Background: Herbal and traditional medicinal products (HTM) are widely used worldwide, particularly in the Asian region. Adulteration of undeclared glucocorticoids in these products may lead to adrenal insufficiency (AI).

Objective: To investigate the relationship between HTM usage and the risk of AI.

Materials and Methods: A 7-year retrospective study of 369 adult patients who had undergone the ACTH stimulation test was conducted in a tertiary care medical center in Thailand. An adjusted risk ratio was used to compare the incidence of AI between patients using HTM and those not using HTM.

Results: Overall, 44.7% of the patients who reported using HTM were diagnosed with AI with adjusted risk ratio of 1.71 (95% CI 1.01 to 2.94). Cushingoid appearance was found to be significantly related to AI.

Conclusion: There is a significantly higher incidence of AI in patients who use HTM. Healthcare professionals should be concerned about AI in the patients who have a history of HTM use.

Keywords: Adrenal insufficiency, Herbal medicine, Traditional medicine, ACTH stimulation test

Received 1 Jul 2019 | Revised 24 Dec 2019 | Accepted 26 Dec 2019