Endocrine Abstracts

The aim of these two case reports (husband and wife) is to highlight the importance of homeopathic medication on HPA axis.

The first case is a 60-year-old Indian lady known to have diabetes mellitus, hypertension and hypercholesterolaemia, who presented with difficulty in losing weight and generalised aches and pains. As part of the investigations by her General Practitioner her serum cortisol was found to be low at 32 mmol/l. Short synacthen test showed normal response with basal cortisol at 33.5 mmol/l and an ACTH of <5.0. Patient was commenced on hydrocortisone replacement with no change in her symptoms. She was subsequently found to be taking homeopathic medication which she had bought over the counter in India. After cessation of homeopathic medication her serum cortisol normalised.

The second case is a 69-year-old Indian gentleman (her husband) who presented initially with excessive sweating, elevated urinary catecholamines and subsequent CT scan showed a small left adrenal mass. His serum cortisol was low at 144 mmol/l. Patient felt no difference in his symptoms following hydrocortisone supplements which were commenced aftershort and long synacthen tests. It became apparent that he had also been taking the same homeopathic medication which was stopped, with subsequent normalisation of his serum cortisol.

Conclusion: Homeopathic and over the counter medications may affect hormonal axis and it is therefore paramount for healthcare professionals to take a thorough, detailed history, bearing in mind that some patients may feel non prescriptive medications are not actual drugs.