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    Actos (pioglitazone) and Avandia (rosiglitazone) cause significant weight gain in 48-58% of patients


    Posted by .(JavaScript must be enabled to view this email address)
    Thursday, November 18, 2004 3:44 am Email this article
    Actos (pioglitazone), an antidiabetic medicine, causes significant weight gain in 48 percent of patients who take it according to a study from Australia. Avandia (rosiglitazone), another antidiabetic medicine, causes significant weight loss in 58 percent of patients. Weight gain in patients taking Actos (pioglitazone)

    Among patients taking Actos (pioglitazone), during the first six months:

    Weight gain in patients taking Avandia (rosiglitazone)

    Among patients taking Avandia (rosiglitazone), during the first six months:

    Both drugs are thiazolidinediones

    Both of these drugs are in a class of drugs called thiazolidinediones, and are used in type 2 diabetics to help control blood sugar.

    Conclusion: These drugs cause weight gain

    “Our results also confirm that weight gain is a significant side effect of [thiazolidinediones] treatment,” the authors of the study concluded. “This was highly correlated with baseline body weight.” In other words, the heavier a person was to start with, the more weight they were likely to gain.

    REFERENCE

    Bent S, Padula A, Neuhaus J. Safety and efficacy of citrus aurantium for weight loss. Am J Cardiol. 2004 Nov 15, 94(10):1359-61.

    AUTHOR’S CONTACT INFORMATION

    Osher Center for Integrative Medicine
    University of California
    San Francisco, California

    Department of Medicine
    San Francisco VA Medical Center
    San Francisco, California

    Articles on the same subject can be found here:


    COMMENTS

    On Feb 14, 2005 at 9:32 am angi wrote:

    . . . . .

    Hi,
    thanks for the artical on avandia and weight gain. I have gained at least 15 lbs in a few months. I expected to lose weight on this drug! I have been exercising hard 4-5x a week, and not losing a pound. I think it is the Avandia. I am going to go off of it and see what happens.
    thanks
    angi

    On Feb 14, 2005 at 10:01 am Larry Hobbs wrote:

    . . . . .

    Thanks for the feedback.

    If you are looking for a drug for type 2 diabetes that does not cause weight gain, and may cause weight loss, Glucophage (metformin) is one such drug.

    One study found that the combination of glucophage (metformin) and Glyburide caused 20% weight loss in diabetics, although I am not aware of any additional studies which have verified these findings.

    You can find the article here:

    http://fatnews.com/index.php/weblog/comments/388/

    On Feb 14, 2005 at 10:10 am Angi wrote:

    . . . . .

    Hi Larry,
    thanks for the quick reply. I appreciate the information. I will follow the link.
    I tried metformin and it made me very dizzy so I stopped taking it. Maybe I will try it again though.
    Thanks a lot!!
    -angi

    On Feb 14, 2005 at 11:04 am Larry Hobbs wrote:

    . . . . .

    Angi,

    You're welcome.

    PubMed notes that dizziness when taking metformin is a symptom of low blood sugar.

    http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a696005.html

    I would assume that taking it with meals with reduce the likelihood of this side effect.

    Acarbose (Precose) is another drug for type 2 diabetes that may cause weight loss.

    I'll post an article about acarbose and weight loss in the next hour.

    On Feb 14, 2005 at 11:28 am Larry Hobbs wrote:

    . . . . .

    Angi,

    The article about weight loss with acarbose versus metformin is posted here:

    http://fatnews.com/index.php/weblog/comments/1427/

    On Feb 14, 2005 at 11:47 am angi wrote:

    . . . . .

    wow thanks!!!
    i will ask my doc if he can prescribe it!!! (acarbose)

    thanks!!
    You are very kind to provide this information!! grin

    On Feb 14, 2005 at 11:56 am Larry Hobbs wrote:

    . . . . .

    Angi,

    You're welcome.

    Let me know how you do.

    On Jun 25, 2005 at 6:35 am Cyndi wrote:

    . . . . .

