[Cushing syndrome because of herbal supplement].

The use of exogenous glucocorticoids is a common cause of Cushing syndrome. We present a case of exogenous Cushing syndrome caused by Binahong: an over-the-counter 'herbal' supplement. A 54-year-old woman presented with weight gain, joint pain, hypertension and poorly regulated type 2 diabetes mellitus despite the start of semaglutide one year before presentation.

[Increased fracture risk and fracture prevention].

An increased fracture risk is a common chronic condition leading to a rising number of fractures, which are injurious to patients and costly to the health care system. Effective diagnostic and treatment options are available for primary and secondary prevention. In this article, we will answer specific practical questions with respect to increased fracture risk and fracture prevention.

[Vitamin D supplementation not useful for all older people].

An estimated 1.5 million Dutch people take vitamin D supplements on prescription, not including those who take multivitamins or vitamin D over the counter. Yet, controversial health benefits of vitamin D supplementation in the general population continues, often explained with not adequately powered studies, combination therapy with calcium, high bolus doses of vitamin D and poor study designs.

A 29-year-old Bodybuilder with Liothyronine-induced Thyrotoxic Hypokalaemic Periodic Paralysis.

Unlabelled: We describe a 29-year-old male bodybuilder with recurrent attacks of myalgia and muscle weakness associated with hypokalaemia and thyrotoxicosis due to abuse of liothyronine. The attacks quickly resolved after potassium supplementation and liothyronine cessation. We concluded that the patient had thyrotoxic hypokalaemic periodic paralysis (TPP).