Herbal product in Singapore found to contain Cushing’s-causing drug

HSA recommends people seek medical supervision to discontinue use

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Singapore’s Health Sciences Authority (HSA) has issued a warning that Gu Jie Ling, an herbal concoction marketed as a “traditional medicine,” contains a drug called dexamethasone that can cause Cushing’s syndrome, and has advised the public not to purchase or consume it.

The HSA recommends that people who have been taking Gu Jie Ling consult a doctor immediately to discuss steps for stopping it safely. People who have been on Gu Jie Ling should not suddenly stop it without appropriate medical supervision, since stopping dexamethasone suddenly can cause dangerous withdrawal symptoms, the HSA cautions. Sellers and suppliers are required to stop selling Gu Jie Ling under penalty of fines and/or jail time.

Dexamethasone is a corticosteroid, a type of medication that mimics the activity of cortisol, a hormone produced naturally in the body. Cortisol is often called the “stress hormone” because it’s made during times of stress. One of its most notable effects is that it suppresses the activity of the immune system. For this reason, corticosteroids like dexamethasone are often prescribed for inflammatory disorders.

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Case of exogenous Cushing’s sparks warnings of herbal supplement

Risk from steroid use

Like any medication, dexamethasone and other corticosteroids carry health risks, especially if used chronically or for a long time. In particular, these medicines can cause medication-induced Cushing’s syndrome. Because they mimic cortisol, corticosteroids can have the same effects as the hormone and trigger Cushing’s symptoms like weight gain when present at high levels in the body.

The HSA was alerted to potential problems with Gu Jie Ling after a 60-year-old woman who’d been taking the supplement for several months to ease foot pain developed Cushing’s syndrome. One of her symptoms included a rounded “moon” face, a hallmark feature of the condition.

Although Gu Jie Ling was marketed as being “made entirely from traditional Chinese medicines” and having “no side effects,” the HSA’s analysis found it contained not only dexamethasone, but also the antihistamine cetirizine, which is used to ease allergic reactions and is not recommended for use without medical supervision. The supplement was labeled with a Malaysian product registration number, but the registration wasn’t valid, indicating Gu Jie Ling might be illegal.

The HSA advises consumers to consult with their doctor before taking any new supplement or medication, not to buy products from unknown or unverified sources, and to be wary of products making bold and exaggerated claims like having “no side effects.”