Herba Epimedium (Horny Goat Weed) Toxicity With Severe Muscle Spasms and Elevated Creatine Kinase and Creatinine: A Case Report

Here, we present the case of a 33-year-old man who presented to the emergency department (ED) with a complaint of severe muscle spasms of a 10-hour duration. He noted that he took a supplement which he purchased over the internet called <i>Epimedium</i>, also known as horny goat weed, for the purpose of improving his mood and sense of energy and reducing his sense of anxiety. He started this supplement one month prior to ED presentation, coincident with the first episodes of muscle cramps. In the ED, he had elevations of his creatine kinase (CK) and creatinine and required hospital admission. His creatinine and CK elevations and muscle spasms improved during his hospital admission. He was discharged from the hospital with instructions to stop taking <i>Epimedium</i> supplements. <i>Epimedium</i> contains a wide variety of chemicals that vary somewhat by individual species. To our knowledge, this is the first specific case report of severe muscle spasms with associated elevations of CK and creatinine caused by <i>Epimedium</i> use. This case reinforces the importance of asking a patient about all medications, including over-the-internet, over-the-counter, and herbal medications.