A 61-year-old California man narrowly survived a life-threatening medical crisis brought on by his use of herbal supplements intended to treat joint pain. His case, recently detailed in the Annals of Internal Medicine: Clinical Cases, underscores the hidden dangers of unregulated supplements and highlights the need for greater public awareness and medical vigilance regarding their use.
The ordeal began when the man arrived at a San Francisco hospital in severely deteriorated health. His symptoms had developed over just two days but were alarming and widespread: intense back pain, fever, nausea, bloating, and a dramatic loss of appetite left him so weak that he could neither walk nor get out of bed without assistance. Medical staff noted that his heart and breathing rates were both elevated, his blood pressure was dangerously low, and he had multiple wounds on his lower body in varying stages of healing.
Initial medical evaluations revealed that his blood was infected with Staphylococcus aureus, a potentially lethal bacterium. Doctors also found a painful abscess on his shoulder and a worsening infection around his spine. They considered surgery to relieve pressure on his spinal cord and nerves, but his unstable blood pressure made any procedure too risky. His condition rapidly declined as he entered hemorrhagic shock due to bleeding in his gastrointestinal (GI) tract, prompting an urgent transfer to the intensive care unit (ICU).
In the ICU, further investigations exposed even more internal damage. His esophagus was severely inflamed, he had an ulcer in his stomach, and another “oozing” ulcer in his small intestine. While doctors managed to control the GI bleeding, his overall condition continued to worsen. His blood pressure plummeted further, and his ability to breathe on his own deteriorated, requiring him to be put on a ventilator.
At this critical juncture, the medical team began to suspect a problem with his adrenal glands—the organs responsible for producing steroid hormones such as cortisol, which is vital for managing stress, maintaining blood pressure, regulating metabolism, and suppressing excessive immune responses. Normally, cortisol production is tightly controlled by a feedback system involving the brain and pituitary gland, known as the hypothalamic–pituitary–adrenal (HPA) axis. Disruption of this system can lead to adrenal insufficiency, a condition marked by vague yet severe symptoms like those the patient was experiencing.
Endocrinologists were brought in, and tests soon confirmed that the man’s cortisol levels were abnormally low, as were the levels of a pituitary hormone that signals for cortisol production. This diagnosis fit with his symptoms but left doctors searching for the underlying cause. Adrenal insufficiency can stem from various issues, including autoimmune disorders and tumors, but none were immediately apparent.
The breakthrough came during a conversation with the man’s family. They revealed that, up until a few months before his hospitalization, he had been taking three different herbal supplements—Artri King, Nhan Sam Tuyet Lien, and Linsen Double Caulis Plus—to manage his joint pain.