Woman diagnosed with Cushing’s syndrome

Posted on May 6, 2016 by MaryO
Thursday, May 05, 2016
AsiaOne

SINGAPORE – The Health Sciences Authority (HSA) has warned the public not to purchase or consume a health product labelled in Chinese as ‘Hai Leng Hai Beh Herbal Itch Removing Capsule’ after a customer consumed it and has now been diagnosed with a metabolic disorder known as Cushing’s syndrome.

In a press release today (May 5), the HSA revealed that a woman in her 40s, bought the capsules from a retail store overseas to ease an itchy skin condition after a relative’s recommendation.

Just a day after consumption her itchy skin condition improved. However after consuming the pills for two months, she gained weight rapidly and her face became puffy.

Evidence later showed that the pills were not entirely herbal in nature and contained “potent traces of steroid and painkillers like paracetemol”, according to HSA.

Dexamethsone, a steroid which is usually prescribed for inflammatory conditions, is known to cause increased blood glucose levels that cause diabetes, high blood pressure, cataracts and muscular and bone disorders when taken over a long period of time without supervision.

These medical conditions may, in turn, cause a consumer to develop Cushing’s syndrome, said HSA.

Chlorpheniramine was also found in the capsule. HSA said the antihistamine is commonly known to treat allergic reactions and can cause drowsiness, blurred vision, vomiting and constipation.

Paracetamol is known to cause swelling of the lips or face and rashes.

The HSA has advised all sellers to stop selling and distributing the capsules immediately.

If caught selling, shop owners could be fined up to $10,000 and may be imprisoned for a period of up to two years, if convicted.

To learn more about the dangers of buying health products from dubious sources, you can visit http://www.healthdangers.sg.

Those with any information on the sale and supply of these capsules or other illegal products can contact HSA’s Enforcement Branch at 68663485 during office hours from Monday to Friday.

mldas@sph.com.sg

– See more at: http://yourhealth.asiaone.com/content/woman-diagnosed-cushings-syndrome-hsa-warns-public-avoid-itch-removing-capsule#sthash.3odVhMMe.dpuf

Filed under: Cushing's | Tagged: , , , , | Leave a comment »

HSA issues alert on 2 illegal pain relief products

Posted on June 4, 2015 by MaryO

SINGAPORE: The Health Sciences Authority (HSA) on Wednesday (Jun 3) issued an alert on two illegal health products sold in Singapore, one of which caused a consumer to be hospitalised for adverse reactions.

HSA added that investigations are ongoing and laboratory tests have found undeclared potent medicinal ingredients in the products.

A woman in her 40s has been hospitalised for “delirium (confusion), high blood sugar, electrolyte imbalance in her blood and suspected Cushing’s syndrome (characterised by a round face or ‘moon face’ and upper body obesity within thin limbs)” after consuming an illegal pain relief product, said HSA.

The woman had been consuming the “powder packed in unlabelled pink sachets” for pain relief over a prolonged period of time because she believed it had “miraculous powers”, HSA added. The powder was found to contain the illegal ingredients Chlorpheniramine and Dexamethasone.

The patient had bought the powder from “an auntie who sells powdered medicine” – a woman in her 60s who would personally deliver the products to the addresses provided by the customers, said HSA.

HSA raided the peddler’s home and discovered another illegal health product – black pills labelled “special effect rheumatism pill”. They were found to contain Dexamethasone and Chlorpheniramine, as well as Bromhexine.

Dexamethasone could cause diabetes, high blood pressure, cataracts and Cushing’s syndrome, among other adverse reactions. Chlorpheniramine and Bromhexine could cause symptoms including diarrhoea, nausea and vomiting.

The authority advised members of the public who have purchased or are consuming the products to:

Consult a doctor as soon as possible before stopping usage as sudden discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms

Avoid buying health products from street peddlers, unknown websites or sellers, or even from well-meaning friends or relatives

Be wary of health products not properly labelled with ingredient information or make exaggerated claims like “instant pain relief”

Seek appropriate medical treatment from a doctor for the management of acute and chronic medical conditions such as arthritis and rheumatism

via HSA issues alert on 2 illegal pain relief products – Channel NewsAsia.

