Edema, Enigma: 11 B-Hydroxysteroid Dehydrogenase Type 2 Inhibition by Sweetener “Stevia”

Salina Esmail, Udaya M. Kabadi

Private Practice, Upland, USA.
University of Iowa Hospitals and Clinics, Iowa City, USA; Des Moines University, Des Moines, USA.

DOI: 10.4236/ojemd.2012.23007                

Abstract

Intrduction: Edema, Hypertension and Hypokalemia occur with inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2 (11B-HSD2) by chronic Licorice ingestion. However, a similar presentation following a chronic use of another commonly used sweetener “Stevia” is not reported. Objective: To document a first case report of a subject presenting with Edema, Prehypertension and Hypokalemia induced by 11B-HSD2 inhibition induced by chronic ingestion of sweetener stevia. Case Report: 32 year old Caucasian woman presented with generalized edema (feet, hands and face) of over 6 months. She was noted to also manifest Prehypertension (138/88 mmHg) and Hypokalemia (3.4 mM/l). Laboratory tests revealed decline in serum aldosterone and plasma renin activity, an increase in plasma cortisol/cortisone ratio. On persistent interrogation, patient admitted to daily consumption of sweetener stevia for over 9 months. All the presenting manifestations resolved with normalization of the laboratory tests on withdrawal of stevia. Conclusion: This case report indicates that chronic ingestion of sweetener stevia may induce edema, hypertension and hypokalemia via reduced conversion of cortisol into cortisone by inhibition of 11 B-Hydroxysteroid Dehydrogenase Type 2.

Keywords

Edema; Enigma; 11 B-Hydroxysteroid Dehydrogenase Type 2; Sweetener “Stevia”

Conflicts of Interest

The authors declare no conflicts of interest.

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