Herbal Fertility Remedies Leading to Massive Pulmonary Embolism: A Case Report
A Trigger for Pulmonary Embolism
Abstract
The rising use of herbal medicines raises concerns about their safety and effectiveness. This case report involves a 55-year-old male who developed shortness of breath and chest discomfort after using herbal substances and sildenafil for erectile dysfunction and infertility. He was diagnosed with a massive acute pulmonary embolism (PE) via CT angiography and treated with alteplase, followed by oral apixaban after discharge. The herbal substances included carob, ginger, red ginseng, and others. This case highlights the need to investigate how herbal remedies may affect hormone balance and contribute to cardiovascular risks, particularly PE.
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2022;15(1):16. https://doi.org/10.1186/s12245-022-00419-3
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[3] Nguyen SM, Ko Ko N, Sattar AS, Gucuk Ipek E, Ali S. Pulmonary Embolism Secondary to Testosterone-Enhancing Herbal Supplement Use. Cureus. 2017 Aug 6;9(8):e1545. https://doi. org/10.7759/cureus.1545
[4] Greyson C, Xu Y, Lu L, Schwartz GG. Right ventricular pressure and dilation during pressure overload determine dysfunction after pressure overload. Am J Physiol Heart Circ Physiol. 2000 May;278(5):H1414-20. https://doi.org/10.1152/ ajpheart.2000.278.5.H1414
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[6] Kostadima E, Zakynthinos E. Pulmonary embolism: pathophysiology, diagnosis, treatment. Hellenic J Cardiol.
2007;48(2):94-107.
[7] Alirezaei T, Hajimoradi B. Is thrombotic event a side effect of oral buprenorphine abuse? Two case reports. Clin Case Rep. 2019;7(4):740-3. https://doi.org/10.1002/ccr3.2086
[8] Gioxari A, et al. Carob: A sustainable opportunity for metabolic health. Foods. 2022;11(14). https://doi.org/10.3390/
foods11142154
[9] Aghajani MMR, Mahjoub S, Mojab F, Namdari M, Gorji NM, Dashtaki A, et al. Comparison of the Effect of Ceratonia
siliqua L. (Carob) Syrup and Vitamin E on Sperm Parameters, Oxidative Stress Index, and Sex Hormones in Infertile Men: a Randomized Controlled Trial. Reprod Sci. 2021 Mar;28(3):766- 74. https://doi.org/10.1007/s43032-020-00314-3
[10] Gholami-Ahangaran M, Karimi-Dehkordi M, Akbari Javar A, Haj Salehi M, Ostadpoor M. A systematic review on the effect of Ginger (Zingiber officinale) on improvement of biological and fertility indices of sperm in laboratory animals, poultry and humans. Vet Med Sci. 2021 Sep;7(5):1959-69. https://doi. org/10.1002/vms3.538
[11] Dokhanchi M, et al. Effects of heart of palm (Palmito) extract on reproductive system of adult male rats. Asian Pac J
Reprod. 2013;2(4):272-6. https://doi.org/10.1016/S2305- 0500(13)60161-X
[12] Park HJ, Choe S, Park NC. Effects of Korean red ginseng on semen parameters in male infertility patients: a randomized, placebo-controlled, double-blind clinical study. Chin J Integr
Med. 2016;22(7):490-5. https://doi.org/10.1007/s11655-015- 2139-9
[13] Abdelnour SA, Abd El-Hack ME, Alagawany M, Taha AE, Elnesr SS, Abd Elmonem OM, et al. Useful impacts of royal jelly on reproductive sides, fertility rate and sperm traits of animals. J Anim Physiol Anim Nutr (Berl). 2020 Nov;104(6):1798--808. https://doi.org/10.1111/jpn.13303
[14] Sistani S, Raeeszadeh M, Amiri A. The phytoestrogenic effect of hydroalcoholic extract of alfalfa on oxidative stress and follicle formation in adult female Wistar rats. J Adv Biomed Sci. 2017;7(4):447-54.
