Stealth steroids

To the Editor: The medical treatment of patients receiving long-term corticosteroid therapy presents several risks, including suppression of the adrenal axis and the possibility of infection with unusual organisms. A physician aware of a patient's risk of such complications can take appropriate steps in treatment, but unrecognized corticosteroid use can have serious consequences. We recently took care of three patients who received medications containing corticosteroids from unconventional practitioners. Patient 1 had been taking tablets that he called“black balls from China”for six months for rheumatoid arthritis. He acquired them from a friend who obtained them from an“herbal specialist”. . .