    Have been on Avandia 2mg for about a year for insulin resistance. Have gained about 30 lbs (now weigh 230). Followed Drs. instructions to exercise, which I have been doing religiously for 4 months 4-5x/week. Recenlty completed a 30 mi bike trip, so obviously have been getting in shape. Just visited Dr. yesterday and haven't lost ONE pound! Am starting to think it's the Avandia. Dr. said this makes it hard to lose weight, but never mentioned it would make me gain. Don't understand why they give a med to someone that makes it hard to lose weight, but if they stay heavy, they will eventually become diabetic! In addition, also have high cholesterol (300), which would also be helped if I could lose some weight. Dr. didn't seem sympathetic to the problem and didn't offer any solutions to lose weight and couldn't explain why the exercise didn't do anything. Am thinking of going off the Avandia and getting a 2nd opinion after looking at people with similar situations on the web.

    On Jun 25, 2005 at 7:56 am Larry Hobbs wrote:

    . . . . .

    Cyndi,

    Thank you for sharing your story.

    I am sorry to hear about your weight gain.

    I will send an email to some doctors who specialize in weight loss and see if any of them have any advice for you.

    Glucophage (metformin) is a drug used for diabetes that increases insulin sensitivity that does not cause weight gain, and may cause a small amount of weight loss.

    Dr. Ward Dean, MD, who I have a great deal of respect for, even recommends Glucophage (metformin) to his patients over 40 as an anti-aging drug.

    An article about metformin by Dr. Dean can be found here:

    http://www.vrp.com/art/551.asp

    Vladimar Dilman, a Russian gerontologist, who coauthored a excellent book with Dr. Ward Dean -- "The Neuroendocrine Theory of Aging and Degenerative Disease" -- believed that phenformin, a stronger chemical cousin to Glucophage (metformin), was the most potent anti-aging substance available.

    You can find article about Glucophage (metformin) and weight loss from this site here:

    http://fatnews.com/index.php/weblog/C30/

    ------

    Increasing omega-3 fatty acids -- found in fish oil, flax oil and green leafy vegetables -- and reducing omega-6 fatty acids -- found abundantly in corn oil and soy bean oil -- can also improve insulin sensitivity and reduce insulin resistance according to the brilliant Artemis P. Simopoulos, MD.

    Here is what she said in an interview:

    Hobbs: Your chapter EVOLUTIONARY ASPECTS OF DIET was very enlightening for me. Have you found anything new since it came out?

    Simopoulos: Yes. I?ve written two papers since that book came out on fatty acids and insulin resistance as well as the effects of trans fatty acids on insulin resistance and body weight. Also there is new information regarding the intake ratio of omega-6-to-omega-3 fatty acids and their relationship to insulin resistance. The papers are in print and are coming out in the New York Academy of Sciences.

    Hobbs: What is the new finding about the ratio [of omega-6 fatty acids, found in corn oil and soybean oil, and omega-6 fatty acids, found in fish oil and green leafy vegetables]?

    Simopoulos: As the ratio of omega-6-to-omega-3 increases above 4-to-1 insulin resistance increases and the prevalence of diabetes increases.

    Hobbs: What is the ratio in the typical American diet?

    Simopoulos: 20-to-1.

    Hobbs: Is this maybe why insulin resistance is a problem in America?

    Simopoulos: Yes. Approximately 25% of the known obese population is insulin resistant.

    ------

    The entire interview can be found here:

    http://fatnews.com/index.php/weblog/comments/341/

    ------

    The cheapest source of fish oil capsules I have seen is Sam's Club.

    Costco may also have them.

    The prices at Sam's Club are half that of the cheapest brand I have seen at the local health food store.

    How much should I take?

    Dr. Simopoulos recommends taking 1 to 3 grams, that is 1,000 to 3,000 mg as a combined total of DHA and EPA which is found in fish oil.

    Here is her answer from the interview:

    Hobbs: What is the right dose [of omega-3 fatty acids from fish oil]?

    Simopoulos: About 1 gram [1,000 mg] per day for health or 3 grams [3,000 mg] per day for people with diseases.

    </b>Hobbs: A combined total of EPA and DHA being 3 grams?</b>

    Simopoulos: Yes.

    ------

    1,000 mg of DHA and EPA is the amount in about 4 capsules of Fish Oil / Omega-3 capsules available from Sam's Club.

    3,000 mg is the amount found in about 10 capsules.

    I find it easiest to take 3-4 capsules with each meal rather than take all 10 capsules at a single meal.

    I find that taking too many at one time can cause me to burp with a taste of fish oil.

    ------

    Please keep us informed as to what happens if you stop the Avandia, and if it helps you to lose the weight you have gained.

