Exogenous Cushing Syndrome and Hip Fracture Due to Over-the-Counter Supplement (Artri King)

Suhail M Saad-Omer; Mustafa Kinaan; Moises Matos; Hanford Yau

doi:10.7759/cureus.41278

Exogenous Cushing Syndrome and Hip Fracture Due to Over-the-Counter Supplement (Artri King)

Cureus. 2023 Jul 2;15(7):e41278. doi: 10.7759/cureus.41278. eCollection 2023 Jul.

Authors

Suhail M Saad-Omer¹, Mustafa Kinaan¹, Moises Matos¹, Hanford Yau²

Affiliations

¹ Department of Internal Medicine, University of Central Florida College of Medicine, University of Central Florida/HCA Florida Healthcare Graduate Medical Education, Orlando, USA.
² Department of Internal Medicine, University of Central Florida College of Medicine, Orlando Veterans Affairs Medical Center, Orlando, USA.

Abstract

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids. We present a case of Artri King (AK)-induced CS in a 40-year-old woman who presented with an intertrochanteric fracture of her right femur. Laboratory testing revealed suppressed cortisol and adrenocorticotropic hormone, which was consistent with suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Following the cessation of the AK supplement, the patient's HPA axis recovered, and the clinical manifestations of CS improved. This case emphasizes the need for better regulation of OTC supplements and the need for cautious use.

Keywords: arti king; cushing syndrome; cushing’s; exogenous; hip fracture; hypercortisolism; osteoporosis; over-the-counter supplement.

Publication types

Case Reports