Clinicians should conform to the recommended protocol when prescribing steroids.

I quote extracts from a standard textbook in the section on steroids: "Electrolyte Balance. – This group of drugs leads to retention of sodium and water and loss of potassium through the kidneys. Oedema of the ankles and eventually hypertension may develop…The correct dose of a steroid is the minimum amount of drug required to produce the desired effect…Patients taking steroids should be seen regularly and the following points noted: General appearance – any evidence of Cushing-like appearance…Blood pressure…Blood electrolytes must be estimated in patients undergoing prolonged therapy with these drugs…A close watch should be kept for undue potassium loss or sodium retention…"

There should be a STATUTORY requirement for health professionals to ABIDE by strict rules with regard to prescribing and monitoring steroids and HRT. Then there would not be new victims created every year, as is presently the case.

When I was initially prescribed oral HRT it included a high (unknown to me) dose of oestrogen and I was kept on that dosage for years before my blood oestrogen levels were measured (at my insistence and privately at my financial cost, my G.P. (now retired) having falsely maintained that he was not allowed to get the levels measured) and were found to be DANGEROUSLY high. There had been NO routine monitoring and care whatsoever. I had been laughed at when I queried the weight gain, explaining that I was definitely not over-eating. - I was routinely assumed to be lying, and my anguished reports of pain, principally in my feet and in my swollen, blood-gorged breasts, were sneered at and I was regarded as a hypochondriac. My increasingly troubling high blood pressure went ignored and largely unrecorded until the intervention of a surgeon whom I consulted prior to having a hysterectomy. He had recognised immediately on seeing me that I had high blood pressure. (Why don't all doctors know about the connection between high blood pressure and a red face?)

My blood electrolytes were not measured until 1998, when I tackled the endocrinologist about her negligence – by which time I had been on HRT for over ten years!

The endocrinologist told me she knew NOTHING AT ALL about Sodium Retention! Well I contend that if a specialist knows nothing, and is content to know nothing, about the principal danger listed as a side-effect of a drug, the prescription of which is her responsibility, then it is a scandalous state of affairs. And if specialists don’t know (and, by implication, don’t care, since she had made no effort over many years to inform herself on the subject), it is unlikely that GPs are any better informed. My own GPs appeared to know nothing about it. And GPs are the main prescribers of HRT and other steroids.

Had I been correctly monitored as detailed in the protocol I would have been spared the nightmare weight gain that was oedema, and the high blood pressure, the intense, sustained pain of overstretched blood vessels and overstretched, ever-thinner skin, etc. If I had even just been given the VITAL information that to avoid/minimise the huge increase in the salt and water content of the bloodstream I needed to avoid salt and salty food, I could have been spared monumental unnecessary suffering and harm.

Even now, obese steroid victims and other obese victims of the injudicious prescribing of drugs that cause sodium and water retention are not being told that to lose some of the excess weight/fluid they carry round with them. they need to minimise their intake of salt and salty food. This critically important information would transform their lives. As well as reducing their overweight it would lower any high blood pressure, lower cholesterol (if anyone is bothered about it), reduce their risk of stroke, type 2 diabetes, heart disease, heart attack, dementia and cancer, and benefit their health in countless other ways too.

Note: I must STRESS that once a person with a salt problem lowers salt intake and loses weight, there needs to be a lifetime commitment to a lowered salt intake. If the previous salt intake is resumed, the weight will return because of the weakened, over-stretched veins. And it is very much more difficult to lose the weight a second time, because high Blood Volume damages the kidneys, which find it harder to deal with sodium.

Read about weight gain caused by steroids and HRT and

my Mensa article about Obesity and the Salt Connection and

the scandalous politics of the situation.