Diabetic Symptoms Associated with Progestational Steroids: Curious Implications

Diabetic symptoms (like obesity) associate with the use of certain progestational steroids.

Do these symptoms (including weight gain) result from a stimulated appetite and/or slowed metabolism, as the Caloric Balance Hypothesis tells us?

Or do they result from direct action on fat tissue metabolism, as the Lipophilia Hypothesis would suggest?

Let's look at some randomly selected evidence culled from a quick Google search for scientific articles about progestational steroids, weight gain, and insulin.

1. Here is an article that appears to confirm our speculation on the cause of the diabetic symptoms: "Effects of gonadal hormones and contraceptive steroids on glucose and insulin metabolism."[1]

The authors found that: "Studies reveal that gonadal and contraceptive steroids may markedly affect glucose and insulin metabolism in man and experimental animals."

They later conclude:

"It is evident that synthetic progestins often modify the glycol metabolic effect of the estrogenic component of oral contraceptives (OCs) in man. Evidence indicates that OCs are not as diabetogenic in man as pregnancy."

2. Here is another article from The Journal of Clinical Endocrinology and Metabolism: "Induction of insulin resistance by androgens and estrogens."[2]

The authors tell us: "Hyperinsulinemia is a common finding in hyperandrogenic women during pregnancy, and women using oral contraceptives."

They conclude that "sex hormone administration, i.e., testosterone treatment in females and ethynylestradiol treatment in males can induce insulin resistance in healthy subjects."

So progestational steroids can impact insulin secretion, just like Lipophilia predicts!

But is there any evidence that these medications might induce weight gain? Indeed, such evidence apparently abounds.

3. Check this out: "Megestrol acetate stimulates weight gain and ventilation in underweight COPD patients."[3]

The authors analyzed the impact of a "progestational appetite stimulant" by performing a "prospective, double blind, randomized, placebo controlled trial."

They conclude: "Body weight increased by 3.2 kilograms in the MA group and 0.7 kg in the placebo group... weight gain was mainly fat."

So, we have evidence that these steroids:

A) can cause changes in insulin metabolism

B) can increase body fat and cause diabetic symptoms

So case closed. Lipophilia wins.

4. Just to drive these points home, here is one last study from an animal trial, which again seems to be in line with our theory: "Sex steroids influence on triglyceride metabolism."[4]

The authors investigated how triglyceride metabolism changes in rats given various progestational steroids. The findings were complicated, but the authors did say that "sex steroid treatments... all increased plasma insulin significantly."

Detaching the science of fat metabolism from the science of nutrition has been a catastrophic mistake. The evidence marshaled here -- sparse and haphazardly assembled as it may be -- nevertheless paints a compelling picture that physiological processes -- rather than psychological forces -- control fat accumulation and regulation. And thus, again, it seems like we must choose the Lipophilia Hypothesis explanation for these diabetic symptoms and reject the Caloric Balance Hypothesis explanation.

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1. Beck PEffects of gonadal hormones and contraceptive steroids on glucose and and insulin metabolism. New York, Plenum, 1969. p. 97-125.

2. KH Polderman, LJ Gooren, H Asscheman, A Bakker and RJ Heine. "Induction of insulin resistance by androgens and estrogens. Journal of Clinical Endocrinology & Metabolism, Vol 79, 265-271, Copyright © 1994 by Endocrine Society.

3. Jeffrey Weisberg, DO, Jack Wanger, MS, Jeffery Olson, PharmD, Barry Streit, MD, FCCP, Charles Fogarty, MD, Thomas Martin, MD, FCCP, and Richard Casaburi, PhD, MD, FCCP "Megestrol acetate stimulates weight gain and ventilation in underweight COPD patients." CHEST April 2002 vol. 121 no. 4 1070-1078.

4. H J Kim and R K Kalkhoff. "Sex steroid influence on triglyceride metabolism." J Clin Invest. 1975 October; 56(4): 888–896.

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