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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006989
  • Novel treatment (new drug/interventions; established drug/procedure in new situation)

Ashwagandha root in the treatment of non-classical adrenal hyperplasia

  1. Alan Sacerdote1–6
  1. 1Department of Internal Medicine, Woodhull Medical Center, Brooklyn, New York, USA
  2. 2Department of Internal Medicine, St George’s University School of Medicine, Grenada, WI
  3. 3Department of Endocrinology, Woodhull Medical Center, Brooklyn, New York, USA
  4. 4Department of Internal Medicine, New York University, New York, New York, USA
  5. 5Department of Internal Medicine, St. George’s University School of Medicine, Grenada, WI
  6. 6Department of Internal Medicine, SUNY Downstate Medical Center, Brooklyn, NY USA
  1. Correspondence to Dr Alan Sacerdote, Alan.Sacerdote{at}woodhullhc.nychhc.org

Summary

Congenital adrenal hyperplasia (CAH) is a well-characterised family of disorders of the adrenal cortices, resulting in varying degrees of cortisol, aldosterone and androgen deficiency or androgen excess, depending on the enzyme(s) affected and the degree of quantitative or functional enzyme deficit. Withania somnifera (WS), commonly known as Ashwagandha, is a medicinal plant that has been employed for centuries in ayurvedic medicine. Preclinical studies have shown that WS increases circulating cortisol levels and improves insulin sensitivity. We report the case of a 57-year-old woman with non-classical adrenal hyperplasia due to both 3-β-ol dehydrogenase deficiency and aldosterone synthase deficiency who was self-treated with WS for 6 months. After 6 months of treatment her serum 18-OH-hydroxycorticoserone, 17-OH-pregnenolone, corticosterone and 11-deoxycortisol decreased by 31%, 66%, 69% and 55%, respectively. The biochemical improvement was accompanied by a noticeable reduction in scalp hair loss.

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