{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:57:19Z","timestamp":1791219439925,"version":"4.1.0"},"reference-count":13,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,19]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>A man in his 40s presented with rapid weight gain, fatigue and clinical signs of Cushing\u2019s syndrome, including abdominal striae and centripetal obesity. Laboratory testing revealed suppressed serum cortisol and adrenocorticotropic hormone levels. He denied prescribed glucocorticoid use but disclosed consumption of the supplement Artri King Reforzado Con Ortiga Y Omega 3 for joint pain. The U.S. Food and Drug Administration (FDA) had recalled this product for undeclared dexamethasone. The patient\u2019s symptoms started a few weeks after he discontinued the supplement and gradually improved with initiation of hydrocortisone for treatment of secondary adrenal insufficiency due to exogenous glucocorticoid use. This case illustrates the potential harm of adulterated supplements and the importance of obtaining a thorough medication and supplement history in cases of suspected iatrogenic Cushing\u2019s syndrome.<\/jats:p>","DOI":"10.1136\/bcr-2025-269314","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:10:24Z","timestamp":1791216624000},"page":"e269314","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Iatrogenic Cushing\u2019s syndrome from an adulterated glucocorticoid-containing supplement"],"prefix":"10.1136","volume":"19","author":[{"given":"Hima","family":"Darapu","sequence":"first","affiliation":[{"name":"Endocrinology, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9507-2340","authenticated-orcid":false,"given":"Sagarika","family":"Gokul","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetes & Metabolism, Prisma Health, Greenville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100509101732000_19.10.e269314.1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.91a.23039"},{"key":"2026100509101732000_19.10.e269314.2","doi-asserted-by":"publisher","DOI":"10.2174\/1874306401509010070"},{"key":"2026100509101732000_19.10.e269314.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61684-0"},{"key":"2026100509101732000_19.10.e269314.4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1218"},{"key":"2026100509101732000_19.10.e269314.5","doi-asserted-by":"crossref","DOI":"10.1111\/dth.13514","article-title":"Iatrogenic Cushing\u2019s syndrome due to topical steroid abuse in a child with Psoriasis presenting as septicaemia","volume":"33","author":"Sachdeva","year":"2020","journal-title":"Dermatol Ther"},{"key":"2026100509101732000_19.10.e269314.6","article-title":"A Case of Iatrogenic Cushing\u2019s Syndrome following Use of an Over-the-Counter Arthritis Supplement","volume":"2023","author":"Dunn","year":"2023","journal-title":"Case Rep Endocrinol"},{"key":"2026100509101732000_19.10.e269314.7","doi-asserted-by":"crossref","DOI":"10.1210\/jcemcr\/luad154","article-title":"Artri King-induced Hypothalamic-pituitary-adrenal Axis Disruption: A Report of 3 Cases","volume":"2","author":"Berg","year":"2024","journal-title":"JCEM Case Rep"},{"key":"2026100509101732000_19.10.e269314.8","unstructured":"FDA . Warning letter to latin foods market. 2022. Available: https:\/\/www.fda.gov\/inspections-compliance-enforcement-and-criminal-investigations\/warning-letters\/latin-foods-market-631753-10282022"},{"key":"2026100509101732000_19.10.e269314.9","unstructured":"FDA . Public notification: artri and ortiga products may contain hidden drug ingredients. 2022. Available: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-warns-consumers-not-purchase-or-use-artri-and-ortiga-products-which-may-contain-hidden-drug"},{"key":"2026100509101732000_19.10.e269314.10","unstructured":"FDA . Latin foods market issues voluntary nationwide recall of artri king reforzado con ortiga y omega 3. 2022. Available: https:\/\/www.fda.gov\/safety\/recalls-market-withdrawals-safety-alerts\/latin-foods-market-issues-voluntary-nationwide-recall-artri-king-reforzado-con-ortiga-y-omega-3-due"},{"key":"2026100509101732000_19.10.e269314.11","unstructured":"FDA . Artri king contains hidden drug ingredients. 2022. 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