When * come, they come not single spies but in battalions.

Yes, you recognised that, "When sorrows come, they come not single spies But in battalions," is a quotation from a speech by Claudius, in Shakespeare's Hamlet. It is something most of us have experienced: something goes wrong, something else goes wrong, and so on. Or as the saying goes, It never rains but it pours.

I am particularly aware of the way that troubles seem almost to breed, when I think of the adverse side-effects of pharmaceutical drugs. Adverse effects of drugs are often spoken of as rare or infrequent. I do not believe this to be the case. They are unfortunately common. For example, consider the many drugs, including including prednisolone (also sold as Pediapred®), prednisone (also sold as Deltasone®, Meticorten, Orasone, SK-Prednisone and Sterapred®), methylprednisolone (Brand names Depo-Medrol, Solu-Medrol), cortisone, hydrocortisone, dexamethasone (Brand name Decadron), betamethasone, beclomethasone, fludrocortisone, triamsinolone, desonide, fluprednidene, clobetasone, alclomethasone, momethasone, desoxymethasone, fluosinonide, budesonide, fluosinolone, triamcinolone (trade names Kenalog, Aristocort, Nasacort, Tri-Nasal, Triderm, Azmacort, Trilone, Volon A, Tristoject, Fougera, Tricortone, Triesence) and other corticosteroids, Advair - a combination drug that contains Fluticasone, a corticosteroid, HRT and other medications containing oestrogen - like Premarin and Prempak, and like some birth control medication (contraceptives) - amitriptyline, doxepin and some other anti-depressants, some anti-psychotic drugs, including Zyprexa (aka olanzapine) and other psychotropic drugs, and some anti-epileptic/anticonvulsant drugs, notably sodium valproate (trade name Epilim), that cause sodium retention.

In effect, sodium retention means that the blood vessels have become distended/swollen with extra sodium and water, and therefore the blood volume is greater than normal. That greater blood volume obviously means that the person's weight is increased by the weight of that extra fluid in the bloodstream. And because the walls of the blood vessels have become stretched, they must also be thinner and weaker, and so the blood volume may more easily fluctuate as the person ingests more, or less, salt/sodium and salty food. This in turn makes blood pressure more variable, and also adds to the variability of blood sugar concentration and increased variability of concentration of other components in the blood. Greater variability of blood sugar concentration is a factor in increasing the risk of developing type 2 diabetes. The weakening of the blood vessel walls increases the risk of stroke and of heart problems.

The weight gain will continue if the offending drugs continue to be taken without reducing sodium intake (and this is usually the case because physicians rarely warn their patients about the dangers and consequences of eating added salt when taking these drugs). So obesity, or even morbid obesity, is a very real possibility. The patients are then likely to be told to eat less and take more exercise in order to lose their excess weight. Taking this advice would cause them further harm because their excess weight is the result of the prescribed medication and their intake of added salt (even if it is only a modest intake of salt), and not because of over-eating or taking in too many calories and expending too few calories. If the person then tries to diet/eat less food than their body requires this will exacerbate the nutritional deficits they are already experiencing as a consequence of sodium retention depleting the body of essential minerals (principally calcium, but also magnesium and potassium). A host of health problems tend to develop because of this malnutrition. They may include nerve damage, excruciating cramps, osteoporosis or even osteomalacia, and therefore very weakened bones and much greater risk of fractures, weaker muscles and reduced mobility.

The swollen blood vessels/veins will proliferate, causing the skin to look redder because of the blood vessels close to the skin surface; the skin itself will be thinning and be becoming weakened and overstretched by the greater volume/mass of the person's swollen, heavier body with its increasing fluid retention. The kidneys become over-worked and their function impaired by the greatly increased blood volume and similarly the heart becomes enlarged. The enlarged heart takes up too much room in the thoracic cavity so that breathing becomes more laboured and the person begins to suffer from breathlessness.

And I haven't even mentioned yet the insults of the ignorant, who add to the emotional problems of the victims of drug-induced sodium/water/fluid retention and obesity, the social isolation, the constant misunderstandings, the fatigue, the pain from the over-stretched blood vessels and over-stretched skin and weakened bones. - Have I sketched out for you enough of the battalions of troubles/sorrows/degenerative health problems/adverse side-effects that can and do come from taking certain pharmaceutical drugs when they are too readily prescribed, by prescribers ill-informed about their side-effects and insufficiently informed about the many possible contributory factors involved in causing obesity? I feel sure that, following my lead, you will be able yourself to think of many more adverse consequences from taking these powerful and highly dangerous drugs, with their insidious cumulative damage. Best avoid them if you can!

See obesity and the salt connection, amitriptyline and sodium in foods.