Filed under: Cushing's | Tagged: , , , , , , | Leave a comment »

Utility of measurement of dexamethasone levels in the diagnostic testing for Cushing’s syndrome

Posted on June 21, 2014 by MaryO

From Day 1 of the 16th International Congress of Endocrinology and the Endocrine Society’s 96th Annual Meeting and Expo »

Chicago, IL – June 21, 2014

ST Sharma, JA Yanovski, SB Abraham, LK Nieman

Summary: Dexamethasone (dex) suppression tests (DST) are used for screening and differential diagnosis of Cushing’s syndrome (CS). The 1 mg overnight (LD) DST is used to diagnose CS, the dex-suppressed CRH stimulation (Dex-CRH) test to differentiate CS from pseudocushings (PCS) while the 8 mg overnight (HD) DST is used to differentiate Cushing’s disease (CD) from ectopic ACTH syndrome (EAS). Researchers assessed the utility of dex levels in improving the diagnostic accuracy of these tests and they found that low dex and high CBG levels can account for false positive (FP) DST and Dex-CRH test results. Use of a higher dex dose in pts with low dex levels can help decrease FP results.

Methods:

  • This is a retrospective study of patients (pts) with CS, PCS and normal volunteers (NV) who had a dex level measured as part of LDDST, HDDST or Dex-CRH test.
  • A post-dex cortisol (F) level ≥1.8 mcg/dl in the LDDST and a 15 min post-CRH F level ≥1.4 mcg/dl in the Dex-CRH test suggested CS.
  • A ≥69% suppression of F levels in HDDST indicated CD.
  • Dex levels

Results:

  • LDDST (n=77): Post-dex F was abnormal in 44 pts, 37 of these did not have CS on follow-up.
  • Proportion of pts with low dex levels was similar in those with incorrect or correct LDDST results (P=0.7).
  • Three of 5 pts with an abnormal result and low dex levels (44-117 ng/dl) had suppressed post-dex F levels after a 2 mg overnight DST. HDDST (N=56): Results were not consistent with the final diagnosis (CD or EAS) in 13 (23%) pts.
  • Of these, 5 had low dex levels (400-1220 ng/dl).
  • Proportion of pts with low dex levels was similar between those with correct and incorrect HDDST results (P=0.5).
  • HDDST in 1 pt with ACTH-dependent CS suggested EAS (28% suppression) with low dex level.
  • IPSS indicated CD.
  • After a doubled dex dose (16 mg), F levels suppressed by 76%, changing the HDDST result to CD.
  • Dex-CRH (n=139): Results were consistent with the final diagnosis in 133 pts (74 CS, 20 NV, 39 PCS).
  • Six pts with an abnormal result had dex levels
  • Of these, repeat testing with doubled dex dose (1 mg every 6 hours) in 2 pts led to higher dex levels (610, 757 ng/dl) and normal F level in one.
  • Two pts with abnormal result were on OCPs, 1 with a known high cortisol binding globulin (CBG) level.
  • None had CS on follow-up.
  • There was no correlation between dex and post-dex F levels in LDDST, 15 min post-CRH F levels in Dex-CRH test and % suppression of F post-dex in HDDST (P=NS).

Filed under: adrenal, Cushing's, Meetings and Conferences, pituitary, Rare Diseases | Tagged: , , , , , , , | Leave a comment »

Suspected case of Cushing’s Syndrome with history of taking medicines prescribed by registered Chinese medicine practitioner

Posted on February 19, 2014 by MaryO

The Department of Health (DH) today (February 18) alerted clients who have consulted a registered Chinese medicine practitioner (CMP) Mr Chan Kong-kin (CMP Chan), practising at G/F, No.25, Leung Tin Village in Tuen Mun, should consult health-care professionals for advice if they have been supplied with medicines suspected to be Western medicines.

The appeal followed the DH’s investigation into two public complaints. The first complaint involved a 23-year-old woman who consulted CMP Chan for management of eczema. She was given a type of green pills, two types of yellow pills and a type of red-yellow capsules for treatment of her disease for about one year.

