One year follow-up study of the recovery of adrenal insufficiency induced by formulated herb drugs
Chen, Y.T.; Chang, C.J.; Yao, W.J.; Wang, P.W.; Wang, J.D.
Journal of the Formosan Medical Association 92(Suppl 4): S250-S257
1993
ISSN/ISBN: 0929-6646 PMID: 7910084 Document Number: 407997
Previous studies have found that taking formulated herb drugs may reduce the serum cortisol level which may result in an adrenal insufficiency. We suspect that this effect is induced by corticosteroids artificially mixed in formulated herb drugs. The objectives of this study were to determine the time course of serum cortisol and plasma ACTH (adrenocorticotropic hormone) levels, and whether pituitary-adrenal function recovers after quitting formulated herb drugs for a period of one year. Forty eight subjects with an initial serum cortisol level smaller than 10.7 micrograms/dL due to the intake of formulated herb drugs were recruited. They were tested for serum cortisol and plasma ACTH levels at 08:00 6, 9 and 12 months after quitting formulated herb drugs, respectively. The diagnosis of adrenal insufficiency was confirmed by an ACTH test at 9 months and 12 months after quitting the formulated herb drugs. The follow-up rates ranged from 63% to 71%. The 08:00 serum cortisol levels at the initial test, 6 months, 9 months, and 12 months were 4.4 +/- 0.5 micrograms/dL, 6.6 +/- 0.8 micrograms/dL, 6.6 +/- 0.7 micrograms/dL, 6.2 +/- 0.8 micrograms/dL, respectively, (interpersonal p = 0.0001, intrapersonal p = 0.0004, repeated measures ANOVA test.) The 08:00 plasma ACTH levels at the initial test, 6 months, 9 months and 12 months were 33.8 +/- 6.4 pg/mL, 67.6 +/- 16.8 pg/mL, 21.0 +/- 3.2 pg/mL, 16.3 +/- 2.2 pg/mL, respectively (interpersonal P = 0.0001, intrapersonal P = 0.0003, repeated measures ANOVA test.) The statistical significance was the same after logarithmic transformation of the ACTH levels.