A case report in BMJ Case Reports describes a man in his 40s who developed Cushing's syndrome after taking a joint pain supplement called Artri King Reforzado Con Ortiga Y Omega 3. The patient reported rapid weight gain, stretch marks, fatigue, and other symptoms over several months, but denied using any glucocorticoid medications. He had been taking the supplement for nine months before symptoms began, and later testing showed low morning cortisol and ACTH levels, consistent with exogenous steroid exposure.
Clinicians initially suspected Cushing's, but the patient's denial of steroid use prompted a detailed supplement history. The supplement had previously been recalled by the FDA for undeclared dexamethasone, a potent glucocorticoid. The authors concluded that the hidden dexamethasone was the likely cause of his iatrogenic Cushing's syndrome. The patient was treated with hydrocortisone replacement and gradually tapered off over about four months as his adrenal function recovered.
An outside expert, Dr. Maria Fleseriu of Oregon Health & Science University, said such cases are seen more frequently in clinic, especially with arthritis supplements bought online. She emphasized that some supplements contain undeclared glucocorticoids, which can suppress ACTH and endogenous cortisol production while producing classic Cushingoid features. The case authors noted that despite FDA alerts and recalls, these products remain available online and in retail markets, pointing to persistent regulatory gaps and the need for stronger oversight and clinician awareness.