannot be trusted." - This wasn't news to me! - I've been agitating about this for years, as have other people - but effective regulation seems as distant as ever. - I invite you to wonder why this is...
*Update on the correspondence between Nick Clegg and the Department of Health. - Here are extracts from the email I sent to Nick Clegg on 8th September 2006:
"Thank you very much for your letter dated 09 August 2006 and for sending me a copy of the letter you sent to Patricia Hewitt, Secretary of State for Health, and a copy of the reply you received from the Department of Health...
I was disturbed, but not surprised, at the complacent tone of the reply you received from Andy Burnham. - If you were to write to the Department of Transport about traffic signals not working, you would not expect a reply that stated that traffic signals should be working, nor would you find it a satisfactory response. - But you wrote about the need for patients taking steroids or certain other medicines to be warned not to eat salt while taking the drugs and the reply was, "Where appropriate, doctors and pharmacists should advise patients on the need for any modifications to their diet (including salt intake) and/or lifestyle when taking medicines." - Stripped of circumlocution and ambiguity, this reads, "Doctors and pharmacists should warn patients not to eat salt when taking these drugs." - This reply is arrant nonsense! - Patients are NOT being warned to avoid salt and salty food when taking steroids and HRT and other drugs that cause sodium and water retention and thereby initiate morbid obesity and a host of other grave and painful health problems for the innocent patients they are prescribing the drugs for! - If they were, there would not be the many thousands of steroid victims (people with steroid-induced Cushing's Syndrome) that there are! - Nor, to the best of my knowledge, is there any reference to the importance of avoiding salt and salty food while on the medication in the PIL which accompanies the medicine and which I take leave to guess Mr Burnham has not checked up on.
I didn't think much to the website www.medicines.org.uk. There appears to be no warning about salt/sodium re steroids there either, and for amitriptyline, they say, "Increased appetite and weight gain may be a side effect of the medicine or may be due to the relief of depression." - Whereas the cause is sodium and water retention...
This is a tragedy and a scandal similar to that perpetrated by the tobacco industry, which for decades lied/avoided telling the truth about its harmful products. People need to be told the truth about steroids and other medications, and doctors who are so ignorant about the ghastly and extremely common side-effects of the drugs they far too readily prescribe should not be ALLOWED to prescribe them. - The endocrinologist who was largely responsible for the harm done to me by the HRT I was inappropriately prescribed for nearly ten years confessed to me that she had never even HEARD of sodium retention until I showed it to her in a copy of the British National Formulary I had obtained!!!! - It is the most common side-effect of the HRT and is the direct cause of most of the other side-effects of HRT. - She'd never even bothered to look the HRT up in the BNF! - She wept on my shoulder and urged me to sue her for negligence, saying she was well insured, but I have almost as low an opinion of the Law as practised in this country as I have of medicine as practised in this country and did not want to waste my scant energy and money I needed to cope with all my disabilities by suing her."
And I drew Nick Clegg's attention to some of my blog entries about all this. I did not receive a reply to my email and I have not heard from Nick Clegg that he is pursuing the subject, and despite my repeated requests for him to come to see me again so that I can better explain the matter to him, he does not appear to intend doing so.
When people are prescribed steroids or other drugs that result in sodium retention, they should be warned not to eat salt or foods containing salt while they are taking the medication.
If you have gained a lot of weight and become obese because of
taking prescribed steroids or HRT then I have very good news for you!
When children become fat it is essentially because they are eating salty food. Children are especially vulnerable to salt because of their small size and small blood volume, and because their blood vessels are weaker than those of adults... read more
During pregnancy a woman's hormone levels alter. The hormone most relevant to undesirable weight gain is oestrogen... read more
Patients may sometimes find it helps with the problem for which it has been prescribed, but be that as it may, it frequently produces a host of adverse side-effects, including weight gain... read more
...most or possibly all of these symptoms are the result of fluid retention and will be lessened or avoided by reducing salt intake... read more
You may like to write to your MP to ask that warning labels be put on packs of steroids and the other drugs that cause sodium retention, about the dangers of eating salt while taking the medication. The warning label should say something like: DO NOT EAT SALT, OR FOODS CONTAINING SALT, WHILE TAKING THIS MEDICATION, BECAUSE IT COULD CAUSE FLUID RETENTION RESULTING IN WEIGHT GAIN. I could prove what I say about increased blood volume if I could get my blood volume measured. It is a perfectly legal diagnostic procedure and I am willing to pay to have it done, but when I ask to have it done, my request is refused. - I have written to MPs about this, but no one has helped me to get it measured. Anyway, with this website you can benefit from my experience. - Eat less salt! And let me know how you get on!