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- Mihir Patel, Rebecca Newell, Matthew Hillier, and Ramanan Ramalingam.
- Department of Anaesthetics, Royal London Hospital, Bart's Health NHS Trust, London, UK.
- Brit J Hosp Med. 2024 Jun 30; 85 (6): 141-4.
AbstractA 37-year-old woman presented with nausea, vomiting and headache. She was found to be profoundly hyponatraemic with a sodium of 121 mmol/L, which deteriorated following a fluid challenge. An initial hyponatraemia screen identified adrenal insufficiency, with cortisol of 48 nmol/L. History confirmed she had been taking the herbal plant, ashwagandha. After 3 days of fluid restriction and steroid replacement, her sodium returned to normal (139 mmol/L). This article reviews the possible harmful effects of over-the-counter herbal remedies and highlights the importance of considering a wide differential diagnosis in patients presenting with non-specific symptoms.
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