She developed round face and increased facial hair which are features compatible with Cushing’s syndrome and steroid overdose can cause the syndrome. The patient was admitted to a public hospital on February 5 for investigation and was discharged on February 7.

The second complaint involved a 24-year-old woman who was recommended by the first complainant to consult CMP Chan for management of allergic rhinitis and eczema. She was given similar medicines as those for the first complainant for three days.

Her condition was stable.

Today, chemical analysis by the Government Laboratory on the patients’ drug samples showed that Western medicine Dexamethasone was detected in the red-yellow capsule.

Dexamethasone is a potent steroid. Taking dexamethasone for a long time, especially when in substantial dosage, can cause side effects such as moon face, high blood pressure, high blood sugar, muscle atrophy, peptic ulcer and even osteoporosis.

DH has set up a hotline 2125 1133 for public enquiries related to the medicines prescribed by the CMP.

It will operate from 9am to 9pm, Monday to Friday.

“Preliminary investigation by the DH revealed that pills and capsules were found in the CMP’s premises and all have been seized for further investigation,” the spokesman said.

“In December 31, 2012, the DH announced that CMP Chan was found in possession of Part I poisons and unregistered pharmaceutical products in the same clinic which also involved medicines with steroid. The DH subsequently took enforcement action and the relevant legal proceeding is in progress.

The case has also been referred to the Chinese Medicine Council of Hong Kong for follow-up action,” the spokesman added

“On completion of our investigation, the DH will seek advice from the Department of Justice regarding possible contravention of the Pharmacy and Poisons Ordinance (Cap 138) for the illegal sale or possession of Part I poisons. According to the Ordinance, the maximum penalty for each offence is a fine of $100,000 and two years’ imprisonment. Besides, the DH will also refer this case to the Chinese Medicine Council of Hong Kong for possible disciplinary action”, the spokesman remarked.

People who have been supplied with medicines by the concerned CMP and are in doubt should consult health-care professionals as soon as possible.

They should submit the medicines to the Chinese Medicine Division of DH at 16/F, AIA Kowloon Tower, Landmark East, 100 How Ming Street, Kwun Tong, during office hours for disposal.

Source: HKSAR Government

From http://7thspace.com/headlines/453015/suspected_case_of_cushings_syndrome_with_history_of_taking_medicines_prescribed_by_registered_chinese_medicine_practitioner.html

Filed under: Cushing's, Rare Diseases | Tagged: , , , , , , , , , , , , | Leave a comment »

Remaining calm = Reducing illness

Posted on October 9, 2013 by MaryO

Have you ever noticed that when you are “stressed” you can feel either emotionally/physically depleted or energized?  When our body is under stress the brain responds by producing epheniphrine or adrenaline, sending signals to our adrenal glands, increasing the rate at which our heart beats while releasing oxygen to our muscles.  The long term response to this process produces cortisol (aka the stress hormone) facilitating the release of energy throughout our body.  However, when our body isn’t properly balanced these hormones can wreak havoc on our wellness possibly resulting in one of three conditions:  Cushing’s syndrome, Cushing’s disease or Addison’s disease.

adrenal-glandsThe actual Adrenal glands sit physically atop both kidneys, taking on a triangular shape and a roundish rectangular type shape.  These glands are responsible for our sex hormones and cortisol, helping us respond to stress amongst other functions.  When our body is under stress, physically and/or nutritionally, it responds one of two ways:  Produces too much or too little of the cortisol hormone.  Our Adrenal glands also contribute to regulating our blood sugar, blood pressure, salt and water.

Adrenal disorders can cause our body to make too much or not enough of these hormones, bringing about adrenal gland related syndromes and disease.  Cushing’s syndrome results from our body making too much versus Addison’s disease produces too little.

Cushing’s syndrome vs. Cushing’s disease

Glucocorticoids (naturally produced in our body or received through medicine) are groups of corticosteroids (cortisol or dexamethasone) involved in metabolizing our carbohydrate and protein.  When taken synthetically (i.e. treatment of allergies, skin problems, and respiratory problems) or over-produced naturally, the side effects can result in “Cushing’s syndrome”.

