Intended for healthcare professionals

Letters Dietary supplements

Potent and untested drugs sold as “dietary supplements”

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4181 (Published 05 August 2015) Cite this as: BMJ 2015;351:h4181
  1. Andreas Kimergård, principal research fellow1,
  2. Chris Walker, senior analyst2,
  3. David Cowan, professor2
  1. 1National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE5 8BB, UK
  2. 2Drug Control Centre, Department of Pharmacy and Forensic Science, King’s College London
  1. Andreas.Kimergard{at}kcl.ac.uk

A new challenge to public health has recently emerged from potent and untested drugs being sold under the guise of “dietary” supplements.1 2 3 4 Fuelled by growing demand for products promising a better body, enhanced performance, and increased wellbeing, this trend highlights creative marketing strategies used in the illicit supply of drugs.

Nine supplements suspected of containing drugs were analysed as part of an investigation for the television programme Spotlight (broadcasted 31 March 2015 by BBC Northern Ireland). The supplements were bought from high street shops and from an e-commerce site (box). Products were sold as “fat burners” or “pro-hormones,” with packaging often blatantly listing chemical names of drugs.

Content of nine dietary supplements bought on the high street and internet

  • Product 1. Strip Ts*: Caffeine, 1,3-dimethylamylamine (DMAA), synephrine

  • Product 2. Strip Ts*: Caffeine, (DMAA), synephrine

  • Product 3. Angel Dust: Caffeine, 1,3-dimethylbutylamine (DMBA)

  • Product 4. Ostapure: Ostarine

  • Product 5. Hemo Rage: Caffeine, synephrine

  • Product 6. SD Extreme: methasterone

  • Product 7. Metha-Quad Extreme: Methylstenbolone, methasterone, 13-ethyl-3 methoxy-gona-2,5(10)-dien-17-one

  • Product 8. Mutant Noxx Mass Power Blend: Caffeine, DMBA

  • Product 9. M1T Hulk XT: Methyl-1-testosterone

  • *Same product bought from two different shops.

Ostarine, found in product 4, is a selective androgen receptor modulator that is being tested as a medicine, but has not been authorised for marketing. The stimulant 1,3-dimethylamylamine (DMAA) was found in products 1 and 2, and 1,3-dimethylbutylamine (DMBA) was found in products 3 and 8. DMAA was recently identified in “dietary supplements” and has been associated with adverse events, including acute myocardial infarction, strokes, and deaths.4 Since regulators removed DMAA from the market, an analogue DMBA has appeared as a replacement.3 Products 6, 7, and 9 contained anabolic steroids, some of which have been associated with hepatoxicity.2 Although advertised as legal pro-hormones they are controlled drugs in the UK.

These findings illustrate market developments, which now include dietary supplements containing medicines, “legal highs,” and controlled drugs. Many experienced users are aware of this marketing strategy. However, young and inexperienced people may be unknowingly exposing themselves to potent drugs. Clinicians should ask patients about the use of supplements and report suspected adverse events to medicine agencies.

Notes

Cite this as: BMJ 2015;351:h4181

Footnotes

References

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