HSA warns public against consuming herbal remedy containing potent steroid

SINGAPORE – The Health Sciences Authority (HSA) is warning members of the public against purchasing or consuming a herbal product containing a potent steroid, after an elderly woman who was taking it developed a serious medical condition.

Tests by HSA found that the herbal product Huang Niu Mu Zhong Feng Qing Cao Yao contained dexamethasone, a prescription medication usually used to treat inflammation, and which should be used only under strict medical supervision.

The woman, who is in her 70s, consumed the product for two months for joint pain, said HSA on May 20. She received it from a relative who had obtained it from a friend in Malaysia, it added.

During a routine health check, her doctor observed signs of Cushing’s syndrome, with characteristics of a rounded “moon face” appearance and abnormal fat accumulation above her collarbone.

“A laboratory test also revealed that she had a low cortisol level, which is likely caused by the steroid in the product suppressing the body’s natural cortisol production,” said the authority. This can lead to adrenal insufficiency, a serious medical condition, HSA added.

The woman’s doctor suspected the product was adulterated and reported the case to HSA. She has since recovered after she stopped using the product.

HSA said long-term unsupervised use of steroids like dexamethasone can cause increased blood sugar levels that may lead to diabetes, high blood pressure, cataracts, muscular and bone disorders such as osteoporosis, an increased risk of infections and Cushing’s syndrome.

However, suddenly stopping the medication can also be risky.

“Discontinuation of steroids without proper medical supervision can lead to steroid withdrawal effects and adrenal insufficiency, a serious condition where the body does not produce adequate amounts of steroid hormones after stopping long-term steroid use,” HSA added. “This may cause fatigue, generalised weakness, muscle and joint pain, low blood pressure, fits or shock.”

Huang Niu Mu Zhong Feng Qing Cao Yao is touted as a herbal remedy for skin conditions, breathing difficulties, high blood pressure, diabetes, rheumatoid arthritis, and liver and kidney diseases.

The product was found to be sold on the local e-commerce platform Shopee.

HSA said it worked with Shopee to remove the listings and has directed sellers to stop selling the product immediately.

It advised members of the public who are consuming the product to see a doctor immediately.

HSA cautioned that consumers should not stop taking it suddenly – especially when it has been taken for more than a few weeks – because of the withdrawal symptoms.

All sellers and suppliers with the product must stop selling it immediately, said HSA. It added that it will not hesitate to take stern enforcement action against anyone who sells and supplies products found to be adulterated with potent ingredients.

Sellers and suppliers are liable to prosecution and, if convicted, may be jailed for up to two years and/or fined up to $10,000.

Members of the public who have any information on the sale and supply of these illegal products may contact HSA on 6866-3485 during office hours from Monday to Friday, or via e-mail at hsa_is@hsa.gov.sg