An interesting pharmacological challenge

[Guest guest]

Today I had a patient who was suspicious that her recent weight gain (8 kilos in 3 months) may be perhaps because of steroids present in her homeopathic medications.

She asked me if there was some way it could be tested.

Any answers?

rakesh

[Guest guest]

Dear Dr. Rakesh, It is very common to find patients with cushingoid features due to prescription of steroids knowingly or unknowingly. the best way to test is 24 hour urinary free cortisol. Because of exogenous steroids, HPA is supressed and there is relative adrenal atrophy resulting in very low level of urinary steroids. this is in contrast to increase in urinary levels in endogenous steroids. ( Ref. Endocrinology 1th edition, section 4, adrenal steroids) Thanks, Dr.Viral shahRakesh Biswas <rakesh7biswas@...> wrote: Today I had a patient who was suspicious that her recent weight gain (8 kilos in 3 months) may be perhaps because of steroids present in her homeopathic medications. She asked me if there was some way it could be tested. Any answers? rakesh

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[Guest guest]

Thanks Viral,

This was very helpful. I did order a 24 urinary free cortisol on the day the patient consulted me. I shall let you know the results of that follow up.

The patient was keen to know if we can test for the percentage of steroids in the homeopathic medicine itself (for obvious reasons as it would not inconvenience herself and I guess this is acceptable human psychology and also it may be more evidentiary in pinpointing the source of the steroids).

Let me see I shall need to ring her up and find out if she was motivated enough to do the 24 hour urinary cortisol initially suggested.

rakesh

On 2/11/08, Dr.viral shah <viralshah_rational@...> wrote:

Dear Dr. Rakesh,

It is very common to find patients with cushingoid features due to prescription of steroids knowingly or unknowingly. the best way to test is 24 hour urinary free cortisol. Because of exogenous steroids, HPA is supressed and there is relative adrenal atrophy resulting in very low level of urinary steroids. this is in contrast to increase in urinary levels in endogenous steroids. ( Ref. Endocrinology 1th edition, section 4, adrenal steroids)

Thanks,

Dr.Viral shah Rakesh Biswas <rakesh7biswas@...> wrote:

Today I had a patient who was suspicious that her recent weight gain (8 kilos in 3 months) may be perhaps because of steroids present in her homeopathic medications.

She asked me if there was some way it could be tested.

Any answers?

rakesh

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[Guest guest]

Dear Rakesh,Difficult to say in terms of quantification but if patient had developed cushing means more than 7.5 mg of prednisolone or equivalent dose of any steroid.Viral ShahRakesh Biswas <rakesh7biswas@...> wrote: Thanks Viral, This was very helpful. I did order a 24 urinary free cortisol on the day the patient consulted me. I shall let you know the results of that follow up. The patient was keen to know if we can test for the percentage of

steroids in the homeopathic medicine itself (for obvious reasons as it would not inconvenience herself and I guess this is acceptable human psychology and also it may be more evidentiary in pinpointing the source of the steroids). Let me see I shall need to ring her up and find out if she was motivated enough to do the 24 hour urinary cortisol initially suggested. rakesh On 2/11/08, Dr.viral shah <viralshah_rational (DOT) co.in> wrote: Dear Dr. Rakesh, It is very common to find patients with cushingoid features due to

prescription of steroids knowingly or unknowingly. the best way to test is 24 hour urinary free cortisol. Because of exogenous steroids, HPA is supressed and there is relative adrenal atrophy resulting in very low level of urinary steroids. this is in contrast to increase in urinary levels in endogenous steroids. ( Ref. Endocrinology 1th edition, section 4, adrenal steroids) Thanks, Dr.Viral shah Rakesh Biswas <rakesh7biswasgmail> wrote: Today I had a patient who was suspicious that her recent weight gain (8 kilos in 3 months) may be perhaps because of steroids present in her homeopathic medications.

She asked me if there was some way it could be tested. Any answers? rakesh Explore your hobbies and interests. Click here to begin.

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