[15] Chorosho SH, Malik N, Panesar G, Kumari P, Jangra S, Kaur R, Al-Ghamdi MS, Albishi TS, Chopra H, Singh R, Murthy
HCA. Phytochemicals: Alternative for Infertility Treatment and Associated Conditions. Oxid Med Cell Longev. 2023 May
11;2023:1327562. https://doi.org/10.1155/2023/1327562
[16] Dorostghoal M, Seyyednejad SM, Nejad MNT. Beneficial effects of Cichorium intybus L. extract on oxidative status and reproductive parameters in male Wistar rats: An experimental study. Int J Reprod Biomed. 2019;17(6):425-34. https://doi. org/10.18502/ijrm.v17i6.4814
[17] Torkamanpari M, Ghorbani F, Lorian K, Koohestanidehaghi Y. The effects of purslane (Portulaca oleracea) and fennel
(Foeniculum vulgare Mill) hydroalcoholic extracts on the functional parameters of human spermatozoa after
vitrification. Clin Exp Reprod Med. 2023 Jun;50(2):78-85. https://doi.org/10.5653/cerm.2021.04805
[18] Heidary M, Vahhabi S, Reza Nejadi J, Delfan B, Birjandi M, Kaviani H, Givrad S. Effect of saffron on semen parameters of infertile men. Urol J. 2008 Fall;5(4):255-9.
[19] Mustari A, et al. Promoting action of vitamin E and black seed oil on reproductive hormones and organ histoarchitecture of Swiss albino mice. Vet Med Sci. 2022;8(2):710-8. https://doi. org/10.1002/vms3.708
[20] Menakuru SR, Atta M, Dhillon VS, Salih A. Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature. Hematol Rep. 2023 Apr 26;15(2):290-7. https://doi.org/10.3390/ hematolrep15020029
[21] Bachman E, Feng R, Travison T, Li M, Olbina G, Ostland V, et al. Testosterone suppresses hepcidin in men: a potential mechanism for testosterone-induced erythrocytosis. J Clin Endocrinol Metab. 2010 Oct;95(10):4743-7. https://doi. org/10.1210/jc.2010-0864
[22] Van Buren NL, Hove AJ, French TA, Gorlin JB. Therapeutic Phlebotomy for Testosterone-Induced Polycythemia. Am J Clin Pathol. 2020 Jun 8;154(1):33-7. https://doi.org/10.1093/ajcp/ aqaa019
2022;15(1):16. https://doi.org/10.1186/s12245-022-00419-3
[2] Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol. 2014;4:177. https://doi.org/10.3389/ fphar.2013.00177
[3] Nguyen SM, Ko Ko N, Sattar AS, Gucuk Ipek E, Ali S. Pulmonary Embolism Secondary to Testosterone-Enhancing Herbal Supplement Use. Cureus. 2017 Aug 6;9(8):e1545. https://doi. org/10.7759/cureus.1545
[4] Greyson C, Xu Y, Lu L, Schwartz GG. Right ventricular pressure and dilation during pressure overload determine dysfunction after pressure overload. Am J Physiol Heart Circ Physiol. 2000 May;278(5):H1414-20. https://doi.org/10.1152/ ajpheart.2000.278.5.H1414
[5] Lyhne MD, Kline JA, Nielsen-Kudsk JE, Andersen A. Pulmonary vasodilation in acute pulmonary embolism - a systematic review. Pulm Circ. 2020 Mar 4;10(1):2045894019899775. https://doi.org/10.1177/2045894019899775
[6] Kostadima E, Zakynthinos E. Pulmonary embolism: pathophysiology, diagnosis, treatment. Hellenic J Cardiol.
2007;48(2):94-107.
