Can Albuterol Cause Weight Loss? I Use Albuterol in Nebulizer 3x/day Along with Ventolin As Needed

Can Albuterol Cause Weight Loss?

Dear Dr. Mahler:

I continue to lose weight. 9 lbs in 6 months, more before that.  No apparent explanation so I am on the hunt to try to figure it out. I can’t get an appt with an endocrinologist for 3 months.

Have you heard of people with COPD losing weight from taking a lot of albuterol or just from having diminished lung capacity?

I use Albuterol in the nebulizer 3x day plus several puffs of Ventolin during the day. Along with Albuterol I use Budesonide inhalation 2xday as prescribed. I tried all of the other newer “2 in 1” bronchodilators, but either they didn’t work or I had side effects.
I’d appreciate your thoughts.

Sidney from Tacoma, WA

Dear Sidney:

I have not come across your question in my practice previously. To provide an answer to your question – Can Albuterol Cause Weight Loss? – I first summarize information about beta receptors in the body. Second, I review how albuterol works. Third, I include information based on a search of the medical literature on PubMed.

Beta Receptors

There are three types of beta-receptors in the body that work in different ways. Beta1 receptors are located mainly in the heart. When stimulated with a medication, heart rate increases and the heart pumps more blood. Beta2 receptors are located in the breathing tubes and in the blood vessels (arteries) that provide  blood to muscles in the arms and legs. When stimulated with a medication, the muscle that wraps around the breathing tubes relaxes allowing more air to go in and out of the lungs.  This makes it easier to breathe. Beta3 receptors are located in the fat (adipose) tissue of the body. When stimulated, there is break down of fat tissue (called lipolysis).

Muscarinic Receptors

In addition to beta receptors, there are muscarinic receptors located in the breathing tubes that work in a different way to allow more air to go in and out of the lungs. It is common to prescribe both beta2 and muscarinic antagonists because they dilate the airways be different mechanisms and work better than only one type of bronchodilator.

Albuterol Sulfate

Albuterol is a short-acting beta2-agonist bronchodilator. What does this mean? Short-acting means that it lasts for 3 – 4 hours, and then wears off. Beta2 means that is attaches to beta2 receptors – located in the breathing tubes and arteries of skeletal muscle –  and has minimal effect on beta1 and beta3 receptors. Bronchodilator means that it relaxes the smooth muscle that wraps around the breathing tubes to open them and make it easier for air to move in and out.

Smooth muscle wraps around the outside of the breathing tubes. This address Can Albuterol Cause Weight loss

View of smooth muscle wrapping around the outside of the breathing tubes

In general, albuterol is used mainly as needed. This means either as rescue for sudden breathing attacks OR before doing an activity that is expected to cause some breathing difficulty. For maintenance therapy, long-acting bronchodilators are used to treat those with COPD because they keep the breathing tubes open from 12 – 24 hours. I assume that you were tried on long-acting bronchodilator medications and either they did not work for you, or you had side effects.

Can Albuterol Cause Weight Loss?

There is not a lot of medical information to answer your question completely. There is one study published in 1993 in the journal Thorax (Amoroso is first author) which showed a slight increase in metabolism in 10 healthy adults with four puffs of albuterol compared to a placebo over an hour.

A review of side effects of albuterol in Drugs.com listed the following side effects: 16 MAJOR side effects with shakiness and trembling as More Common, fast, irregular, pounding heart rate as Less Common, and 13 different reactions as Rare, none of which was weight loss. There were 11 MINOR side effects listed, again none of which included weight loss.

My Comments

Based on this information and my experience, I consider it very unlikely that your frequent use of albuterol in the nebulizer and by inhaler are causing your weight loss. Ideally, you would try using long-acting bronchodilators so that you would not need to use so much albuterol to breathe.

To know for sure about your concern, you would need to reduce albuterol use markedly. Obviously, that would require you to use long-acting bronchodilators to replace short-acting albuterol.