    On Sep 24, 2006 at 8:39 am Janice Thomas wrote:

    . . . . .

    Your article is very interesting. I was put on Actos and went for a followup and though my bs was good I had gained 18lbs in 2 months.Even though I was on a low carb diet plan. My dr changed my med to Advandia in 1month I had gained 10more lbs. That was not the worse, I got so short of breath I had to go off it. I thought I was going to have a heart attack. After being off these meds for about a month, I have got back to my old self. No shortness of breath, lost the weight and by staying on a low glycemic food plan my bs stays from 90 to 150. I have found out that some of the med out there can make it a lot worse instead of better.
    I wonder if anyone else has complained of shortness of breath, or being weak.
    Thanks for the information.
    Janice Thomas

    On Sep 24, 2006 at 2:19 pm Larry Hobbs wrote:

    . . . . .

    Janice,

    Thank you for sharing your story.

    According to information about Actos (pioglitazone) on the National Library of Medicine's MedlinePlus...

    http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a699016.html

    Weakness is a symptom of either high blood sugar or low blood sugar.

    Shortenss of breath is a symptom of high blood sugar.

    They do not say whether or not these are potential adverse effects of the drug.

    -----

    You are correct. Sometimes the treatment is worse than the disease.

    On Sep 24, 2006 at 2:23 pm Larry Hobbs wrote:

    . . . . .

    Janice,

    The following web page notes the following regarding shortness of breath related to Actos.

    http://www.eurekalert.org/pub_releases/2006-09/k-ah091406.php

    "ACTOS is not for everyone. ACTOS can cause fluid retention that may lead to or worsen heart failure, so tell your doctor if you have a history of these conditions. Talk to your doctor immediately if you experience rapid weight gain, fluid retention, or shortness of breath while taking ACTOS. If you have moderate to severe heart failure, ACTOS is not recommended."

    ? EurekAlert.org, 2006 Sept 14

    On Sep 24, 2006 at 2:25 pm Larry Hobbs wrote:

    . . . . .

    Janice,

    Regarding Avandia and shortness of breath, here is what MedlinePlus says:

    http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500022.html

    "If you are rapidly gaining weight, shortness of breath, or have excessive swelling of hands, wrist, ankles, or feet. These may be symptoms of heart problems or your body keeping too much water."

    On Sep 24, 2006 at 2:26 pm Larry Hobbs wrote:

    . . . . .

    Janice,

    Regarding Avandia and weakness, MedlinePlus says it could be symptoms of liver problems. Here is exactly what they say:

    http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500022.html

    "If you experience abdominal or stomach pain, dark urine, loss of appetite, nausea or vomiting, unusual tiredness or weakness, or yellow eyes or skin, check with your doctor immediately. These may be symptoms of liver problems."

    On Sep 25, 2006 at 6:56 am Janice Thomas wrote:

    . . . . .

    Larry, Thank you so much for the information.
    I really have found out that knowledge makes a difference.
    I'm sure that most people do fine with Actos or Advandia, but not me.
    Thanks again, Janice

    On Sep 25, 2006 at 7:36 am Larry Hobbs wrote:

    . . . . .

    Janice,

    Thank you for sharing your story.

    I think adverse effects to all drugs are much more common than is we realize.

    Drop outs are a huge problem with most studies.

    It is not uncommon for 20-30 percent of patients to drop out of short-term studies and 40-50 percent or more to drop out of longer term studies.

    I seen one year studies where as many as 90 percent of people dropped out of the study.

    The studies usually claim that their dropping out had nothing to do with the drug. They usually say people dropped out for "personal reasons".

    Nonsense. I don't believe it.

    I think most drop outs occur because of adverse effects, but the researchers don't want to report it because they know that the drug companies don't want to hear bad news, and the researchers are trying to tell the drug companies what they want to hear so that they can get more work.

    I also think that drop outs often don't report the adverse effects because they are afraid that the researchers will try to convince them that the effects are transient and will ask them to continue the study.

    I can imagine that if subjects feel lousy on the drug, they simply stop taking it and then fail to show up for their follow up appointment. Then when the researchers secretary calls and says, "You missed your appointment. When can we reschedule it?" A husband might tell his wife, "Will you call them back and tell them I'm too busy right now."

    Please feel free to share your comments about this article.


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