Elderly Woman Developed Cushing’s Syndrome After Taking Herbal Product with Strong Steroid

The Health Sciences Authority (HSA) warns members of the public against purchasing or consuming “黄牛木中风青草药 (Huang Niu Mu Zhong Feng Qing Cao Yao)”. The product has been tested by HSA and was found to contain dexamethasone, a potent steroid. An elderly woman developed Cushing’s syndrome, a serious medical condition, after consuming the product obtained from Malaysia. Anyone who has taken it is advised to see their doctor immediately. Please refer to Annex A for photos of the product. 

2     The woman, who is in her 70s, obtained “黄牛木中风青草药 (Huang Niu Mu Zhong Feng Qing Cao Yao)” through a relative, who in turn obtained it through a friend in Malaysia. She took the product for two months for her joint pain. During a routine health check, her doctor observed signs of Cushing’s syndrome, with characteristics of a rounded “moon face” appearance and abnormal fat accumulation above her collarbone. A laboratory test also revealed that she had a low cortisol level, which is likely caused by the steroid in the product suppressing the body's natural cortisol production. This could lead to adrenal insufficiency, a serious medical condition. The woman’s doctor suspected that the product was adulterated and reported the case to HSA. The woman has since recovered after stopping use of the product.

3     The product was also found to be sold on the local e-commerce platform Shopee. HSA has worked with the platform to remove the listings and has directed the sellers to stop selling the product immediately. 

Harmful effects from unsupervised use of steroids

4     The product “黄牛木中风青草药 (Huang Niu Mu Zhong Feng Qing Cao Yao)” was labelled as a herbal product and claimed to treat skin conditions, breathing difficulties, high blood pressure, diabetes, rheumatoid arthritis, liver and kidney diseases. However, HSA tested the product and found that it contained a potent steroid, dexamethasone, which is a prescription medication usually used to treat inflammation. It should only be used under strict medical supervision.

5     Long-term unsupervised use of steroids like dexamethasone can cause increased blood sugar levels which may lead to diabetes, high blood pressure, cataracts, muscular and bone disorders such as osteoporosis, an increased risk of infections and Cushing’s syndrome. Discontinuation of steroids without proper medical supervision can lead to steroid withdrawal effects and adrenal insufficiency, a serious condition where the body does not produce adequate amounts of steroid hormones after stopping long-term steroid use. This may cause fatigue, generalised weakness, muscle and joint pain, low blood pressure, fits or shock.

Advisory to consumers

6     See a doctor immediately if you are taking “黄牛木中风青草药 (Huang Niu Mu Zhong Feng Qing Cao Yao)”. Do not stop taking it suddenly on your own as it contains a potent steroid and may cause severe withdrawal symptoms such as fatigue, weakness and low blood pressure, especially when it has been taken for more than a few weeks.

Advisory to sellers and suppliers

8     All sellers and suppliers must stop selling “黄牛木中风青草药 (Huang Niu Mu Zhong Feng Qing Cao Yao)” immediately. HSA will not hesitate to take stern enforcement actions against anyone who sells and supplies products found to be adulterated with potent ingredients. Sellers and suppliers are liable to prosecution and if convicted, may be imprisoned for up to 2 years and/or fined up to $10,000.

ANNEX A

Photos of “黄牛木中风青草药 (Huang Niu Mu Zhong Feng Qing Cao Yao)” tested by HSA

All photos are to be credited to the Health Sciences Authority, Singapore.