Endocrine Abstracts

A 45-year-old lady presented to her GP with sweating, poor memory, and decreased, concentration. Investigations revealed elevated oestradiol at 2204 pmol/l, LH at 28.1 IU/l, and FSH at 15.0 IU/l. This raised the possibility of a Gonadotrophinoma. A preclinic pituitary MRI showed a subtle rounded nodule of tissue within the right side of the anterior pituitary. In clinic, she revealed that she was consuming aloe vera juice for several years to improve her skin and general well-being. Her enthusiasm motivated her to become a business owner and distributor of aloe vera products. She was taking 60mls of concentrated juice every day containing 99.7% pure inner leaf aloe vera gel. She was advised to stop taking aloe vera supplements. Blood tests two weeks later had returned to normal level with Oestradiol 554 pmol/l, LH 1.6 IU/l, and FSH 2.8 IU/l. Her symptoms had resolved and were attributed to excessive doses of aloe vera. MRI was reviewed and thought to be an anatomical variation. Aloe vera is a phytoestrogen. These are plant-derived compounds with a similar structure to 17 beta oestradiol. In excessive quantities, they can lead to increased oestrogenic effects by binding to oestrogen receptors. The gel from the inner leaf contains the highest concentration of aloe vera. Health benefits suggest improvement in menopausal symptoms, decreased cardiovascular disease, and lower risk of obesity, type 2 diabetes and metabolic syndrome. Non-medical literature benefits include improvement in skin quality, bowel health, and wellbeing. The potential adverse effects due to the oestrogenic properties of phytoestrogens are infertility and increased risk of cancer in oestrogen sensitive organs. More studies are required to discover if highly concentrated preparations of aloe vera are associated with significant adverse effects which would outweigh the potential benefits. Should alternative therapies carry a health warning?