WebMD Health News
Louise Chang, MD
Jan. 5, 2009 -- Steve Jobs today posted a letter on the Apple web site
stating that he has a "hormonal imbalance" that caused him to lose weight throughout 2008, and
that he's being treated and staying on the job as Apple's CEO.
In 2004, Jobs had surgery to remove a pancreatic tumor, which he called a
very rare form of pancreatic cancer called islet
cell neuroendocrine tumor.
But in today's statement, Jobs doesn't mention cancer or his 2004 cancer
treatment. Instead, Jobs says he has a "hormonal imbalance that has been
'robbing' me of the proteins that my body needs to be healthy."
Jobs adds that "the remedy for this nutritional problem is relatively simple
and straightforward, and I've already begun treatment," and that it will take
him until spring to regain the weight.
What is a hormonal imbalance and what might it mean about Jobs' health?
Here's what four doctors -- who aren't treating Jobs -- told WebMD today.
All four doctors said there isn't a lot of medical information in the
statement -- for instance, Jobs doesn't say what hormone or hormones are out of
balance. But they read between the lines and offered some perspective.
"Basically, the definition of a hormone is very simple. It's a chemical your
body makes in one place that works in another. It has to be something your body
makes and has to be made in one cell and work in a different cell," says Robert
Lustig, MD, an endocrinologist at the University of California, San Francisco.
Lustig adds that the body makes hundreds of hormones.
The pancreas -- which is where Jobs had his 2004 tumor -- makes hormones
including insulin, which regulates blood sugar, and also releases enzymes into
the digestive system, says Bernard
A. Roos, MD, director of the Geriatric Research Education and Clinical Center
at the Miami VA and the University of Miami Miller School of Medicine.
"The imbalance is a manifestation of something wrong with a gland. But then
you have to figure out what's wrong with the gland, and unfortunately we can't
tell from [Jobs' statement]," Lustig says.
Maybe, but not necessarily.
"Certainly, the fact that he had a pancreatic neuroendocrine tumor back in
2004 puts him at higher risk for another endocrine tumor, of the pancreas or
elsewhere. That's true, but that doesn't mean what's going on here, because
then it would not be a 'nutritional problem' and certainly would not have a
simple treatment," says Lustig.
It's possible. But exactly what that surgery involved -- such as how much of
the pancreas was removed -- hasn't been made public; all Jobs has said about it
in the past is that he was "fine" after the operation.
"The more of the pancreas that's taken out in surgery, the more likelihood
of developing a hormonal problem," says Jay Marks, MD, an associate clinical
professor of medicine at UCLA who contributes to MedicineNet, which is part of
the WebMD network.
Because of his previous pancreatic cancer and treatment, Jobs may be low on
pancreatic enzymes, and fixing that would mean taking pancreatic enzyme supplements with meals. And if
he doesn't do that or is on a dose that's too low, that could hinder his
digestion and lead to weight loss, explains Otis Brawley, MD, chief medical
officer at the American Cancer Society.
He could have a thyroid problem, note Brawley
and Roos. Roos also says it's possible that Jobs has low levels of growth
hormone due to a chronic illness. "There are three possibilities: He has growth hormone deficiency, he
has pancreatic enzyme deficiency, or he has both," says Roos.
But that's speculation.
"I definitely encourage folks to take him at his word and realize that the
weight loss could be due to his disease progressing, but it's also very, very
likely due to some nonmalignant process," says Brawley.
SOURCES:Robert Lustig, MD, professor of clinical pediatrics, division of
endocrinology, University of California, San Francisco.Bernard A. Roos, MD, director, Geriatric Research, Education, and Clinical
Center, Miami VA and University of Miami Miller School of Medicine.Jay Marks, MD, associate clinical professor of medicine, University of
California at Los Angeles.Otis Brawley, MD, chief medical officer, American Cancer Society.
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