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

Abstract

Background

Weight loss and sports supplements containing deterenol have been associated with serious adverse events including cardiac arrest.

Objective

To determine the presence and quantity of experimental stimulants in dietary supplements labeled as containing deterenol sold in the United States.

Methods

Dietary supplements available for sale in the US and labeled as containing deterenol or one of its synonyms (e.g., isopropylnorsynephrine and isopropyloctopamine) were purchased online. For each brand, one container or subsample was analyzed by NSF International (Ann Arbor, MI) and one container or subsample by the Netherland’s National Institute for Public Health and the Environment (RIVM, Bilthoven, The Netherlands). When differences existed between the two containers or subsamples of the same brand, both products were reanalyzed by Sciensano (Brussels, Belgium). NSF International carried out qualitative and quantitative analyses using ultra-high-performance liquid chromatography (UHPLC) quadrupole-Orbitrap mass spectrometry. RIVM performed qualitative and quantitative analysis using UHPLC quadrupole time-of-flight mass spectrometry. Sciensano carried out qualitative analysis using UHPLC quadrupole-Orbitrap mass spectrometry.

Results

Seventeen brands of supplements were analyzed. Many brands included more than one prohibited stimulant in the same product: 4 brands (24%, 4/17) included 2 stimulants, 2 (12%, 2/17) combined 3 stimulants, and 2 (12%, 2/17) combined 4 stimulants. The range of quantities per recommended serving size of the 9 stimulants detected 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).

Conclusion

Weight loss and sports supplements listing deterenol as an ingredient contained 9 prohibited stimulants and 8 different mixtures of stimulants, with as many as 4 experimental stimulants per product. These cocktails of stimulants have never been tested in humans and their safety is unknown.

Keywords:

• Cardiovascular
• dietary supplements
• adulteration

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Correction

Acknowledgements

The authors wish to thank Patricia Redd, MLS of Cambridge Health Alliance and Paul Bain, PhD of Harvard Medical School for their expert assistance in obtaining obscure references. Nicolas Rasmussen, PhD of University of New South Wales, Australia for the 1940s Vondedrine advertisement. We also thank Cristina Avonto, PhD of University of Mississippi, Oxford, MS for assistance with translations from the Italian.

Disclosure statement

P.A. Cohen has received research support from Consumers Union and PEW Charitable Trusts. P.A. Cohen was the subject of a civil suit brought by Hi-Tech Pharmaceuticals, a supplement company, in which the jury found in Dr Cohen’s favor. J.C. Travis is an employee of NSF International, and some of NSF International’s clients are dietary supplement manufacturers. C. Vanhee, D. Ohana and B.J. Venhuis report no disclosures relevant to the manuscript.