Using Herbal and Traditional Medicinal Products is the Risk Factor of Adrenal Insufficiency in Thailand: The Retrospective Cohort Study
Manosroi W, MD¹, Buranapin S, MD¹, Atthakomol P, MD², Manosroi A, PhD³, Manosroi J, PhD³
Affiliation : ¹ Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand ² Department of Orthopaedics, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand ³ Faculty of Engineering and Technology, North Chiang Mai University, Manose Health and Beauty Research Center, Chiang Mai, Thailand
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.
Received 1 Jul 2019 | Revised 24 Dec 2019 | Accepted 26 Dec 2019
Keywords : Adrenal insufficiency, Herbal medicine, Traditional medicine, ACTH stimulation test