Cushing’s syndrome can occur one of two ways:  Endogenous or Exogenous.  Endogenous is caused by the body (usually through tumors).  Exogenous is caused by medication.  In both cases, the body produces too much cortisol.

Symptoms: Severe fatigue/muscle weakness, high blood sugar and high blood pressure, upper body obesity, thin arms/legs, bruising easily

Treatment:  The cure and treatment for Cushing’s disease can come through medicine, surgery, or by lowering the dosage of your current synthetic hormone treatment.  Cushing’s syndrome can be cured.

Cushing’s disease is the most common form of endogenous Cushing’s syndrome and is likely treatable.  Caused by a tumor in the pituitary gland secreting too much Adrenocorticotropic hormone (ACTH), this type of tumor does not spread and can be removed through surgery.

Nutrition:  See a nutritionist or dietician for your condition.  Mostly, avoid excess sodium.  High blood sugar (hyperglycemia) and high blood pressure can easily occur with this condition.  Bone loss density is common with this condition, so be extra aware of your calcium (800 – 1200 mg per day, based upon age) and Vitamin D intake (5mcg from age 0-50, increasing up to 10 mcg 50-71, and 15 mcg after 71).  Eating healthy, balanced and whole food (versus processed) is extremely important.

(Resource:  http://www.aboutcushings.com/understanding-cushings-disease/causes-and-differences.jsp)

Addison’s disease

Opposite from Cushing’s syndrome, Addison’s disease doesn’t make “enough” of the sex hormones and cortisol.  The result of this disease causes our immune system to attack our tissue, damaging our adrenal glands.

Symptoms:  Weight loss, muscle weakness, increasingly worse fatigue, low blood pressure and patchy or dark skin.

Treatment:  If left untreated, the condition can be fatal.  Lifetime hormone treatment is usually required. Addison disease patients should always carry medical/emergency ID on them, listing their medication, dosage and disease

Lab tests can confirm that you have Addison’s disease. If you don’t treat it, it can be fatal. You will need to take hormone pills for the rest of your life. If you have Addison’s disease, you should carry an emergency ID. It should say that you have the disease, list your medicines and say how much you need in an emergency.”

(Ref: http://www.nlm.nih.gov/medlineplus/cushingssyndrome.html, NIH: National Institute of Neurological Disorders and Stroke)                                                                                                                                                                                                                                        Learning how to balance our stress-filled lives is extremely important to our overall health.  Healthy nutrition always contributes benefits to our overall wellness.  We can overwhelm our endocrine system by simply not eating nutritionally.  Understanding that “Food is a drug” is vitally important to how we help our body naturally heal itself.  The above two conditions are the result of our body not handling the stress we are putting it through, causing our body to producing too much or too little of the sex hormones and cortisol.

Unless we first address what we can do naturally through nutrition, the medicine we consume will only do so much in helping our body heal completely.  You simply cannot continue doing the same thing over and over again, expecting the medicine to do all the work.  Some diseases are brought upon us through our environment (emotionally as well as physically) as well as our diet/nutrition.  Reviewing our entire wellness is always wisdom whenever we’re diagnosed with anything.

Certainly listen to your doctor and their advice.  But also ask your doctor to refer you to a nutritionist or clinical/registered dietician for a complete evaluation that includes a review of your nutritional diet/wellness.  Too often we reach for a pill or a procedure to “fix” our health problems, ignoring what we should be doing on our own to help our body heal.  Medical intervention is the result of providing our body with what it cannot produce on its own.  Nutrition should always be the “natural” medicine we take, as well as what we might need through prescribed medication.

Adapted from (Spelling errors corrected) http://hamptonroads.com/2013/10/remaining-calm-reducing-illness

Filed under: adrenal, Cushing's, pituitary, Treatments | Tagged: , , , , , , , , , , , , , , , , , , , , , | 2 Comments »

« Previous Page — Next Page »