In a recent press release, the Health Sciences Authority (HSA) has alerted the public against consuming unlabelled, illegal health products provided by a local home-based traditional massage facility. A customer, in his 20s, was hospitalised after allegedly consuming illegal pills and capsules – obtained from the massage facility – for over a year.

The massage facility, Samsudin Traditional Massager, is run by a traditional masseur, in his 50s, at Teck Whye Lane residential unit. HSA raided the unit and seized around 6,500 units of black round pills, brown and green and white capsules. Packed in unlabelled plastic bags and bottles, the capsules are provided by the masseur to his customers for free after massage sessions – allegedly for “pain relief and slimming” purposes.

Cushing's syndrome, withdrawal symptoms due to alleged prolonged potent steroid use

The illegal health products had been tested and found to contain “undeclared potent Western medicinal ingredients”. Frusemide (a diuretic that helps the body to get rid of excess fluid) and chlorpheniramine (an anti-allergenic pill) are discovered in the products.

In addition, the products also contain dexamethasone – a potent synthetic steroid – of which with long-term use can cause Cushing syndrome, then leading to high blood pressure, diabetes and an increased risk of infections. Dexamethasone also suppresses the cortisol production in normal subjects to a very low level.

(clockwise from top left) Black pills in unlabeled plastic bags, green and white capsules in unlabeled plastic bags, brown pills in an unlabeled plastic bottle, brown capsules in unlabeled plastic pill pouches. Photo credit: HSA/The Straits Times
(clockwise from top left) Black pills in unlabeled plastic bags, green and white capsules in unlabeled plastic bags, brown pills in an unlabeled plastic bottle, brown capsules in unlabeled plastic pill pouches. Photo credit: HSA/The Straits Times

Cushing syndrome, sometimes known as hypercortisolism, occurs when the body is exposed to excess levels of the hormone cortisol over a long period of time – more commonly due to the use of oral corticosteroid medication.

Due to prolonged consumption of steroids, the patient had developed Cushing's syndrome, which results in a round or “moon face” appearance, along with upper body obesity and thin limbs. Additionally, purple stretch marks are observed on his arms, abdomen and thighs. He had apparently gained 20kg within a year.

The hospitalised customer had also suffered withdrawal symptoms (e.g. fatigue, confusion and low blood pressure) when he ran out of the illegal health products. Despite that, according to the patient, the illegal products had helped to keep his chronic gout condition under control.

Patient discharged; traditional masseur currently under HSA investigations

As of now, the patient has been discharged after receiving medical treatment.

The first step in distinguishing the type of Cushing’s syndrome is a blood test for the measurement of ACTH obtained in the morning.
The first step in distinguishing the type of Cushing’s syndrome is a blood test for the measurement of ACTH obtained in the morning.

HSA had urged those who had consumed the unlabelled products to consult doctor or pharmacist as soon as possible, to manage “acute and chronic medical symptoms and conditions (such as joint pain, arthritis and rheumatism)”. The agency further emphasised that “discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms”. Early treatment for Cushing’s syndrome can increase the chances of recovery.

The traditional masseur, however, is currently under investigations by the HSA. The agency has yet to provide details on the number of customers impacted, nor the duration these products have been consumed.

HSA further pointed out that anyone who is found guilty of supplying illegal health products is liable to prosecution. If convicted, the offenders can be imprisoned up to three years, fined up to SGD100,000, or both. MIMS

Read more:
Operation Pangea: HSA seizes more than 39,000 illegal health products sold online
Illegal sex drugs: Demands on the rise, despite health issues
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Sources:
http://www.straitstimes.com/singapore/man-hospitalised-after-consuming-illegal-health-products-from-local-masseur?login=true
http://www.hsa.gov.sg/content/hsa/en/News_Events/Press_Releases/2017/samsudintraditional.html
http://www.todayonline.com/singapore/man-develops-moon-face-purple-stretch-marks-after-taking-illegal-pills-masseur
http://www.channelnewsasia.com/news/singapore/man-hospitalised-after-taking-pills-from-samsudin-traditional-9317854