Finally, I support your effort to look for another reason for weight loss. I would start with your primary care provider, and then with an endocrinologist as you are planning.

Best wishes in finding an answer.

Donald A. Mahler, M.D.

Walking a Dog: It Helped Me Be More Active and Lose Weight

Walking a Dog – Helped to Lose Weight

Dear Dr. Mahler:

I am 79 years old and was hospitalized last month for a flare-up of COPD. Usually I have 1-2 episodes of bronchitis during the winter and need an antibiotic and prednisone. I usually get short of breath clearing snow off of my car and drying off my dog when he gets wet from rolling in the snow.

The reason that I am writing is to share my “secret” for losing weight.  I live alone in a trailer, but last May I got a dog for company and activity. He wants to go out at least 6 times a day, and I need to walk him with a lease. There isn’t enough space for him to run around in my small yard. To care for my dog, I walk several times a day, up to 20 min at a time. Although I had not planned on this, I have lost 18 pounds since last May. I feel so much better being more active and it is easier to breathe losing my belly fat. Please share my experience walking a dog with your readers.

Sally from Bennington, VT

Dear Sally,

Many thanks for you note. Congrats on losing 18 pounds and make sure to give your dog a treat for helping you lose weight.

Woman walking a dog

Woman walking her dog

Here is some information about walking a dog and health benefits. In general, dog owners get twice as much exercise as those who do not have a dog. One survey reported that on average dog owners walked with their dog 24 minutes twice a day which adds up to 5 hours and 36 minutes a week. Studies show that those who walk their dog have the following health benefits:

  • Lower blood pressure
  • Increased mental attitude and sharpness
  • A lower risk of heart disease

The amount of exercise required for your dog will vary depending upon their breed and energy. Your dog can be a great incentive to get outside.

Here are some suggestions for those who have dogs. Set a daily routine with your dog. Try to walk at the same time each day. Also, find a dog park for fun and variety.

Sally – thanks again for your email. Hopefully, your experience will help others have a new friend and find a way to lose weight.

Best wishes,

Donald A. Mahler, M.D.

 

Obesity and Worse Outcomes in COPD: More Shortness of Breath

In COPD, A Link between Obesity and Worse Outcomes (more shortness of breath, poor Quality of Life, and reduced walking distance)

Background: Although obesity is common in the United States (see post on January 1, 2017 under COPD News), the association between obesity and worse outcomes in those with COPD  is unclear.

Study: Dr. Allison Lambert, Assistant Professor of Medicine at Johns Hopkins University, and colleagues analyzed information on 3,631 participants in the COPDGene study. A body mass index of 30 or higher was used to define obesity. The findings were published in the January 2017 issue of the journal CHEST (volume 151; pages 68-77).

Obesity and worse outcomes regardless of shape

Two common types of obesity – apple and pear shapes

Findings: Overall, 35% of participants in the study were obese – which is identical to the general population in the United States.  Increasing obesity was associated with worse quality of life, reduced distance walked in six minutes, more shortness of breath, and greater odds of a severe exacerbation (sudden worsening) of COPD. 

Conclusions: The authors concluded that obesity is common among individuals with COPD and is associated with worse outcomes. These include more shortness of breath with activities, poor quality of life, shorter distance walked in six minutes, and more frequent severe exacerbations.

Obese adults walking

My Comments: If you have COPD and are obese, I strongly encourage you to lose weight. Certainly, losing weight is hard work especially with food being a focus of celebrations including birthdays, holidays, anniversaries, etc. Studies show that the most effective way to lose weight is a combination of

Seniors participating in physical activity such as walking, biking, and swimming

Seniors Exercising

eating fewer calories and an exercise program. Regular exercise can burn some calories, but its major effect with weight loss is to increase the metabolic rate (which burns more calories throughout the day). Participation in a pulmonary rehabilitation program is a great way to start an exercise routine. Talking to a nutritionist may help you select healthy and low calorie foods.