Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons

Unregulated supplements containing undisclosed glucocorticoids can cause exogenous Cushing syndrome and adrenal suppression on abrupt withdrawal. To our knowledge, we present the first known case of a patient using Ardosons for a decade, an over-the-counter arthritis supplement containing betamethas...

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Main Authors: Faidat Adeola Ishola, Angela Rao, Dimpi Desai, Deborah E. Sellmeyer
Format: Article
Language:English
Published: American College of Physicians 2025-05-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.1123
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author Faidat Adeola Ishola
Angela Rao
Dimpi Desai
Deborah E. Sellmeyer
author_facet Faidat Adeola Ishola
Angela Rao
Dimpi Desai
Deborah E. Sellmeyer
author_sort Faidat Adeola Ishola
collection DOAJ
description Unregulated supplements containing undisclosed glucocorticoids can cause exogenous Cushing syndrome and adrenal suppression on abrupt withdrawal. To our knowledge, we present the first known case of a patient using Ardosons for a decade, an over-the-counter arthritis supplement containing betamethasone leading to hypercortisolism. A 47-year-old man with ankylosing spondylitis developed Cushingoid features with subsequent adrenal insufficiency after abruptly stopping Ardosons. He was treated with hydrocortisone, leading to symptomatic improvement. Five weeks later, he had lost 7.3 kg, with reduced striae. Adrenal function remained suppressed 9 months after presentation. A thorough medication reconciliation is essential to identify hidden corticosteroids in patients with mixed Cushingoid and adrenal insufficiency symptoms.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-49df5ac2400442ac971c266c097ddbf22025-08-20T03:47:41ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-05-014510.7326/aimcc.2024.1123Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement ArdosonsFaidat Adeola Ishola0Angela Rao1Dimpi Desai2Deborah E. Sellmeyer31Division of Endocrinology, Gerontology, and Metabolism, Department of Internal Medicine, Stanford Health Care, Palo Alto, California1Division of Endocrinology, Gerontology, and Metabolism, Department of Internal Medicine, Stanford Health Care, Palo Alto, California1Division of Endocrinology, Gerontology, and Metabolism, Department of Internal Medicine, Stanford Health Care, Palo Alto, California1Division of Endocrinology, Gerontology, and Metabolism, Department of Internal Medicine, Stanford Health Care, Palo Alto, CaliforniaUnregulated supplements containing undisclosed glucocorticoids can cause exogenous Cushing syndrome and adrenal suppression on abrupt withdrawal. To our knowledge, we present the first known case of a patient using Ardosons for a decade, an over-the-counter arthritis supplement containing betamethasone leading to hypercortisolism. A 47-year-old man with ankylosing spondylitis developed Cushingoid features with subsequent adrenal insufficiency after abruptly stopping Ardosons. He was treated with hydrocortisone, leading to symptomatic improvement. Five weeks later, he had lost 7.3 kg, with reduced striae. Adrenal function remained suppressed 9 months after presentation. A thorough medication reconciliation is essential to identify hidden corticosteroids in patients with mixed Cushingoid and adrenal insufficiency symptoms.https://www.acpjournals.org/doi/10.7326/aimcc.2024.1123
spellingShingle Faidat Adeola Ishola
Angela Rao
Dimpi Desai
Deborah E. Sellmeyer
Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons
Annals of Internal Medicine: Clinical Cases
title Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons
title_full Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons
title_fullStr Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons
title_full_unstemmed Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons
title_short Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons
title_sort concomitant exogenous cushing syndrome and adrenal insufficiency from use and withdrawal of the supplement ardosons
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.1123
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