In the past, people looking to get high on designer drugs had to seek them out, knowingly risking their health on products like "bath salts."
Now, new research suggests that many consumers may be unknowingly ingesting similar untested designer stimulants — because over-the-counter nutrition supplements can be laced with them.
That's the conclusion of a new study published in the journal Drug Testing and Analysis. "This is the third time in the last year that we have seen a brand-new class of drugs appear in mainstream supplements," said lead author Pieter Cohen, an internist and assistant professor at Harvard Medical School, who conducted the research with colleagues in Michigan and the Netherlands.
Cohen and his co-investigators examined over-the-counter supplements for the presence of a new, designer stimulant called DMBA. Designer drugs are just synthetic variations on the chemical structure of existing drugs, made to have similar effects but avoid being classified as illegal. In this case, DMBA is a man-made version of the chemical DMAA, also known as as 1,3-dimethylamylamine, methylhexanamine or geranium extract.
The researchers found DMBA — the new designer stimulant — in a dozen supplements. The health effects of DMBA are unknown because it has only ever been studied in a small number of cats and dogs, but never humans. And DMAA — the parent compound from which DMBA is derived — was banned in the US, UK and several other countries because it is linked to strokes, heart failure and sudden death.
"In 2006, DMAA was introduced on the market, but it should not have been in supplements," said Cohen. DMAA was found in dozens of sports and diet pills, selling to the tune of $100 million in 2010 alone.
"It took people getting sickened by it — having bleeds in their heads, dropping dead running marathons, that pathologists realized were due to DMAA — that finally moved the Food and Drug Administration to get DMAA off the market. That was seven years after it was introduced."
But while it's now illegal to put DMAA in supplements because it poses such a health risk, the new research shows manufacturers are using a sister chemical instead. With their new discovery, Cohen said, "There is no need to wait seven years. Here we are finding the next version of DMAA."
Nutrition supplements are very loosely regulated
Cohen is a critic of the way the Food and Drug Administration regulates supplements, and said consumers need to be on alert since the labels on their pill bottles might not tell them the full truth about what they are putting in their bodies.
Supplement manufacturers are not required to prove that their products actually do what they are marketed for in humans. So these pills can be promoted for weight loss or any number of health benefits, with no real evidence backing the claims. As Cohen showed, they may also contain chemicals and designer stimulants that have never been tested before.
There's no organized approach to collecting information about the adverse effects related to supplements, he explained. "So the combination of no human trials before these products reach store shelves combined with fact we have no systematic way of detecting harm, it's like throwing a match into a forest during a drought."
There's growing evidence that supplements can be harmful
The new study is part of a growing body of evidence on the dangerous health effects related to supplement use. Liver damage and failure from these pills has been a well-documented problem. In one example, Cohen writes about in a recent Harvard Public Health Review article, the Centers for Disease Control and Prevention found that the weight-loss supplement OxyElite Pro caused nearly 100 people in 16 states to develop hepatitis, leading to liver replacements, hospitalization, and even death.
The Federal Trade Commission has been waging war on weight-loss supplements, too, recently suing the makers of popular products such as green-coffee beans for misleading and harmful marketing practices.
Dr. Mehmet Oz, host of the popular Dr. Oz Show, has featured some of these weight-loss supplements on-air, and was dragged before a senate sub-committee last summer to explain why. As one senator put it: "The scientific community is almost monolithic against you in terms of the efficacy of those three products that you called miracles."
Consumers need to proceed with caution
Until there's a more robust regulatory process, Cohen said it has to be buyer beware. "This category of supplements is sold as if they're going to help you: supplements for weight loss, to improve workouts in the gym. They are often labelled as having tons of diff natural ingredients combined. But actually they might rely on one chemical to have this effect."And that chemical might be dangerous.
"No consumer product should kill you. With supplements, we accept it's okay to take these pills, even if they might lead to a heart attack or stroke. To me it's mind boggling that we accept this."