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Lipodystrophy and WastingLipodystrophy and Wasting
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about anabolic steroids for lipodystrophy
May 9, 2000

in an earlier question you stated that anabolic steroids have been useful for lipodystrophy. My dr. said that steroids have no effect in preventing lipo. Could you elaborate on their benefits

Response from Dr. Hellerstein

I'm not sure what was said before about anabolics and lipodystrophy. Here's what I'd say.

Lipodystrophy refers to loss of fat from the extremities. There is no known treatment of any type that is effective against this complication. Indeed, growth hormone probably makes this worse, not better. Even discontinuing antivirals does not reverse this, whereas other metabolic abnormalities (blood lipids, insulin, etc.) may get better after therapy is stopped. I've yet to see anyone who had lost their fat, regain it by any treatment, however. So anabolics should not be expected to work here, either.

Associated with lipodystrophy is often an increase in abdominal fat ("paunch"). This is not lipodystrophy per se, but commonly goes with it. Again, nothing is proven to work for this, but there is non-definitive data that some things can help. Growth hormone may reduce belly size somewhat. Combining anabolics (oxandrolone) with weight lifting caused loss of fat in a study that we published last year. Perhaps this is what you were referring to from a previous answer?

Anyway, the short answer is that nothing yet really works for loss of fat (lipodystrophy). Keep tuned, though, as new treatments are tried over the next year.

Marc Hellerstein, M.D., Ph.D.

Arthritis in HIV/AIDS Patients
follow up question to anabolics in early infection

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