Doctor Duong Minh Tuan of the Department of Endocrinology and Diabetes at Bach Mai Hospital reported on the case. His team immediately initiated adrenal hormone replacement therapy, managed the patient's blood sugar, and addressed co-existing health conditions. The patient had endured chronic musculoskeletal pain. Influenced by persistent social media advertisements for rapid pain relief, he purchased remedies online without consulting a medical professional.

After three months of self-treatment, he experienced alarming symptoms: exhaustion, a swollen and reddened face, thin skin, easy bruising from minor impacts, and small scratches that failed to heal for weeks.

Doctor Tuan diagnosed the patient with Cushing's syndrome and adrenal insufficiency, attributing it to the misuse of corticosteroids—a potent anti-inflammatory and pain-relieving compound. The adrenal glands, situated above the kidneys, produce cortisol, which is vital for maintaining blood pressure, regulating blood sugar, and protecting the body from illness.

High doses of unregulated corticosteroids trick the brain into believing the body has an excess of hormones, prompting it to signal the adrenal glands to stop functioning. This sustained suppression causes the glands to shrink and lose their capacity to produce cortisol naturally.

The patient exhibits slow-healing bruises. *Photo: Provided by doctor*

Crucially, abruptly discontinuing the medication, especially during complications, causes hormone levels to plummet. When faced with stressors such as high fever, infection, or trauma, the compromised adrenal glands cannot produce sufficient cortisol, potentially triggering an acute adrenal crisis. This severe condition manifests as critically low blood pressure, electrolyte imbalances, shock, and can be fatal.

Corticosteroids encompass common active ingredients like dexamethasone, prednisolone, methylprednisolone, and betamethasone, typically administered orally, via joint injections, nasal sprays, or topical applications. Unfortunately, unscrupulous vendors often secretly incorporate these substances into traditional remedies, marketing them as "herbal" or "complete joint pain relief" to mislead consumers with false promises of efficacy.

Doctors strongly advise individuals with musculoskeletal conditions against purchasing unregulated medications based on social media advertisements. If symptoms like a rounded, deformed face, thin skin, slow-healing wounds, or profound fatigue emerge, patients must immediately seek specialized medical care, bringing all current medications for accurate diagnosis. Crucially, individuals should never abruptly discontinue or alter medication dosages independently, as this could precipitate a life-threatening adrenal crisis.

Thuy Quynh