[7] Alirezaei T, Hajimoradi B. Is thrombotic event a side effect of oral buprenorphine abuse? Two case reports. Clin Case Rep. 2019;7(4):740-3. https://doi.org/10.1002/ccr3.2086
[8] Gioxari A, et al. Carob: A sustainable opportunity for metabolic health. Foods. 2022;11(14). https://doi.org/10.3390/
foods11142154
[9] Aghajani MMR, Mahjoub S, Mojab F, Namdari M, Gorji NM, Dashtaki A, et al. Comparison of the Effect of Ceratonia
siliqua L. (Carob) Syrup and Vitamin E on Sperm Parameters, Oxidative Stress Index, and Sex Hormones in Infertile Men: a Randomized Controlled Trial. Reprod Sci. 2021 Mar;28(3):766- 74. https://doi.org/10.1007/s43032-020-00314-3
[10] Gholami-Ahangaran M, Karimi-Dehkordi M, Akbari Javar A, Haj Salehi M, Ostadpoor M. A systematic review on the effect of Ginger (Zingiber officinale) on improvement of biological and fertility indices of sperm in laboratory animals, poultry and humans. Vet Med Sci. 2021 Sep;7(5):1959-69. https://doi. org/10.1002/vms3.538
[11] Dokhanchi M, et al. Effects of heart of palm (Palmito) extract on reproductive system of adult male rats. Asian Pac J
Reprod. 2013;2(4):272-6. https://doi.org/10.1016/S2305- 0500(13)60161-X
[12] Park HJ, Choe S, Park NC. Effects of Korean red ginseng on semen parameters in male infertility patients: a randomized, placebo-controlled, double-blind clinical study. Chin J Integr
Med. 2016;22(7):490-5. https://doi.org/10.1007/s11655-015- 2139-9
[13] Abdelnour SA, Abd El-Hack ME, Alagawany M, Taha AE, Elnesr SS, Abd Elmonem OM, et al. Useful impacts of royal jelly on reproductive sides, fertility rate and sperm traits of animals. J Anim Physiol Anim Nutr (Berl). 2020 Nov;104(6):1798--808. https://doi.org/10.1111/jpn.13303
[14] Sistani S, Raeeszadeh M, Amiri A. The phytoestrogenic effect of hydroalcoholic extract of alfalfa on oxidative stress and follicle formation in adult female Wistar rats. J Adv Biomed Sci. 2017;7(4):447-54.
[15] Chorosho SH, Malik N, Panesar G, Kumari P, Jangra S, Kaur R, Al-Ghamdi MS, Albishi TS, Chopra H, Singh R, Murthy
HCA. Phytochemicals: Alternative for Infertility Treatment and Associated Conditions. Oxid Med Cell Longev. 2023 May
11;2023:1327562. https://doi.org/10.1155/2023/1327562
[16] Dorostghoal M, Seyyednejad SM, Nejad MNT. Beneficial effects of Cichorium intybus L. extract on oxidative status and reproductive parameters in male Wistar rats: An experimental study. Int J Reprod Biomed. 2019;17(6):425-34. https://doi. org/10.18502/ijrm.v17i6.4814
[17] Torkamanpari M, Ghorbani F, Lorian K, Koohestanidehaghi Y. The effects of purslane (Portulaca oleracea) and fennel
(Foeniculum vulgare Mill) hydroalcoholic extracts on the functional parameters of human spermatozoa after
vitrification. Clin Exp Reprod Med. 2023 Jun;50(2):78-85. https://doi.org/10.5653/cerm.2021.04805
[18] Heidary M, Vahhabi S, Reza Nejadi J, Delfan B, Birjandi M, Kaviani H, Givrad S. Effect of saffron on semen parameters of infertile men. Urol J. 2008 Fall;5(4):255-9.
[19] Mustari A, et al. Promoting action of vitamin E and black seed oil on reproductive hormones and organ histoarchitecture of Swiss albino mice. Vet Med Sci. 2022;8(2):710-8. https://doi. org/10.1002/vms3.708
[20] Menakuru SR, Atta M, Dhillon VS, Salih A. Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature. Hematol Rep. 2023 Apr 26;15(2):290-7. https://doi.org/10.3390/ hematolrep15020029
[21] Bachman E, Feng R, Travison T, Li M, Olbina G, Ostland V, et al. Testosterone suppresses hepcidin in men: a potential mechanism for testosterone-induced erythrocytosis. J Clin Endocrinol Metab. 2010 Oct;95(10):4743-7. https://doi. org/10.1210/jc.2010-0864
[22] Van Buren NL, Hove AJ, French TA, Gorlin JB. Therapeutic Phlebotomy for Testosterone-Induced Polycythemia. Am J Clin Pathol. 2020 Jun 8;154(1):33-7. https://doi.org/10.1093/ajcp/ aqaa019
| Files | ||
| Issue | Vol 9 No 2 (2024): March-April | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v9i2.16929 | |
| Keywords | ||
| Pulmonary embolism Herbal medicine Testosterone Infertility treatment | ||
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How to Cite
1.
Bhia I, Seraj A, Alirezaei T. Herbal Fertility Remedies Leading to Massive Pulmonary Embolism: A Case Report. CRCP. 2024;9(2):74-78.
