SUN-439 Hypothalamic-Pituitary-Adrenal Axis Disruption from Unregulated Glucocorticoid Use: A Case Series

This case series highlights the issue of iatrogenic Cushing syndrome resulting from unregulated over-the-counter (OTC) glucocorticoid use, particularly among immigrant populations using medications from other countries. The study presents four cases where patients developed hypothalamic-pituitary-adrenal (HPA) axis disruption due to OTC agents marketed as joint pain relief or vitamin injections. Symptoms included hypertension, weight gain, cushingoid features, and adrenal insufficiency. The authors emphasize the importance of thorough medication reconciliation to prevent such complications, as these hidden glucocorticoids pose significant health risks. The study underscores the need for clinicians to be vigilant in identifying and managing these exposures to avoid unnecessary health complications.