Study from NSF finds illegal stimulants in sports nutrition and weight management products

A recent study conducted by NSF International and Harvard Medical School found nine prohibited stimulants in 17 sports and weight loss supplements on top of the illegal Deterenol already on the label.

A recent study published in Clinical Toxicology1, conducted by NSF International (Ann Harbor, MI) and Harvard Medical School, with help from Netherlands' National Institute for Public Health and the Environment (RIVM; Bilthoven, The Netherlands) and Sciensano (Brussels, Belgium), found nine prohibited stimulants in 17 sports and weight loss supplements. The 17 supplements were chosen because they were labeled to contain Deterenol, or one of its synonyms. Deterenol is a pharmaceutical beta-agonist that has not been approved for use in human in the U.S. and prohibited by the U.S. Food and Drug Administration as ingredients in dietary supplements in 2004.

In the study, the 17 dietary supplements were purchased online, and for each brand, one container or subsample was analyzed by NSF International, one container or subsample was analyzed by RIVM, and when differences existed between the two samples of the same brand, both products were reanalyzed by Sciensano. Results showed that many of the tested products contained more than one prohibited stimulant. Four brands contained two stimulants, two contained three stimulants, and two contained four stimulants. Of the nine stimulants detected, the range of quantities per recommended serving size were 2.7 mg to 17 mg of deterenol; 1.3 mg to 20 mg of phenpromethamine (Vonedrine); 5.7 mg to 92 mg of beta-methylphenylethylamine (BMPEA); 18 mg to 73 mg of octodrine; 18 mg to 55 mg of oxilofrine; 48 mg of higenamine; 17 mg of 1,3-dimethylamylamine (1,3-DMAA); 1.8 mg to 6.6 mg of 1,3-dimethylbutylamine (1,3-DMBA); and 5.3 mg of 1,4-dimethylamylamine (1,4-DMAA).

“We're urging clinicians to remain alert to the possibility that patients may be inadvertently exposed to experimental stimulants when consuming weight loss and sports supplements," said Pieter Cohen, MD, asssociate professor of medicine at Harvard Medical School, internist at Cambridge Health Alliance and a co-author of the study, in a press release. "We're talking about active pharmaceutical stimulants that have not been approved by the U.S. FDA for oral use as either prescription medications or dietary supplements. These ingredients have no place in dietary supplements."

"These hidden stimulant cocktails have never been tested in humans and their safety is unknown," added John Travis, senior researcher at NSF International and co-author of the study. "You never want to find unlabeled ingredients in supplements, but it is especially concerning to find these strange brews of experimental stimulants in products that are readily available in the United States."

The research points to the need for more third-party testing and certification of dietary supplements to ensure products are unadulterated. However, the Council for Responsible Nutrition (CRN; Washington, D.C.) leveled some criticism at the study, saying that it mischaracterized sports nutrition and weight management supplements based on a small sample of products chosen because they contained an illegal ingredient on the label.

“The products identified in the analysis are not legal dietary supplements but illegal products that masquerade as supplements, hoping to evade detection. Legitimate dietary supplements in the sports nutrition and weight management categories—the ones most consumers would encounter in local stores or on mainstream shopping platforms—are safe, beneficial, and help consumers meet their fitness and weight goals,” said Steve Mister, president and CEO of CRN. “This report serves as a reminder for consumers that it matters where one purchases dietary supplements. The illegal products identified in the report come from unscrupulous online sellers, unlikely to be found on store shelves of reputable retailers or mainstream online platforms. CRN reminds consumers to seek products from nationally recognized brands or store brands from trusted retailers. Avoid products that promise extreme results, research companies and supporting science, and always talk to a healthcare practitioner for advice on responsible supplement use.”

“CRN does agree with the report’s conclusion that stronger, more proactive enforcement action is needed to protect the public from adulterated products in the market,” adds Mister. “When illicit products are brought to the agency’s attention, FDA must act more quickly and decisively, both to establish a deterrent and to protect consumers. FDA lacks a system to efficiently track products that come to market, so CRN continues to advocate for a mandatory product listing as a solution. This would allow FDA to identify new products and act more quickly to remove illegal products from the market.”

CRN’s own voluntary product registry, the Supplement OWL (Online Wellness Library), serves as a proof of concept for mandatory product listing, and gives consumers and regulators access to important product and manufacturer information. It also showcases brands that choose to be accountable and transparent about their ingredients.

Reference

  1. Cohen PA et al. “Nine prohibited stimulants found in sports and weight loss supplements: deterenol, phenpromethamine (Vonedrine), oxilofrine, octodrine, beta-methylphenylethylamine (BMPEA), 1,3-dimethylamylamine (1,3-DMAA), 1,4-dimethylamylamine (1,4-DMAA), 1,3-dimethylbutylamine (1,3-DMBA) and higenamine.” Clinical Toxicology, Published online ahead of print on March 23, 2021