SFEEU2023 Society for Endocrinology National Clinical Cases 2023 Poster Presentations (48 abstracts)
Royal Sussex County Hospital, Brighton, United Kingdom
We present two cases of alternative approaches to treating endocrine disease.
Case 1: A 55-year-old man became steroid dependent in 2017, following a skiing accident and C3/4 fracture, for which he received 13-months of high-dose hydrocortisone. Upon cessation, he developed adrenal crisis, confirmed on short synacthen test. Hydrocortisone replacement therapy was begun. His dose was doubled, then tripled to control his symptoms, in addition to frequent rescue injections for crises. His high steroid requirement was felt due to significant neuropathic pain and dose reduction attempts failed. In 2021, he decided to attempt to stimulate his adrenals to recover functioning, using crystal meth and ice baths, methodology he researched online. By December 2021, he had discontinued hydrocortisone, serum cortisol increased to within normal range and symptoms resolved. He remains off hydrocortisone, and now plans to wean off crystal meth.
Case 1 | Cortisol nmol/l | Case 2 | ||
Date | Baseline | 30mins | Date | Prolactin (miu/l) |
14/8/2018 | 48 | 129 | 2011 | 970 |
19/3/2019 | 10 | 53 | 2014 | 3945 |
27/9/2019 | 312 | 2015 | 351 | |
06/12/2021 | 431 | |||
29/11/2022 | 456 |
Conclusions: We describe two cases of complementary therapies associated with remarkable improvements in endocrine disease. In case 1, clinical and biochemical resolution of adrenal insufficiency was surprising, given high steroid requirements. However, there is plausibility in his methodology. Methamphetamines are a known HPA-axis stimulant, with marked ACTH-mediated adrenal glucocorticoid secretion following ingestion. Case 2 details a rare but recognised clinical course of non-functioning pituitary adenomas. Resolution also coincided with menopause, which can occur with prolactinomas. Crystal healing could have been causative or coincidental in this notable improvement. The patient keeps copies of her sequential imaging to support crystal healing practices. These cases highlight the power of self-belief as an influential healer in medicine.