Phan suffered from leg pain and began taking a type of "tobacco medicine" he purchased online. While it initially relieved his pain, his condition worsened when he stopped using it. Over one year of taking this medicine, his weight increased from 80 kg to 120 kg, and his waist circumference reached 120 cm. Blood test results at Tam Anh General Hospital, Ho Chi Minh City, showed his cortisol levels were below 3 mcg/dl. He presented with all the classic symptoms of Cushing's syndrome, including weight gain, a round red face, obesity, fat deposits around the neck and upper back, and thin, stretch-marked skin.

Doctor Tran Huu Thanh Tung from the Department of Endocrinology and Diabetes diagnosed Phan with exogenous Cushing's syndrome, caused by the misuse of corticosteroid-containing medication. Cortisol is a hormone produced by the adrenal glands, essential for maintaining blood sugar, blood pressure, responding to stress, and regulating inflammatory responses. Prolonged use of products containing corticosteroids can suppress adrenal gland activity, leading to adrenal insufficiency.

Doctor Tung advises a patient. *Photo: Tam Anh General Hospital*

Drug-induced Cushing's syndrome stimulates excessive weight gain, placing significant stress on joints. If left untreated, patients risk developing muscle weakness, proximal muscle atrophy, osteoporosis, fractures, hypertension, sexual dysfunction, and neuropsychological disorders.

Doctor Tung advised Phan to reduce his body weight by 10-15%, noting that this would significantly alleviate his joint pain and sleep apnea. He recommended Phan stop using the "tobacco medicine" and switch to prescribed oral medications or injections. Additionally, Phan was advised to reduce his intake of starchy foods and fatty meats, increase lean meat, green vegetables, and fruits, and drink plenty of water. He also started a 20-minute daily home exercise routine under the guidance of an exercise medicine specialist.

After three months, Phan lost 10 kg, became more agile, and experienced less difficulty sleeping and breathing. In addition to overall fat reduction, he also underwent cryolipolysis technology to slim his abdomen, reducing it by 5 cm.

Doctor Tung cautioned patients against self-medicating with traditional oriental medicine, southern herbal medicine, pills, or unverified family remedies for pain relief or arthritis treatment. Drug-induced Cushing's syndrome often progresses silently and, over time, can lead to endocrine disorders, adrenal insufficiency, or other dangerous complications. Patients should seek medical attention if they notice any unusual symptoms and use corticosteroids only as prescribed by a doctor.

Duc Hanh

*Patient's name has been changed